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Int J Sports Med 2016; 37(11): 863-869
DOI: 10.1055/s-0042-110572
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

The Role of Body Habitus in Predicting Cardiorespiratory Fitness: The FRIEND Registry

T. Baynard
1   Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, United States
,
R. A. Arena
2   Department of Physical Therapy, University of Illinois at Chicago, Chicago, United States
,
J. Myers
3   Cardiology Division, VA Palo Alto Health Care System, Palo Alto, California, United States
,
L. A. Kaminsky
4   School of Kinesiology, Ball State University, Muncie, Indiana, United States
› Author Affiliations
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Publication History



accepted after revision 07 June 2016

Publication Date:
04 August 2016 (online)

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Abstract

This study aimed to validate and cross-validate a non-exercise prediction model from a large and apparently healthy US cohort of individuals who underwent an analysis of body habitus (waist circumference (WC) and body mass index (BMI)) with measured CRF. The large cohort (5 030 individuals) was split into validation (4 030) and cross-validation (1 000) groups, whereby waist circumference and maximal aerobic capacity (VO2max) were assessed by rigorously approved laboratories. VO2max was estimated in 2 multiple regression equations using age, sex and either WC (r=0.77; standard error of the estimate (SEE) 6.70 mLO2∙kg−1∙min−1) or BMI (r=0.76; SEE 6.89 mLO2∙kg−1∙min−1).Cross-validation yielded similar results. However, as VO2max increased, there was increased bias, suggesting VO2max may be underestimated at higher values. Both WC and BMI prediction models yielded similar findings, with WC having a slightly smaller SEE. These measures of body habitus appear to be adequate in predicting CRF using non-exercise parameters, even without a measure of physical activity. Caution should be taken when using these equations in more fit individuals.

Key words

waist circumference - body mass index - prediction equation - maximal aerobic capacity
 

