The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index.
Prevalence and Cardiovascular Disease Correlates of Low Cardiorespiratory Fitness in Adolescents and Adults
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.
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“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]
In the citing paper
“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]
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Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Chobanian, A., Bakris, G., Black, H., Cushman, W., Green, L., Izzo, J., Jones, D. W., Materson, B., Oparil, S., Wright, J. T., et al. (2003) · Journal of the American Medical Association (JAMA) · doi:10.1097/00132578-200307000-00027 · Cited by 26,188
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026
(2014) · Medical Entomology and Zoology · Cited by 9,400
Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001
Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003) · JAMA · doi:10.1001/jama.289.1.76 · Cited by 5,866
Physical Activity and Health: A Report of the Surgeon General
(1995) · PsycEXTRA Dataset · doi:10.1037/e525162010-001 · Cited by 5,488
Age-predicted maximal heart rate revisited
Tanaka, H., Monahan, K. D., & Seals, D. R. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)01054-8 · Cited by 3,775
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Janssen, I., & LeBlanc, A. G. (2010) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-7-40 · Cited by 4,829
Kavey, R., Simons-Morton, D., & de Jesus, J. D. (2011) · Pediatrics · doi:10.1542/peds.2009-2107c · Cited by 2,131
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., Douglas, P. S., Foody, J. M., Gerber, T. C., Hinderliter, A. L., et al. (2012) · Circulation · doi:10.1161/cir.0b013e3182776f83 · Cited by 2,419
Validation of Accelerometer Wear and Nonwear Time Classification Algorithm
CHOI, L., LIU, Z., MATTHEWS, C. E., & BUCHOWSKI, M. S. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181ed61a3 · Cited by 1,804
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., Douglas, P. S., Foody, J. M., Gerber, T. C., Hinderliter, A. L., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.07.013 · Cited by 1,583
Metadata
- Authors
- Carnethon, M. R.
- Affiliations
- Northwestern University (US)
- Corresponding author
- 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
- 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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Physiology (medical) › 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
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