CoChat
Sign Up
Cited by 419Physical Activity and HealthCardiovascular and exercise physiologyObesity, Physical Activity, Diet

Prevalence and Cardiovascular Disease Correlates of Low Cardiorespiratory Fitness in Adolescents and Adults

Carnethon, Mercedes R.·2005·JAMA
DOI 10.1001/jama.294.23.2981
Open this paper in CoChat — free account

Abstract

CONTEXT: Population surveys indicate that physical activity levels are low in the United States. One consequence of inactivity, low cardiorespiratory fitness, is an established risk factor for cardiovascular disease (CVD) morbidity and mortality, but the prevalence of cardiorespiratory fitness has not been quantified in representative US population samples. OBJECTIVES: To describe the prevalence of low fitness in the US population aged 12 through 49 years and to relate low fitness to CVD risk factors in this population. DESIGN, SETTING, AND PARTICIPANTS: Inception cohort study using data from the cross-sectional nationally representative National Health and Nutrition Examination Survey 1999-2002. Participants were adolescents (aged 12-19 years; n = 3110) and adults (aged 20-49 years; n = 2205) free from previously diagnosed CVD who underwent submaximal graded exercise treadmill testing to achieve at least 75% to 90% of their age-predicted maximum heart rate. Maximal oxygen consumption (VO2max) was estimated by measuring the heart rate response to reference levels of submaximal work. MAIN OUTCOME MEASURES: Low fitness defined using percentile cut points of estimated VO2max from existing external referent populations; anthropometric and other CVD risk factors measured according to standard methods. RESULTS: Low fitness was identified in 33.6% of adolescents (approximately 7.5 million US adolescents) and 13.9% of adults (approximately 8.5 million US adults); the prevalence was similar in adolescent females (34.4%) and males (32.9%) (P = .40) but was higher in adult females (16.2%) than in males (11.8%) (P = .03). Non-Hispanic blacks and Mexican Americans were less fit than non-Hispanic whites. In all age-sex groups, body mass index and waist circumference were inversely associated with fitness; age- and race-adjusted odds ratios of overweight or obesity (body mass index > or =25) ranged from 2.1 to 3.7 (P<.01 for all), comparing persons with low fitness with those with moderate or high fitness. Total cholesterol levels and systolic blood pressure were higher and levels of high-density lipoprotein cholesterol were lower among participants with low vs high fitness. CONCLUSION: Low fitness in adolescents and adults is common in the US population and is associated with an increased prevalence of CVD risk factors.

Integrity signals

Registry

Crossref · 10.1001/jama.294.23.2981

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Adolescents who have low levels of cardiorespiratory fitness and positive energy balance are more likely to be overweight or obese compared with those with moderate or high levels of cardiorespiratory fitness.

    “In addition, adolescents who have low levels of cardiorespiratory fitness and positive energy balance are more likely to be overweight or obese compared with those with moderate or high levels of cardiorespiratory fitness.58”

    From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [58]

  • Adolescents who have low levels of cardiorespiratory fitness have an increased risk of cardiovascular diseases (high cholesterol, low high-density lipoprotein cholesterol, impaired glucose levels, increased prevalence of metabolic syndrome) in comparison to moderately fit and highly fit adolescents.

    “Adolescents who have low levels of cardiorespiratory fitness have an increased risk of cardiovascular diseases (ie, high cholesterol, low high-density lipoprotein cholesterol, impaired glucose levels, increased prevalence of metabolic syndrome) in comparison to moderately fit and highly fit adolescents.”

    From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [58]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Carnethon, M. R.
Affiliations
Northwestern University (US)
Corresponding author
Carnethon, Mercedes R.
ORCID
Carnethon, Mercedes R.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2005-12-21
Volume
294
Issue
23
Pages
2981
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.294.23.2981
OpenAlex
W2045977346
Semantic Scholar
ce5597af147efccd9411d6cd4d36a9577e3036ac
Cited by
417
References
47
Citations by year
2026: 3 · 2025: 5 · 2024: 17 · 2023: 14 · 2022: 23 · 2021: 12 · 2020: 14 · 2019: 20 · 2018: 14 · 2017: 16 · 2016: 18 · 2015: 26 · 2014: 37 · 2013: 24 · 2012: 27
FWCI
10.99
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (K01HL073249, 5 K01 HL73249-02)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
cardiovascular risk, prevalence, adolescents, adults, physical inactivity, VO2max, cardiovascular risk factors, obesity, body mass index, waist circumference, sex differences, racial differences, Mexican Americans, non-Hispanic blacks, total cholesterol, systolic blood pressure, HDL cholesterol
MeSH terms
Adolescent, Adult, Cardiovascular Diseases, Exercise Test, Female, Health Status, Humans, Male, Nutrition Surveys, Oxygen Consumption, Physical Fitness, Pulmonary Ventilation, Respiratory Function Tests, Risk Factors, United States, Cohort Studies, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review