Associations of Adolescent BMI and Physical Fitness With Cardiovascular Health in Middle Age: A Population-Based Prospective Study of Swedish Men
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction Early-life determinants of middle-age cardiovascular health are poorly understood. This study examines associations of body mass index (BMI) and physical fitness in male adolescents with cardiovascular health measured by the Life's Essential 8 score in middle age. Methods A population-based cohort study linked BMI and physical fitness from the Swedish Military Conscription Register (men conscripted 1972-1987) to cardiovascular health from the Swedish CArdioPulmonary bioImage Study (SCAPIS, 2013-2018). In 2025, 8930 men (mean age 18.3 years) were analyzed after 38.2 years of follow-up. Physical fitness included cardiorespiratory fitness (maximal cycle-ergometer test), and muscular strength (isometric dynamometry of knee extension, elbow flexion, and handgrip). Cardiovascular health was evaluated using the American Heart Association Life's Essential 8 score (0–100; poor health <60). Associations were assessed using linear and binomial logistic regressions and restricted cubic splines. Results BMI and cardiorespiratory fitness exhibited J-shaped and linear associations, respectively, with cardiovascular health. Compared to normal weight (BMI: 18.5-24.9 kg/m2), adjusted odds ratios (ORs) of having poor cardiovascular health for overweight (BMI: 25.0-29.9 kg/m2) and obesity (BMI ≥30 kg/m2) were OR 2.42 (95% confidence interval [CI] 2.00-2.92) and OR 5.38 (95% CI 2.99-9.70). No statistically significant associations were observed between muscular strength and cardiovascular health. Conclusions Obesity and low levels of cardiorespiratory fitness in male adolescents were associated with lower cardiovascular health in middle age, after nearly four decades of follow-up. Although further studies are needed, promotion of a healthy body weight and cardiorespiratory fitness in youth may be of importance for later cardiovascular health.
Authors: Ángel Herraiz-Adillo, Viktor H. Ahlqvist, Kristofer Hedman, Sara Higueras-Fresnillo, Emil Hagström, Melony Fortuin-de Smidt, Bledar Daka, Cecilia Lenander, Anton Olsson, Daniel Berglind, Carl Johan Östgren, Karin Rådholm, Francisco B. Ortega, Pontus Henriksson
Institutions: Linköping University, Aarhus University, Karolinska Institutet, Region Östergötland, Universidad Autónoma de Madrid, Uppsala University, Umeå University, University of Gothenburg, Lund University, Stockholm School of Economics, Region Stockholm, The George Institute for Global Health, UNSW Sydney, The George Institute for Global Health, Universidad de Granada, Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, University of Jyväskylä
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,300
Funders: Joanna Cocozza Foundation, Children's Medical Research, Amgen, Pfizer, AstraZeneca, Regeneron Pharmaceuticals, Amarin Corporation, Ministerio de Ciencia, Innovación y Universidades, VINNOVA, Lunds Universitet, Hjärt-Lungfonden, Linköpings Universitet, Karolinska Institutet, Knut och Alice Wallenbergs Stiftelse, Novo Nordisk, Stockholms Läns Landsting, Vetenskapsrådet, Universidad Autónoma de Madrid, Ministerio de Ciencia e Innovación, Umeå Universitet, Sahlgrenska Universitetssjukhuset, Göteborgs Universitet, Uppsala Universitet, Junta de Andalucía, Skånes universitetssjukhus
Awards: G3828852936, G5805502524, G8187380464
OpenAlex ID: W4414591207
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