Low cardiorespiratory fitness and obesity during adolescence are strongly associated with chronic disability later in life from various causes and diseases, according to study results published in Annals of Internal Medicine.

To evaluate associations between cardiorespiratory fitness and obesity in male adolescents with later receipt of a disability pension, researchers followed a cohort of 1,079,128 Swedish adolescents and young adults conscribed into military service (age 16 to 19 years at baseline). The researchers measured participants for cardiorespiratory fitness and body mass index at baseline. Data regarding monitored disability pensions were garnered from the Social Insurance Agency.

Over a median follow-up of 28.3 years, 54,304 participants received a disability pension. The researchers discovered that low cardiorespiratory fitness in adolescence was strongly associated with eventual receipt of disability from all causes (hazard ratio [HR], 3.74) and as a result of specific classifications including psychiatric causes (HR, 4.01), musculoskeletal causes (HR, 3.72), injuries (HR, 2.74), nervous system causes (HR, 2.86), circulatory conditions (HR, 4.87), and tumors (HR, 1.89).

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There was also a significant association between severe obesity and disability pension receipt for all causes (HR, 3.21), psychiatric causes (HR, 1.63), and musculoskeletal causes (HR, 4.11), with participants in the obesity 2 and 3 classes at the greatest risk.

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Compared with poor fitness, moderate or high fitness levels in adolescence were associated with reduced risk for disability pension across all body mass index groups. For example, highly fit obese males were at significantly lower risk for disability pension from all causes than unfit males with obesity (HR, 2.27 vs 4.67, respectively).

Limitations to this study included an absence of data on smoking status and alcohol intake, as well as its exclusion of female participants.

“[L]ow cardiorespiratory fitness and obesity are strongly associated with receipt of a disability pension due to a wide range of diseases and causes later in life,” the researchers said, adding, “Although additional well-designed studies are required to provide further evidence, these findings emphasize the importance of high cardiorespiratory fitness and healthy body weight during adolescence.”

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Henriksson P, Henriksson H, Tynelius P, et al. Fitness and body mass index during adolescence and disability later in life: a cohort study [published online February 12, 2019]. Ann Intern Med. doi:10.7326/M18-1861