Twenty year fitness trends in young adults and incidence of prediabetes and diabetes: the CARDIA study
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Aims/hypothesis The prospective association between cardiorespiratory fitness (CRF) measured in young adulthood and middle age on development of prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance, or diabetes by middle age remains unknown. We hypothesised that higher fitness levels would be associated with reduced risk for developing incident prediabetes/diabetes by middle age.Methods Participants were from the Coronary Artery Risk Development in Young Adults (CARDIA) study who were free from prediabetes/diabetes at baseline (year 0 [Y0]: 1985-1986). CRF was quantified by treadmill duration (converted to metabolic equivalents [METs]) at Y0, Y7 and Y20 and prediabetes/diabetes status was assessed at Y0, Y7, Y10, Y15, Y20 and Y25. We use an extended Cox model with CRF as the primary time-varying exposure. BMI was included as a time-varying covariate. The outcome was development of either prediabetes or diabetes after Y0. Model 1 included age, race, sex, field centre, CRF and BMI. Model 2 additionally included baseline (Y0) smoking, energy intake, alcohol intake, education, systolic BP, BP medication use and lipid profile.Results Higher fitness was associated with lower risk for developing incident prediabetes/diabetes (difference of 1 MET: HR 0.99898 [95% CI 0.99861, 0.99940], p < 0.01), which persisted (difference of 1 MET: HR 0.99872 [95% CI 0.99840, 0.99904], p < 0.01] when adjusting for covariates.Conclusions/interpretation Examining participants who had fitness measured from young adulthood to middle age, we found that fitness was associated with lower risk for developing prediabetes/diabetes, even when adjusting for BMI over this time period. These findings emphasise the importance of fitness in reducing the health burden of prediabetes and diabetes.
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In the CARDIA study, higher levels of CRF in young adulthood were associated with a lower risk of diabetes mellitus in middle age.
“In the CARDIA study, higher levels of CRF in young adulthood were associated with a lower risk of DM in middle age [88] .”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [88]
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“In the CARDIA study, higher levels of CRF in young adulthood were associated with a lower risk of DM in middle age [88].”
- Authors
- Chow, L. S., Odegaard, A. O., Bosch, T. A., Bantle, A. E., Wang, Q., Hughes, J., Carnethon, M., Ingram, K. H., Durant, N., Lewis, C. E., Ryder, J., Shay, C. M., Kelly, A. S., & Schreiner, P. J.
- Affiliations
- University of Minnesota (US)
- University of California, Irvine (US)
- Northwestern University (US)
- Kennesaw State University (US)
- University of Alabama at Birmingham (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Chow, Lisa S.
- ORCID
- Venue
- Diabetologia
- Published
- 2016-05-16
- Volume
- 59
- Issue
- 8
- Pages
- 1659-1665
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC4930716
- OpenAlex
- W2369106355
- Cited by
- 39
- References
- 41
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 4 · 2022: 3 · 2021: 8 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 5
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HHSN268201300029C, HHSN268200900041C)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- cardiorespiratory fitness, prediabetes, diabetes incidence, young adults, middle age (human life stage), treadmill exercise testing, metabolic equivalents, body mass index, CARDIA study, impaired fasting glucose, impaired glucose tolerance, cardiovascular risk
- MeSH terms
- Adolescent, Adult, Blood Pressure, Diabetes Mellitus, Type 2, Female, Humans, Male, Physical Fitness, Prediabetic State, Prospective Studies, Risk Factors, Cohort Studies, Multicenter Studies as Topic, Incidence, Young Adult
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