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. 2019 Feb;29(2):232-239.
doi: 10.1111/sms.13328. Epub 2018 Nov 15.

Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017

Elin Ekblom-Bak  1 , Örjan Ekblom  1 , Gunnar Andersson  2 , Peter Wallin  2 , Jonas Söderling  3 , Erik Hemmingsson  1 , Björn Ekblom  1
Affiliations

Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017

Elin Ekblom-Bak et al. Scand J Med Sci Sports. 2019 Feb.

Abstract

Background: Long-term trend analyses of cardiorespiratory fitness (VO2 max) in the general population are limited.

Objectives: To describe trends in VO2 max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.

Methods: A total of 354 277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L/min) and relative (mL/min/kg) VO2 max, and the proportion with low (<32) relative VO2 max are reported. VO2 max was estimated using a submaximal cycle test.

Results: Absolute VO2 max decreased by -6.7% (-0.19 L/min) in the total population. Relative VO2 max decreased by -10.8% (-4.2 mL/min/kg) with approximately one-third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs women (8.7% vs 5.3%), in younger vs older (6.5% vs 2.3%), in short (11.4%) vs long (4.5%) education, and in rural vs urban regions (6.5% vs 3.5%), all P < 0.001. The proportions with low VO2 max increased from 27% to 46% (P < 0.001).

Conclusion: Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education, and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups.

Keywords: VO2max; aerobic capacity; maximal oxygen consumption; population; secular trend.

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Conflict of interest statement

GA (responsible for research and method) and PW (CEO and responsible for research and method) are employed at HPI Health Profile Institute. JS reports personal fees from HPI Health Profile Institute during the conduct of the study.

Figures

Figure 1
Figure 1
Change in standardized mean of absolute (L/min, left) and relative (mL/min/kg, right) VO2max from 1995 to 2017 in the total study sample and in relation to sex
Figure 2
Figure 2
Change in standardized mean of absolute (L/min, left) and relative (mL/min/kg, right) VO2max from 1995 to 2017 in relation to age‐group (A and B), length of education (C and D), and region (E and F)
Figure 3
Figure 3
Standardized proportions of women (left) and men (right) with a low VO2max using different cutoffs, from 1995 to 2017
See this image and copyright information in PMC

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