  • References

  • 1 Arena R, Myers J, Abella J, Pinkstaff S, Brubaker P, Moore B, Kitzman D, Peberdy MA, Bensimhon D, Chase P, Forman D, West E, Guazzi M. Determining the preferred percent-predicted equation for peak oxygen consumption in patients with heart failure. Circ Heart Fail 2009; 2: 113-120
    CrossrefPubMedGoogle Scholar
  • 2 Arena R, Myers J, Guazzi M. The future of aerobic exercise testing in clinical practice: Is it the ultimate vital sign?. Future Cardiol 2010; 6: 325-342
    CrossrefPubMedGoogle Scholar
  • 3 Arena R, Myers J, Kaminsky LA. Revisiting age-predicted maximal heart rate: Can it be used as a valid measure of effort?. Am Heart J 2016; 173: 49-56
    CrossrefPubMedGoogle Scholar
  • 4 Barry VW, Baruth M, Beets MW, Durstine JL, Liu J, Blair SN. Fitness vs. Fatness on all-cause mortality: A meta-analysis. Prog Cardiovasc Dis 2014; 56: 382-390
    CrossrefPubMedGoogle Scholar
  • 5 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310
    PubMedGoogle Scholar
  • 6 Church TS, Kampert JB, Gibbons LW, Barlow CE, Blair SN. Usefulness of cardiorespiratory fitness as a predictor of all-cause and cardiovascular disease mortality in men with systemic hypertension. Am J Cardiol 2001; 88: 651-656
    CrossrefPubMedGoogle Scholar
  • 7 Cink RE, Thomas TR. Validity of the Åstrand-Ryhming nomogram for predicting maximal oxygen intake. Br J Sports Med 1981; 15: 182-185
    CrossrefPubMedGoogle Scholar
  • 8 Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006; 444: 881-887
    CrossrefPubMedGoogle Scholar
  • 9 Farrell SW, Braun L, Barlow CE, Cheng YJ, Blair SN. The relation of body mass index, cardiorespiratory fitness, and all-cause mortality in women. Obes Res 2002; 10: 417-423
    CrossrefPubMedGoogle Scholar
  • 10 Guazzi M, Arena R. Cardiopulse. New clinical cardiopulmonary exercise testing joint statement from the European Society of Cardiology and American Heart Association. Eur Heart J 2012; 33: 2627-2628
    PubMedGoogle Scholar
  • 11 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2016 update. Int J Sports Med 2015; 36: 1121-1124
    Google Scholar
  • 12 Heil DP, Freedson PS, Ahlquist LE, Price J, Rippe JM. Nonexercise regression models to estimate peak oxygen consumption. Med Sci Sports Exerc 1995; 27: 599-606
    PubMedGoogle Scholar
  • 13 Jackson AS, Blair SN, Mahar MT, Wier LT, Ross RM, Stuteville JE. Prediction of functional aerobic capacity without exercise testing. Med Sci Sports Exerc 1990; 22: 863-870
    CrossrefPubMedGoogle Scholar
  • 14 Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004; 79: 379-384
    PubMedGoogle Scholar
  • 15 Jurca R, Jackson AS, LaMonte MJ, Morrow Jr. JR, Blair SN, Wareham NJ, Haskell WL, van Mechelen W, Church TS, Jakicic JM, Laukkanen R. Assessing cardiorespiratory fitness without performing exercise testing. Am J Prev Med 2005; 29: 185-193
    PubMedGoogle Scholar
  • 16 Kaminsky LA, Arena R, Beckie TM, Brubaker PH, Church TS, Forman DE, Franklin BA, Gulati M, Lavie CJ, Myers J, Patel MJ, Pina IL, Weintraub WS, Williams MA. American Heart Association Advocacy Coordinating Committee. CoCC, Council on Nutrition PA, Metabolism. The importance of cardiorespiratory fitness in the United States: The need for a national registry: A policy statement from the American Heart Association. Circulation 2013; 127: 652-662
    CrossrefPubMedGoogle Scholar
  • 17 Kaminsky LA, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: Data from the fitness registry and the importance of exercise national database (FRIEND Registry). Mayo Clin Proc 2015;
    PubMedGoogle Scholar
  • 18 Kline GM, Porcari JP, Hintermeister R, Freedson PS, Ward A, McCarron RF, Ross J, Rippe JM. Estimation of VO2max from a one-mile track walk, gender, age, and body weight. Med Sci Sports Exerc 1987; 19: 253-259
    Google Scholar
  • 19 Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara A, Totsuka K, Shimano H, Ohashi Y, Yamada N, Sone H. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: A meta-analysis. JAMA 2009; 301: 2024-2035
    CrossrefPubMedGoogle Scholar
  • 20 Lakoski SG, Willis BL, Barlow CE, Leonard D, Gao A, Radford NB, Farrell SW, Douglas PS, Berry JD, DeFina LF, Jones LW. Midlife cardiorespiratory fitness, incident cancer, and survival after cancer in men: The cooper center longitudinal study. JAMA Oncol 2015; 1: 231-237
    CrossrefPubMedGoogle Scholar
  • 21 Lee DC, Artero EG, Sui X, Blair SN. Mortality trends in the general population: The importance of cardiorespiratory fitness. J Psychopharmacol 2010; 24: 27-35
    PubMedGoogle Scholar
  • 22 Leger LA, Lambert J. A maximal multistage 20-m shuttle run test to predict VO2 max. Eur J Appl Physiol Occup Physiol 1982; 49: 1-12
    CrossrefPubMedGoogle Scholar
  • 23 Liu R, Sui X, Laditka JN, Church TS, Colabianchi N, Hussey J, Blair SN. Cardiorespiratory fitness as a predictor of dementia mortality in men and women. Med Sci Sports Exerc 2012; 44: 253-259
