Cardiorespiratory fitness and mortality from all causes, cardiovascular disease and cancer: dose–response meta-analysis of cohort studies

• Published in: British journal of sports medicine Vol. 56; no. 13; pp. 733 - 739
• Main Authors: Han, Minghui, Qie, Ranran, Shi, Xuezhong, Yang, Yongli, Lu, Jie, Hu, Fulan, Zhang, Ming, Zhang, Zhenzhong, Hu, Dongsheng, Zhao, Yang
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine 01.07.2022; BMJ Publishing Group LTD
• Subjects: Bias; Cancer; Cardiac stress tests; Cardiovascular disease; Cohort analysis; death; Diabetes; Epidemiology; Fitness equipment; Meta-analysis; Mortality; Original research; Physical fitness; Public health; United Kingdom > UK; United States > US; death; meta-analysis
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsports-2021-104876

ObjectiveCurrent evidence of the associations between cardiorespiratory fitness (CRF) and mortality is limited. We performed a meta-analysis to assess the dose–response association of CRF with mortality from all causes, cardiovascular disease (CVD) and cancer in healthy population.MethodsPubMed, EMBASE and Web of Science were searched up to 26 December 2019 for reports of cohort studies giving risk estimates for all-cause, CVD and cancer mortality by level of CRF. Cohort studies were included if CRF was assessed by an exercise stress test and reported as at least three levels or per incremental increase, and the association of CRF with all-cause, CVD and cancer mortality was evaluated. Generalised least-squares regression models were used to assess the quantitative relation of CRF with all-cause, CVD and cancer mortality.Results34 cohort studies were eligible for the meta-analysis. The pooled relative risks (RRs) for all-cause, CVD and cancer mortality per one-metabolic equivalent increase in CRF were 0.88 (95% CI 0.83 to 0.93), 0.87 (95% CI0.83 to 0.91) and 0.93 (95% CI 0.91 to 0.96), respectively. As compared with lowest CRF, with intermediate CRF, the summary RRs for all-cause, CVD and cancer mortality were 0.67 (95% CI 0.61 to 0.74), 0.60 (95% CI 0.51 to 0.69) and 0.76 (95% CI 0.69 to 0.84), respectively, and with highest CRF were 0.47 (95% CI 0.39 to 0.56), 0.49 (95% CI 0.42 to 0.56) and 0.57 (95% CI 0.46 to 0.70), respectively.ConclusionOur analysis showed inverse dose–response associations of CRF with all-cause, CVD and cancer mortality, which provides evidence for public health recommendations for preventing all-cause, CVD and cancer mortality.PROSPERO registration numberCRD42020208883.