title: Fitness and adiposity as predictors of functional limitation in adults.
abstract: BACKGROUND
  This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.
  
  
  METHODS
  Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age-and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.
  
  
  RESULTS
  After adjusting for potential confounders and either BMI or WC, CRF was inversely related to IFL (P trend < .001). The association between BMI and IFL was significant after adjusting for all confounders (P trend = .002), but not after additional adjustment for CRF (P trend = .23). After controlling for all confounders and CRF, high WC was associated with greater odds of IFL in those aged 30 to 49; normal WC was associated with greater odds of IFL in those aged 50+.
  
  
  CONCLUSIONS
  CRF was a significant predictor of IFL in middle aged and older adults, independent of overall or abdominal adiposity. Clinicians should consider the importance of preserving functional capacity by recommending regular physical activity for normal-weight and overweight individuals.
authors.affiliation: Dept of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
authors.forename: Andréa L
authors.initials: AL
authors.lastname: Maslow
authors.forename: Anna E
authors.initials: AE
authors.lastname: Price
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.forename: Duck-chul
authors.initials: DC
authors.lastname: Lee
authors.forename: Ikka
authors.initials: I
authors.lastname: Vuori
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D002320:Cardiovascular Physiological Phenomena; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D010809:Physical Fitness / Q000502:physiology*; D011446:Prospective Studies; D012143:Respiratory Physiological Phenomena; D013781:Texas; D055105:Waist Circumference; D055815:Young Adult