Developmental Origins of Physical Fitness: The Helsinki Birth Cohort Study

PLOS ONE, Jul 2011

Background Cardiorespiratory fitness (CRF) is a major factor influencing health and disease outcomes including all-cause mortality and cardiovascular disease. Importantly CRF is also modifiable and could therefore have a major public health impact. Early life exposures play a major role in chronic disease development. Our aim was to explore the potential prenatal and childhood origins of CRF in later life. Methods/Principal Findings This sub-study of the HBCS (Helsinki Birth Cohort Study) includes 606 men and women who underwent a thorough clinical examination and participated in the UKK 2-km walk test, which has been validated against a maximal exercise stress test as a measure of CRF in population studies. Data on body size at birth and growth during infancy and childhood were obtained from hospital, child welfare and school health records. Body size at birth was not associated with adult CRF. A 1 cm increase in height at 2 and 7 years was associated with 0.21 ml/kg/min (95% CI 0.02 to 0.40) and 0.16 ml/kg/min (95% CI 0.03 to 0.28) higher VO2max, respectively. Adjustment for adult lean body mass strengthened these findings. Weight at 2 and 7 years and height at 11 years became positively associated with CRF after adult lean body mass adjustment. However, a 1 kg/m2 higher BMI at 11 years was associated with −0.57 ml/kg/min (95% CI −0.91 to −0.24) lower adult VO2max, and remained so after adjustment for adult lean body mass. Conclusion/Significance We did not observe any significant associations between body size at birth and CRF in later life. However, childhood growth was associated with CRF in adulthood. These findings suggest, importantly from a public point of view, that early growth may play a role in predicting adult CRF.

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Developmental Origins of Physical Fitness: The Helsinki Birth Cohort Study

et al. (2011) Developmental Origins of Physical Fitness: The Helsinki Birth Cohort Study. PLoS ONE 6(7): e22302. doi:10.1371/journal.pone.0022302 Developmental Origins of Physical Fitness: The Helsinki Birth Cohort Study Minna K. Salonen 0 Eero Kajantie 0 Clive Osmond 0 Tom Forse n 0 Hilkka Yliha rsila 0 Maria Paile- 0 Hyva rinen 0 D. J. P. Barker 0 Johan G. Eriksson 0 J. Jaime Miranda, Universidad Peruana Cayetano Heredia, Peru 0 1 Department of Chronic Disease Prevention, National Institute for Health and Welfare , Helsinki , Finland , 2 Department of Public Health, University of Helsinki, Finland, 3 Epidemiology Resource Centre , Southampton , United Kingdom , 4 Vaasa Health Care Centre, Diabetes Unit , Vaasa , Finland , 5 Developmental Origins of Health and Disease Division, University of Southampton , Southampton , United Kingdom , 6 Department of General Practice and Primary Health Care, University of Helsinki , Helsinki , Finland , 7 Helsinki University Central Hospital, Unit of General Practice, Finland, 8 Vaasa Central Hospital , Vaasa , Finland , 9 Folkha lsan Research Center , Helsinki , Finland Background: Cardiorespiratory fitness (CRF) is a major factor influencing health and disease outcomes including all-cause mortality and cardiovascular disease. Importantly CRF is also modifiable and could therefore have a major public health impact. Early life exposures play a major role in chronic disease development. Our aim was to explore the potential prenatal and childhood origins of CRF in later life. Methods/Principal Findings: This sub-study of the HBCS (Helsinki Birth Cohort Study) includes 606 men and women who underwent a thorough clinical examination and participated in the UKK 2-km walk test, which has been validated against a maximal exercise stress test as a measure of CRF in population studies. Data on body size at birth and growth during infancy and childhood were obtained from hospital, child welfare and school health records. Body size at birth was not associated with adult CRF. A 1 cm increase in height at 2 and 7 years was associated with 0.21 ml/kg/min (95% CI 0.02 to 0.40) and 0.16 ml/kg/min (95% CI 0.03 to 0.28) higher VO2max, respectively. Adjustment for adult lean body mass strengthened these findings. Weight at 2 and 7 years and height at 11 years became positively associated with CRF after adult lean body mass adjustment. However, a 1 kg/m2 higher BMI at 11 years was associated with 20.57 ml/kg/min (95% CI 20.91 to 20.24) lower adult VO2max, and remained so after adjustment for adult lean body mass. Conclusion/Significance: We did not observe any significant associations between body size at birth and CRF in later life. However, childhood growth was associated with CRF in adulthood. These findings suggest, importantly from a public point of view, that early growth may play a role in predicting adult CRF. - Cardiorespiratory fitness (CRF) is a good indicator of overall health. Physical activity and CRF are associated with the risk of all cause mortality, cardiovascular disease and several cancers [16]. It has been also suggested, that CRF is associated with brain structure and function [7] and that improvements in CRF brought about by exercise training are implicated in the restoration of neural and cognitive functioning in older adults [810]. Animal models and epidemiological studies in humans propose that physical activity and CRF may have a prenatal origin [1116]. Babies who grow at slow rates in utero and thus end up being small or thin at birth, are at increased risk of developing cardiovascular disease (CVD), type 2 diabetes and components of the metabolic syndrome [1721] in later life. Major influences of postnatal growth patterns on later health are also well established. While results of several studies suggest that slow gain in body size during the first two years of life is associated with cardiovascular disease and its risk factors [2224], including type 2 diabetes [23] and dyslipidemia [25,26], the others have shown the opposite effect of growth during infancy [27,28] on these diseases and the risk factors. Postnatal conditions including dietary and exercise habits and other behavioral related aspects are mostly modifiable and hence important from a public health point of view. Recent findings from the NordNet Study showed that the associations found between birth weight and leisure time physical activity (LTPA) are weak within the normal birth weight range. However, both low and high birth weights were associated with lower LTPA [12]. In a previous Finnish study, a low birth weight was associated with the metabolic syndrome, but not among those who were fit and active [13]. Our previous findings in a cohort of men and women born 192433 suggest that people born thin or with a low birth weight benefit most from physical activity and exercise in adult life by getting the biggest protective effect against diabetes [14]. More recent findings from Helsinki Birt (...truncated)


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Minna K. Salonen, Eero Kajantie, Clive Osmond, Tom Forsén, Hilkka Ylihärsilä, Maria Paile-Hyvärinen, D. J. P. Barker, Johan G. Eriksson. Developmental Origins of Physical Fitness: The Helsinki Birth Cohort Study, PLOS ONE, 2011, 7, DOI: 10.1371/journal.pone.0022302