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Fit for life? Low cardiorespiratory fitness in adolescence is associated with a higher burden of future disability
  1. Pontus Henriksson1,
  2. Eric J Shiroma2,
  3. Hanna Henriksson1,
  4. Per Tynelius3,4,
  5. Daniel Berglind3,4,
  6. Marie Löf1,5,
  7. I-Min Lee6,7,
  8. Francisco B Ortega5,8
  1. 1 Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
  2. 2 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, Maryland, USA
  3. 3 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
  4. 4 Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
  5. 5 Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
  6. 6 Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  8. 8 PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
  1. Correspondence to Dr Pontus Henriksson, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping 58183, Sweden; pontus.henriksson{at}

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The burden of disability is an important public health challenge as the majority of people will experience disability throughout their life. Disability includes impairments, activity limitations and participation restrictions, all of which may reduce the capability for work. People with chronic disabilities that limit the ability to work are granted disability pensions in many countries. Therefore, disability pension is informative for health and disease outcomes, as well as for economic consequences.

Previous studies have indicated that obesity as well as low cardiorespiratory fitness and muscular strength already in adolescence are related to later mortality and disease, but few studies have examined corresponding associations for future disability due to all and specific chronic diseases. Thus, we examined the associations of obesity, cardiorespiratory fitness and muscular strength in male adolescents with later disability pension due to all and specific causes in more than 1 million participants through linkage of data from the Swedish conscription registry with other nationwide registries.1–3

Low cardiorespiratory fitness in isolation1 3, or together with low muscular strength2 or obesity1 3, was a strong risk factor for later disability pension due to all and specific causes (eg, psychiatric, musculoskeletal and cardiovascular diseases). Strengths of these previous studies include the large size and representativeness of the study sample (97%–98% of all adolescent males since conscription was mandatory by law during the study years3), the long follow-up (~30 years) and the objective markers of chronic disability (ie, disability pension) and exposures. However, thus far, no actual …

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  • Twitter @DanielBerglind, @ortegaporcel

  • Contributors PH, EJS, HH, PT, DB and FBO conceived and designed the current study. PH performed the statistical analyses and EJS performed the PAF calculations. PH, HH and FBO drafted the manuscript, which was critically revised by PT, DB, ML, IML and EJS. All authors approved the final manuscript.

  • Funding FBO was supported by a visiting grant (to MLs research group) from Henning and Johan Throne-Holst Foundation. EJS is supported by the Intramural Research Program at the National Institute on Aging (USA). This study was conducted under the umbrella of the ActiveBrains and the SmarterMove projects supported by the MINECO/FEDER (DEP2013‐47540, DEP2016‐79512‐R, DEP2017-91544-EXP). Additional funding was obtained from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES); and Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). These funders had no role in study design, data collection, analysis, or interpretation, writing of the report or in the decision to submit the paper for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.