title: Decline in physical fitness from childhood to adulthood associated with increased obesity and insulin resistance in adults.
abstract: OBJECTIVE
  To examine how fitness in both childhood and adulthood is associated with adult obesity and insulin resistance.
  
  
  METHODS
  A prospective cohort study set in Australia in 2004-2006 followed up a cohort of 647 adults who had participated in the Australian Schools Health and Fitness Survey in 1985 and who had undergone anthropometry and cardiorespiratory fitness assessment during the survey. Outcome measures were insulin resistance and obesity, defined as a homeostasis model assessment index above the 75th sex-specific percentile and BMI >or=30 kg/m(2), respectively.
  
  
  RESULTS
  Lower levels of child cardiorespiratory fitness were associated with increased odds of adult obesity (adjusted odds ratio [OR] per unit decrease 3.0 [95% CI 1.6-5.6]) and insulin resistance (1.7 [1.1-2.6]). A decline in fitness level between childhood and adulthood was associated with increased obesity (4.5 [2.6-7.7]) and insulin resistance (2.1 [1.5-2.9]) per unit decline.
  
  
  CONCLUSIONS
  A decline in fitness from childhood to adulthood, and by inference a decline in physical activity, is associated with obesity and insulin resistance in adulthood. Programs aimed at maintaining high childhood physical activity levels into adulthood may have potential for reducing the burden of obesity and type 2 diabetes in adults.
authors.affiliation: Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Melbourne, Australia. terry.dwyer@mcri.edu.au
authors.forename: Terence
authors.initials: T
authors.lastname: Dwyer
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schmidt
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: Anne-Louise
authors.initials: AL
authors.lastname: Ponsonby
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.forename: Russell
authors.initials: R
authors.lastname: Thomson
authors.forename: Verity J
authors.initials: VJ
authors.lastname: Cleland
authors.forename: Alison
authors.initials: A
authors.lastname: Venn
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D001315:Australia; D002648:Child; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D010809:Physical Fitness; D012129:Respiratory Function Tests; D012959:Socioeconomic Factors