Nicholas R Lamoureux1, John S Fitzgerald1, Kevin I Norton2, Todd Sabato1, Mark S Tremblay3, Grant R Tomkinson4,5. 1. Department of Education, Health and Behavior Studies, University of North Dakota, 2751 2nd Avenue North, Stop 8235, Grand Forks, ND, 58202, USA. 2. Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia. 3. Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. 4. Department of Education, Health and Behavior Studies, University of North Dakota, 2751 2nd Avenue North, Stop 8235, Grand Forks, ND, 58202, USA. grant.tomkinson@und.edu. 5. Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia. grant.tomkinson@und.edu.
Abstract
OBJECTIVE: To estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of adults, and to examine relationships between trends in CRF and trends in health-related, socioeconomic, and environmental indicators. METHODS: Data were obtained from a systematic search of studies that explicitly reported temporal trends in the CRF of apparently healthy adults aged 18-59 years. Sample-weighted temporal trends were estimated using best-fitting regression models relating the year of testing to mean CRF. Post-stratified population-weighted mean changes in percent and standardized CRF were estimated. Pearson's correlations were used to describe associations between linear trends in CRF and linear trends in health-related, socioeconomic, and environmental indicators. RESULTS: 2,525,827 adults representing eight high- and upper-middle-income countries between 1967 and 2016 collectively showed a moderate decline of 7.7% (95% CI - 8.4 to - 7.0) or 1.6% per decade (95% CI - 1.7 to - 1.5). Internationally, CRF improved in the 1960s and 1970s, and progressively declined at an increasing rate thereafter. Declines were larger for men than for women, and for young adults (< 40 years) than for middle-aged adults (≥ 40 years). All countries experienced declines in CRF with a very strong negative correlation between CRF trends and obesity trends. CONCLUSIONS: There has been a meaningful decline in the CRF of adults since 1980, which has progressively increased in magnitude over time, suggestive of a corresponding decline in population health. Continuous national and international surveillance systems are needed in order to monitor health and fitness trends, especially among low- and middle-income countries for which data do not currently exist. PROSPERO registration number: CRD42013003678.
OBJECTIVE: To estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of adults, and to examine relationships between trends in CRF and trends in health-related, socioeconomic, and environmental indicators. METHODS: Data were obtained from a systematic search of studies that explicitly reported temporal trends in the CRF of apparently healthy adults aged 18-59 years. Sample-weighted temporal trends were estimated using best-fitting regression models relating the year of testing to mean CRF. Post-stratified population-weighted mean changes in percent and standardized CRF were estimated. Pearson's correlations were used to describe associations between linear trends in CRF and linear trends in health-related, socioeconomic, and environmental indicators. RESULTS: 2,525,827 adults representing eight high- and upper-middle-income countries between 1967 and 2016 collectively showed a moderate decline of 7.7% (95% CI - 8.4 to - 7.0) or 1.6% per decade (95% CI - 1.7 to - 1.5). Internationally, CRF improved in the 1960s and 1970s, and progressively declined at an increasing rate thereafter. Declines were larger for men than for women, and for young adults (< 40 years) than for middle-aged adults (≥ 40 years). All countries experienced declines in CRF with a very strong negative correlation between CRF trends and obesity trends. CONCLUSIONS: There has been a meaningful decline in the CRF of adults since 1980, which has progressively increased in magnitude over time, suggestive of a corresponding decline in population health. Continuous national and international surveillance systems are needed in order to monitor health and fitness trends, especially among low- and middle-income countries for which data do not currently exist. PROSPERO registration number: CRD42013003678.
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