The association of adolescent fitness with cardiometabolic diseases in late adulthood: A 45‐year longitudinal study

Objectives The aim of this study was to examine the associations of adolescent cardiorespiratory fitness (CRF), muscular fitness (MF), and speed‐agility fitness (SA) with middle‐aged cardiometabolic disease risk and explore sex differences. Methods This 45‐year prospective cohort study examined the associations between objectively measured fitness at adolescence (12–19 years) and physician‐ascertained diabetes mellitus, elevated blood pressure (BP), and coronary heart disease reported either in early (37–44 years) or late (57–64 years) middle age, and self‐measurement of waist circumference (WC) in late middle age. Fitness measurements for healthy adolescents in baseline included CRF (1.5 km [girls] and 2 km [boys] run), MF (standing broad jump, sit‐ups, pull‐ups [boys], and flexed‐arm hang [girls]), and SA (50 m dash and 4 × 10 m shuttle run). Logistic regression and general linear models were adjusted for baseline age, sex, and body mass index (BMI), involving data from baseline and at least one follow‐up measurement (N up to 1358, 47% males). Results Adolescent CRF was inversely, and regardless of adiposity, associated with middle age accumulated burden of cardiometabolic conditions in the whole sample (N = 562, ß = −0.10, 95% confidence intervals [CI] [−0.18, −0.03], p = 0.006), and elevated BP in females (N = 256, OR = 0.71, 95% CI [0.51, 0.91]). Overall, we observed stronger associations in females than in males. An inverse association of adolescent MF and SA with middle‐aged WC was observed, but it did not show as consistent associations as with CRF. Conclusions In this study, adolescent fitness, particularly CRF, was inversely associated with the burden of cardiometabolic conditions up to 45 years. Promotion of fitness in youth may be beneficial in preventing adulthood cardiometabolic diseases.