Decline in physical fitness from childhood to adulthood associated with increased obesity and insulin resistance in adults

  1. Terence Dwyer, Professor (terry.dwyer{at}mcri.edu.au)1,2,
  2. Costan G. Magnussen, PhD Student2,
  3. Michael D. Schmidt, Research Fellow2,
  4. Obioha C. Ukoumunne, Biostatistician1,
  5. Anne-Louise Ponsonby, Professor1,2,
  6. Olli T. Raitakari, Professor3,
  7. Paul Z. Zimmet, Professor4,
  8. Steven N. Blair, Professor5,
  9. Russell Thomson, Research Fellow2,
  10. Verity J. Cleland, Research Fellow6 and
  11. Alison Venn, Associate Professor2
  1. 1Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Melbourne, Australia
  2. 2Menzies Research Institute, University of Tasmania, Hobart, Australia
  3. 3Department of Clinical Physiology, University of Turku, Turku, Finland
  4. 4International Diabetes Institute, Melbourne, Australia
  5. 5The Arnold School of Public Health, University of South Carolina, USA
  6. 6Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Australia

    Abstract

    Objective: To examine how child and adult fitness are associated with adult obesity and insulin resistance.

    Research Design and Methods: Prospective cohort study.

    Setting: Australia.

    Participants: A follow-up cohort of 647 adults in 2004-6 who were participants of the Australian Schools Health and Fitness Survey in 1985 (aged 9 to 15 years) who had an anthropometry and cardiorespiratory fitness assessment.

    Outcome measures: Insulin resistance was defined as a HOMA index above the 75th sex-specific percentile. Adults with a BMI ≥ 30kg/m2 were termed obese.

    Results: Lower levels of child cardiorespiratory fitness were associated with increased odds of adult obesity (adjusted OR per unit increase = 3.0, 95% CI: 1.6 to 5.6) and insulin resistance (adjusted OR = 1.7, 95% CI: 1.1 to 2.6). A decline in fitness level between childhood and adulthood was associated with increased obesity (adjusted OR = 4.5, 95% CI: 2.6 to 7.7) and insulin resistance (adjusted OR = 2.1, 95% CI: 1.5 to 2.9) per unit decline.

    Conclusions: A decline in fitness from childhood to adulthood, and by inference a decline in physical activity, is associated with obesity and insulin resistance in adulthood. Programs aimed at maintaining high childhood PA levels into adulthood may have potential for reducing the burden of obesity and type 2 diabetes in adults.

    Footnotes

      • Received September 4, 2008.
      • Accepted December 15, 2008.

    This Article

    1. Published online before print December 23, 2008, doi: 10.2337/dc08-1638
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