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Physical Fitness and Changes in Mortality

The Survival of the Fittest

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Abstract

Physical fitness is a term describing maximal aerobic capacity adjusted for body size and composition, and is an integrated measure of cardiorespiratory and neuromusculo-skeletal function, oxygen transport and delivery, and psychological drive. Accordingly, high physical fitness requires that all these important body functions function normally, while low physical fitness suggests malfunction of one or more of them

High levels of physical fitness - maintained through heavy daily exercise — has probably been a necessary requirement for survival in the earlier history of humans. In modern, industrialised countries the demand for physical activity to sustain life is declining, and a decline in physical fitness is observed in many populations.

Epidemiological studies over the past 50 years have unanimously shown that low physical activity and physical fitness is associated with high cardiovascular and total mortality. Recent data also suggest that low physical activity and physical fitness is followed by an increased incidence of diabetes mellitus and nonfatal cardiovascular diseases. A number of unfavourable biochemical and physiological aberrations following physical inactivity probably explain these observations. However, recent studies also indicate that changes in physical activity, and especially changes that bring increases in physical fitness, can reverse this rather pessimistic scenario.

The Global Burden of Disease Study initiated by the World Health Organization included physical inactivity among the most important risk factors threatening global health. A sedentary life style may be as detrimental to health as smoking. Encouragement of physical activity is an important and difficult task, as society is becoming increasingly successful in reducing our need to move.

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References

  1. Murray CJL, Lopez AD. Evidence-based health policy-lessons from the global burden of disease study. Science 1996; 274: 740–3

    Article  PubMed  CAS  Google Scholar 

  2. Åstrand P-O, Rodahl K. Textbook of work physiology: physiological bases of exercise. 3rd ed. New York: McGraw-Hill, 1986

    Google Scholar 

  3. Wei M, Kampert JB, Barlow CE, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999; 282 (16): 1547–53

    Article  PubMed  CAS  Google Scholar 

  4. Sandvik L, Erikssen G, Thaulow E. Long term effects of smoking on physical fitness and lung function: a longitudinal study of 1393 middle aged Norwegian men for seven years. BMJ 1995; 311: 715–8

    Article  PubMed  CAS  Google Scholar 

  5. Dvorac RV, Tchernof A, Starling RD, et al. Respiratory fitness, free living physical activity, and cardiovascular disease risk in older individuals: a doubly labelled water study. J Clin Endocrinol Metab 2000; 85 (3): 957–63

    Article  Google Scholar 

  6. Erikssen G, Liestøl K, Bjørnholt JV, et al. Changes in physical fitness and changes in mortality. Lancet 1998; 352: 759–62

    Article  PubMed  CAS  Google Scholar 

  7. Hambrecht R, Wolf A, Gielen S, et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med 2000; 342: 454–60

    Article  PubMed  CAS  Google Scholar 

  8. Sørensen M, Anderssen S, Hjermann I, et al. The effects of exercise and diet on mental health and quality of life in middleaged individuals with elevated risk-factors for cardiovascular disease. J Sports Sci 1999; 17: 369–77

    Article  PubMed  Google Scholar 

  9. Suzuki I, Yamada H, Sugiura T, et al. Cardiovascular fitness, physical activity and selected coronary heart disease risk factors in adults. Sports Med Phys Fitness 1998; 38: 149–57

    CAS  Google Scholar 

  10. McMurray RG, Aisworth BE, Harrell JS, et al. Is physical activity or aerobic power more influential on reducing cardiovascular disease risk factors? Med Sci Sports Exerc 1998; 30 (10): 1521–9

    Article  PubMed  CAS  Google Scholar 

  11. Morris JN, Heady JA, Raffle PAB, et al. Coronary heart disease and physical activity at work. Lancet 1953; II: 1053–7

    Article  Google Scholar 

  12. Pfaffenbarger RS, Laughlin ME, Gima AS, et al. Work activity of longshoremen is related to death from coronary heart disease and stroke. N Engl J Med 1970; 282: 1109–14

    Article  Google Scholar 

  13. Leon AS, Connett J, Jacobs DR, et al. Leisure-time physical activity levels and risk of coronary heart disease and death: the multiple risk factor intervention trial. JAMA 1987; 258: 2388–95

    Article  PubMed  CAS  Google Scholar 

  14. Pfaffenbarger RS, Hyde RT, Wing AL, et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328: 538–45

    Article  Google Scholar 

  15. Lemaitre RN, Heckbert SR, Psaty BM, et al. Leisure-time physical activity and the risk of nonfatal myocardial infarction in postmenopausal women. Arch Int Med 1995; 155: 2301–8

    Article  Google Scholar 

  16. Thune I, Brenn T, Lund E, et al. Physical activity and the risk of breast cancer. N Engl J Med 1997; 336: 1269–75

    Article  PubMed  CAS  Google Scholar 

  17. Ekelund L-G, Haskell WL, Johnson JL, et al. Physical fitness as a predictor of cardiovascular mortality in asymptomatic North American men: the lipid research clinics mortality follow-up study. N Engl J Med 1988; 319: 1379–84

