title: The association of fitness with reduced cardiometabolic risk among smokers.
abstract: BACKGROUND
  Despite the health benefits associated with smoking cessation, continued smoking and relapse following cessation are common. Physical activity is associated with reduced risk of cardiovascular disease in general, though less is known about how cardiorespiratory fitness may influence cardiometabolic risk among smokers. Strategies are needed to protect against the health consequences of smoking among those unwilling or unable to quit smoking. The purpose of this study is to determine whether greater cardiorespiratory fitness is associated with reduced metabolic risk among smokers.
  
  
  METHODS
  The prospective influence of estimated cardiorespiratory fitness (i.e., maximal METs) on the development of metabolic syndrome and its components were examined among adult smokers (N=1,249) who completed at least two preventive medical visits at the Cooper Clinic (Dallas TX) between 1979 and 2011. Statistical analyses were completed in 2013 and 2014.
  
  
  RESULTS
  The rate and risk for metabolic syndrome, as well as abnormal fasting glucose and high-density lipoprotein cholesterol levels declined linearly with increases in cardiorespiratory fitness (all p<0.05). Smokers in the moderate and high fitness categories had significantly reduced risk of developing metabolic syndrome and elevated fasting glucose relative to smokers in the lowest fitness category. In addition, smokers in the high fitness category were less likely to develop abnormal high-density lipoprotein cholesterol levels.
  
  
  CONCLUSIONS
  Moderate to high cardiorespiratory fitness among smokers is associated with a reduced likelihood of developing certain cardiovascular disease risk factors and metabolic syndrome.
authors.affiliation: University of Texas Health Science Center, School of Public Health; University of Texas Southwestern Medical Center, Harold C. Simmons Cancer Center, Population Science and Cancer Control Program. Electronic address: darla.kendzor@utsouthwestern.edu.
authors.forename: Darla E
authors.initials: DE
authors.lastname: Kendzor
authors.affiliation: Cooper Institute.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Finley
authors.affiliation: University of Texas Health Science Center, School of Public Health; Cooper Institute.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.affiliation: University of Texas Health Science Center, School of Public Health.
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Whitehurst
authors.affiliation: University of Texas Health Science Center, School of Public Health; University of Texas Southwestern Medical Center, Harold C. Simmons Cancer Center, Population Science and Cancer Control Program.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Businelle
authors.affiliation: University of Texas Health Science Center, School of Public Health; University of Texas Southwestern Medical Center, Harold C. Simmons Cancer Center, Population Science and Cancer Control Program.
authors.forename: Bijal A
authors.initials: BA
authors.lastname: Balasubramanian
authors.affiliation: Cooper Clinic, Dallas, Texas.
authors.forename: Nina B
authors.initials: NB
authors.lastname: Radford
authors.affiliation: Intramural Research Department, The American Cancer Society, Atlanta, Georgia.
authors.forename: Kerem
authors.initials: K
authors.lastname: Shuval
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000378:metabolism*