title: Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - the Lifestyle, Biomarker, and Atherosclerosis study.
abstract: BACKGROUND
  The progression of cardiovascular disease (CVD) and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0-25.9 years have been studied to identify early risk factors for atherosclerosis.
  
  
  OBJECTIVE
  The aims of this study were to 1) assess selected cardiometabolic biomarkers, carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2max); 2) analyze the associations between cIMT and lifestyle factors; and 3) identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD.
  
  
  METHODS
  Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2max was measured by ergometer bike test. The risk score was calculated according to Wildman.
  
  
  RESULTS
  cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO2max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2max (mL/kg/min) and cIMT. Using Wildman's definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001).
  
  
  CONCLUSIONS
  High aerobic fitness is associated with low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.
authors.affiliation: Department of Medical Diagnostics, Medical Faculty, School of Health Sciences.
authors.forename: Maria
authors.initials: M
authors.lastname: Fernström
authors.affiliation: Medical Faculty, School of Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Fernberg
authors.affiliation: Department of Medical Diagnostics, Medical Faculty, School of Health Sciences.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Eliason
authors.affiliation: Department of Medical Diagnostics, Medical Faculty, School of Health Sciences.
authors.forename: Anita
authors.initials: A
authors.lastname: Hurtig-Wennlöf
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D000072599:Cardiorespiratory Fitness; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D005080:Exercise Test; D005247:Feeding Behavior; D018737:Hand Strength; D064368:Healthy Volunteers; D006801:Humans; D007333:Insulin Resistance; D053580:Muscle Strength; D015995:Prevalence; D011379:Prognosis; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: aerobic fitness; body fat; cIMT; cholesterol; diet; insulin resistance