    Article  PubMed  CAS  Google Scholar 

  18. Slattery ML, Jacobs DR. Physical fitness and cardiovascular disease mortality: the US railroad study. Am J Epidemiol 1988; 127: 571–80

    PubMed  CAS  Google Scholar 

  19. Blair SN, Kohl HW, Pfaffenbarger RS, et al. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989; 262: 2395–401

    Article  PubMed  CAS  Google Scholar 

  20. Sandvik L, Erikssen J, Thaulow E, et al. Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Engl J Med 1993; 328: 533–7

    Article  PubMed  CAS  Google Scholar 

  21. Pfaffenbarger RS, Hyde RT, Wing AL, et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993; 328: 538–45

    Article  Google Scholar 

  22. Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet 1998; 351: 1603–8

    Article  PubMed  CAS  Google Scholar 

  23. Blair SN, Kohl HW, Barlow CE, et al. Changes in physical fitness and all-cause mortality. JAMA 1995; 273: 1093–8

    Article  PubMed  CAS  Google Scholar 

  24. Hein HO, Suadicani P, Gyntelberg F. Physical fitness or physical activity as a predictor of ischaemic heart disease? J Int Med 1992; 232: 471–9

    Article  CAS  Google Scholar 

  25. Bijnen FCH, Feskens EJM, Caspersen CJ, et al. Baseline and previous physical activity in relation to mortality in elderly men. Am J Epidemiol 1999; 160: 189–96

    Google Scholar 

  26. Hambrecht R, Niebauer J, Marburger C, et al. Various intensities of leisure time physical activity in patients with coronary artery disease: effects of cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol 1993; 22 (2): 468–77

    Article  PubMed  CAS  Google Scholar 

  27. Fletcher GF. The antiatherosclerotic effect of exercise and development of an exercise prescription. Cardiol Clin 1996; 14 (1): 85–95

    Article  PubMed  CAS  Google Scholar 

  28. Franklin B. Exercise and cardiovascular events: a double-edged sword? J Sports Sci 1999; 17: 437–42

    Article  PubMed  CAS  Google Scholar 

  29. Siscovick DS, Weiss NS, Fletcher RH, et al. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med 1984; 311: 874–7

    Article  PubMed  CAS  Google Scholar 

  30. Mittelman MA, Maclure M, Toffler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion: protection against triggering by regular exertion. N Engl J Med 1993; 329: 1677–83

    Article  Google Scholar 

  31. Bradford Hill A. Statistical evidence and inference. In: Principles of medical statistics. 9th ed. New York: Oxford University Press, 1971: 309–23

    Google Scholar 

  32. Bruce RA, Hossack KF, DeRouen TA, et al. Enhanced risk assessment for primary coronary heart disease events by maximal exercise testing: 10 years experience of Seattle Heart Watch. J Am Coll Cardiol 1983; 2 (3): 565–73

    Article  PubMed  CAS  Google Scholar 

  33. Mundal R, Kjeldsen SE, Sandvik L, et al. Exercise blood pressure predicts cardiovascular mortality in middle-aged men. Hypertension 1994; 24: 56–62

    Article  PubMed  CAS  Google Scholar 

  34. Sandvik L, Erikssen J, Ellestad M, et al. Heart rate increase and maximal heart rate during exercise as predictors of cardiovascular mortality: a 16-year follow-up study of 1960 healthy men. Coron Artery Dis 1995; 6: 667–78

    Article  PubMed  CAS  Google Scholar 

  35. Cole CR, Foody J-A, Blackstone EH, et al. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 2000; 132: 552–5

    PubMed  CAS  Google Scholar 

  36. Barinaga M. How much pain for cardiac gain? Science 1997; 276: 1324–7

    Article  PubMed  CAS  Google Scholar 

  37. Thompson PD, Mitchell JH. Exercise and sudden cardiac death: protection or provocation? N Engl J Med 1984; 311: 914–5

    Article  PubMed  CAS  Google Scholar 

  38. Snell PG, Mitchell JH. Physical inactivity — an easily modified risk factor? Circulation 1999; 100: 2–4

    Article  PubMed  CAS  Google Scholar 

  39. Samitz G. Körperliche aktivität zur senkung der kardiovaskulären mortalitet und gesamtmortalitet: eine public health perspektive. Wien Klin Wochenscr 1998; 110 (17): 589–96

    CAS  Google Scholar 

  40. Hahn RA, Teutsch SM, Rothenberg RB, et al. Excess deaths from nine chronic diseases in the United States, 1986. JAMA 1990; 264: 2654–9

    Article  PubMed  CAS  Google Scholar 

  41. Popkin BM. The nutrition transition in low-income countries: an emerging crisis. Nutr Rev 1994; 52: 285–98

    Article  PubMed  CAS  Google Scholar 

  42. Darwin C. The origin of species. London: Down, Bromley, Kent, 1859

    Google Scholar 

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Authors and Affiliations

  1. Medical Department, Central Hospital of Akershus, N-1474, Nordbyhagen, Norway

    Gunnar Erikssen

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  1. Gunnar Erikssen
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Correspondence to Gunnar Erikssen.

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Erikssen, G. Physical Fitness and Changes in Mortality. Sports Med 31, 571–576 (2001). https://doi.org/10.2165/00007256-200131080-00001

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