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Cited by 465Physical Activity and HealthCardiovascular and exercise physiologyCardiovascular Effects of Exercise

Changes in physical fitness and changes in mortality

Erikssen, Gunnar, Liestøl, Knut, Bjørnholt, Jørgen, Thaulow, Erok, Sandvik, Leiv, Erikssen, Jan·1998·The Lancet
DOI 10.1016/s0140-6736(98)02268-5
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Abstract

Background Point estimates of physical fitness give important information on the risk of death in healthy people, but there is little information available on effects of sequential changes in physical fitness on mortality. We studied this latter aspect in healthy middle-aged men over a total follow-up period of 22 years. Methods 2014 healthy men aged 40-60 years had a bicycle exercise test and clinical examination, and completed a questionnaire in 1972-75 (survey 1). This was repeated for 1756 (91%) of 1932 men still alive by Dec 31, 1982 (survey 2). The exercise scores were adjusted for age. The change in exercise scores between surveys was divided into quartiles (Q1=least fit, Q4=fittest). An adjusted Cox's proportional hazards model was used to study the association between changes in physical fitness and mortality, with the Q1 men used as controls. Findings By Dec 31, 1994, 238 (17%) of the 1428 men had died, 120 from cardiovascular causes. There were 37 deaths in the Q4 group (19 cardiovascular); their relative risks of death were 0.45 (95% CI 0.29-0.69) for any cause and 0.47 (0.26-0.86) for cardiovascular causes. There was a graded, inverse relation between changes in physical fitness and mortality irrespective of physical fitness status at survey 1. Interpretation Change in physical fitness in healthy middle-aged men is a strong predictor of mortality. Even small improvements in physical fitness are associated with a significantly lowered risk of death. If confirmed, these findings should be used to influence public health policy.

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  • Erikssen et al. reported a similar pattern and concluded that even modest fitness gains significantly reduce death risk.

    “Erikssen et al. (165) found similar trend and concluded that even small improvements in physical fitness are associated with a significantly lowered risk of death.”

    From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [165]

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Authors
Erikssen, G., Liestøl, K., Bjørnholt, J., Thaulow, E., Sandvik, L., & Erikssen, J.
Affiliations
  • Akershus University Hospital (NO)
  • University of Oslo (NO)
  • Oslo University Hospital (NO)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
1998-09
Volume
352
Issue
9130
Pages
759-762
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(98)02268-5
OpenAlex
W2038621442
Cited by
464
References
25
Citations by year
2026: 7 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 17 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 20 · 2017: 21 · 2016: 16 · 2015: 17 · 2014: 12 · 2013: 29 · 2012: 22
FWCI
8.81
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
physical fitness, mortality, cardiovascular mortality, middle-aged men, exercise capacity, bicycle exercise test, fitness change, mortality prediction, public health policy
MeSH terms
Adult, Cardiovascular Diseases, Cause of Death, Exercise Test, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Neoplasms, Physical Fitness, Risk, Proportional Hazards Models

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