    CrossrefPubMedGoogle Scholar
  • 24 Milani RV, Lavie CJ. Impact of cardiac rehabilitation on depression and its associated mortality. Am J Med 2007; 120: 799-806
    CrossrefPubMedGoogle Scholar
  • 25 Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler 3rd ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB. American Heart Association Statistics C, Stroke Statistics S. Heart disease and stroke statistics – 2015 update: A report from the American Heart Association. Circulation 2015; 131: e29-e322
    CrossrefPubMedGoogle Scholar
  • 26 Myers J, Forman DE, Balady GJ, Franklin BA, Nelson-Worel J, Martin BJ, Herbert WG, Guazzi M, Arena R. American Heart Association Subcommittee on Exercise CR, Prevention of the Council on Clinical Cardiology CoL, Cardiometabolic Health CoE, Prevention, Council on C, Stroke N. Supervision of exercise testing by nonphysicians: A scientific statement from the American Heart Association. Circulation 2014; 130: 1014-1027
    CrossrefPubMedGoogle Scholar
  • 27 Myers J, McAuley P, Lavie CJ, Despres JP, Arena R, Kokkinos P. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: Their independent and interwoven importance to health status. Prog Cardiovasc Dis 2015; 57: 306-314
    CrossrefPubMedGoogle Scholar
  • 28 Nes BM, Janszky I, Vatten LJ, Nilsen TI, Aspenes ST, Wisloff U. Estimating VO2peak from a nonexercise prediction model: The hunt study, Norway. Med Sci Sports Exerc 2011; 43: 2024-2030
    CrossrefPubMedGoogle Scholar
  • 29 Peel JB, Sui X, Adams SA, Hebert JR, Hardin JW, Blair SN. A prospective study of cardiorespiratory fitness and breast cancer mortality. Med Sci Sports Exerc 2009; 41: 742-748
    PubMedGoogle Scholar
  • 30 Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, Kuk JL, Seidell JC, Snijder MB, Sorensen TI, Despres JP. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference?. Obes Rev 2008; 9: 312-325
    CrossrefPubMedGoogle Scholar
  • 31 Ross RM, Murthy JN, Wollak ID, Jackson AS. The six minute walk test accurately estimates mean peak oxygen uptake. BMC Pulm Med 2010; 10: 31
    CrossrefPubMedGoogle Scholar
  • 32 Sallis R, Franklin B, Joy L, Ross R, Sabgir D, Stone J. Strategies for promoting physical activity in clinical practice. Prog Cardiovasc Dis 2015; 57: 375-386
    CrossrefPubMedGoogle Scholar
  • 33 Smith JL, Verrill TA, Boura JA, Sakwa MP, Shannon FL, Franklin BA. Effect of cardiorespiratory fitness on short-term morbidity and mortality after coronary artery bypass grafting. Am J Cardiol 2013; 112: 1104-1109
    CrossrefPubMedGoogle Scholar
  • 34 Stelken AM, Younis LT, Jennison SH, Miller DD, Miller LW, Shaw LJ, Kargl D, Chaitman BR. Prognostic value of cardiopulmonary exercise testing using percent achieved of predicted peak oxygen uptake for patients with ischemic and dilated cardiomyopathy. J Am Coll Cardiol 1996; 27: 345-352
    PubMedGoogle Scholar
  • 35 Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM. American Heart Association Physical Activity Committee of the Council on L, Cardiometabolic H, Cardiovascular ECR, Prevention Committee of the Council on Clinical C, Council. Guide to the assessment of physical activity: Clinical and research applications: A scientific statement from the American Heart Association. Circulation 2013; 128: 2259-2279
    CrossrefPubMedGoogle Scholar
  • 36 Sui X, Laditka JN, Church TS, Hardin JW, Chase N, Davis K, Blair SN. Prospective study of cardiorespiratory fitness and depressive symptoms in women and men. J Psychiatr Res 2009; 43: 546-552
    CrossrefPubMedGoogle Scholar
  • 37 Sui X, Lee DC, Matthews CE, Adams SA, Hebert JR, Church TS, Lee CD, Blair SN. Influence of cardiorespiratory fitness on lung cancer mortality. Med Sci Sports Exerc 2010; 42: 872-878
    CrossrefPubMedGoogle Scholar
  • 38 Vidoni ED, Honea RA, Billinger SA, Swerdlow RH, Burns JM. Cardiorespiratory fitness is associated with atrophy in Alzheimer’s and aging over 2 years. Neurobiol Aging 2012; 33: 1624-1632
    CrossrefPubMedGoogle Scholar
  • 39 Wang J, Thornton JC, Bari S, Williamson B, Gallagher D, Heymsfield SB, Horlick M, Kotler D, Laferrere B, Mayer L, Pi-Sunyer FX, Pierson Jr RN. Comparisons of waist circumferences measured at 4 sites. Am J Clin Nutr 2003; 77: 379-384
    PubMedGoogle Scholar
  • 40 Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 2000; 132: 605-611
    PubMedGoogle Scholar
  • 41 Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger Jr. RS, Blair SN. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999; 282: 1547-1553
    CrossrefPubMedGoogle Scholar
  • 42 Whaley MH, Kaminsky LA, Dwyer GB, Getchell LH. Failure of predicted VO2peak to discriminate physical fitness in epidemiological studies. Med Sci Sports Exerc 1995; 27: 85-91
    PubMedGoogle Scholar
  • 43 Wier LT, Jackson AS, Ayers GW, Arenare B. Nonexercise models for estimating VO2max with waist girth, percent fat, or BMI. Med Sci Sports Exerc 2006; 38: 555-561
    CrossrefPubMedGoogle Scholar