Rethinking the Impact of Adolescent Fitness on Future Cardiovascular Health

Genetic and environmental factors and risk of cardiovascular diseases in adolescents

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Main summary

There is a well-known relationship between good physical fitness at a young age and a lower risk of cardiovascular disease later in life. However, when the researchers adjusted for family factors using sibling analysis, they found a weaker association, although the link between a high body mass index (BMI) and cardiovascular disease remained strong.

The study, carried out by researchers from Karolinska Institutet and other universities, is published in Open JAMA Network.

“This does not mean that fitness is irrelevant,” says the study’s last author, Viktor Ahlqvist, a doctoral student in the Department of Global Public Health at the Karolinska Institute. “We were still able to see an association, although it was weaker after taking into account factors shared by siblings. We also think that adolescence is an important time in life to establish good habits like exercising and having a healthy diet.”

Challenging the test of causal associations

Many observational studies have previously demonstrated links between various risk factors at a young age and cardiovascular disease in adulthood. However, it is difficult to demonstrate whether the associations are causal due to the possible influence of unaccounted for genetic and environmental factors. Therefore, a collaborative team including researchers from the Karolinska Institute in Sweden has sought to examine whether a large proportion of cardiovascular diseases in adulthood could be prevented by a lower BMI, lower blood pressure, better physical fitness or greater muscle strength in adolescence.

Obtaining data from the Swedish Military Conscription Registry and other Swedish registries, the researchers identified more than one million 18-year-old men and followed them for 60 years. Almost half of them were full siblings.

“The strength of our study, which makes it more reliable than many other conventional observational studies, is that we used sibling analysis,” says the first author of the study, Marcel Ballin, a researcher at Uppsala University and an analyst at the Center for Epidemiology and Community of the Stockholm Region. Medicine. “By doing so, we could examine how the relationship changes when all shared factors between siblings are controlled. This includes environmental factors such as childhood environment and half of genetics.”

A high BMI is a strong risk factor

The results show that a high BMI in late adolescence was strongly associated with future cardiovascular disease, even after the researchers had controlled for shared family factors. However, the association between physical fitness and cardiovascular disease was considerably weaker in the sibling analysis, suggesting that many previous observational studies may have overestimated the relevance of adolescent physical fitness for later cardiovascular health. of the life.

“Our conclusion is that, of the risk factors studied, high BMI is the strongest single risk factor for cardiovascular disease, and that efforts to address the obesity epidemic should continue to be given high priority,” says co-author Daniel Berglind, professor at the Department of Global Public Health, Karolinska Institutet. “A good level of physical fitness and muscle strength in adolescence does not seem so crucial, but physical activity is still important for public health, as it can provide other health benefits.”

Various limitations

The study examined the association between risk factors at a young age and future cardiovascular disease; other disease outcomes were not investigated. The researchers did not have data on whether participants’ risk factors varied later in life and only studied men, making it difficult to extend their findings to women. The Military Conscription Registry also lacks details on certain risk factors for future cardiovascular disease, such as diet, alcohol consumption, smoking, blood lipids, and blood glucose.

Publication

The researchers did not receive any specific grant for this study. Co-author Martin Neovius serves on advisory panels for Ethicon, Johnson & Johnson and Itrim and has been a consultant to the Swedish armed forces outside the scope of this study. No other conflicts of interest have been reported.

“Genetic and environmental factors and risk of cardiovascular disease in adolescents”, Marcel Ballin, Martin Neovius, Francisco B. Ortega, Pontus Henriksson, Anna Nordström, Daniel Berglind, Peter Nordström, Viktor H. Ahlqvist, JAMA Network Open, online 17 November 2023.

Attribution/Source(s):

This peer-reviewed article related to our Fitness and Nutrition section was selected for publication by Disabled World editors because of its likely interest to our readers in the disability community. Although content may have been edited for style, clarity, or length, the article “Rethinking the impact of adolescent physical fitness on future cardiovascular health” was originally written by Karolinska Institutet and published by Disabled-World.com on 11/17/2023 (Updated: 11/18/2023). If you require further information or clarification, you can contact Karolinska Institutet at ki.se. Disabled World makes no warranties or representations in connection therewith.

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