University of Oulu

Kiviniemi, Antti M. & Perkiömäki, Nelli & Auvinen, Juha & Niemelä, Maisa & Tammelin, Tuija & Puukka, Katri & Ruokonen, Aimo & Keinänen-Kiukaanniemi, Sirkka & Tulppo, Mikko P. & Järvelin, Marjo-Riitta & Jämsä, Timo & Huikuri, Heikki V. & Korpelainen, Raija(2017) Fitness, Fatness, Physical Activity, and Autonomic Function in Midlife. Medicine and Science in Sports and Exercise, 49 (12), 2459-2468. doi:10.1249/MSS.0000000000001387

Fitness, fatness, physical activity, and autonomic function in midlife

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Author: Kiviniemi, Antti M.1,2; Perkiömäki, Nelli1,2; Auvinen, Juha3,4;
Organizations: 1Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Unit of Primary Care, Oulu University Hospital, Oulu, Finland
5Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
6LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
7NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
8Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
9Biocenter Oulu, University of Oulu, Oulu, Finland
10Diagnostic Imaging, Oulu University Hospital, Oulu, Finland
11Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.9 MB)
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Language: English
Published: Wolters Kluwer, 2017
Publish Date: 2019-05-09


Purpose: Although low cardiorespiratory fitness (CRF), physical inactivity, and obesity are associated with impaired autonomic function, they are also extensively interrelated. The present study aimed to assess the extent to which they contribute to autonomic function independently of each other.

Methods: At the age of 46 yr, 1383 men and 1761 women without cardiorespiratory diseases and diabetes underwent assessments of vagally mediated heart rate (HR) variability (root mean square of successive differences in R-R interval (rMMSD)), peak HR during a submaximal step test (CRF), and 60-s HR recovery (HRR). Moderate-to-vigorous physical activity (MVPA; ≥3.5 METs, 2 wk) was measured by wrist-worn accelerometer and body fat percentage (Fat%) by bioimpedance

Results: In men, CRF and Fat% were significantly associated with higher rMSSD (standardized β = 0.31 and -0.16) and HRR (β = 0.19 and -0.18), whereas higher MVPA was linked with higher HRR (β = 0.13) when including CRF, MVPA, and Fat% in the initial regression. After adjustments for other lifestyle and cardiometabolic factors, CRF remained significantly associated with rMMSD (β = 0.24) and HRR (β = 0.14), as did MVPA with HRR (β = 0.11). In women, CRF was associated with rMSSD (β = 0.23) and HRR (β = 0.15), and MVPA (β = 0.17) and Fat% (β = -0.07) with HRR, when CRF, MVPA, and Fat% were adjusted for each other. After further adjustments, CRF remained a significant determinant of rMSSD (β = 0.20) and HRR (β = 0.13), as did MVPA with HRR (β = 0.15). The final models explained 23% and 21% of variation in rMSSD and HRR in men, and 10% and 12% in women, respectively.

Conclusions: CRF was a more important determinant of cardiac autonomic function than MVPA and body fat. Furthermore, MVPA but not body fat was independently associated with cardiac autonomic function in both men and women.

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Series: Medicine & science in sports & exercise
ISSN: 0195-9131
ISSN-E: 1530-0315
ISSN-L: 0195-9131
Volume: 49
Issue: 12
Pages: 2459 - 2468
DOI: 10.1249/MSS.0000000000001387
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was supported by University of Oulu [grant number 24000692], Oulu University Hospital [grant number 24301140], European Regional Development Fund [grant number 539/2010 A31592], the Academy of Finland [grant numbers 267435, 285547], Ministry of Education and Culture [grant number 86/686/2014], the Sigrid Juselius Foundation, the Finnish Foundation for Cardiovascular Research, Helsinki, Finland, and the European Union’s Horizon 2020 research and innovation programme [DynaHEALTH, grant number 633595; ALEC, grant number 633212; iHealth-T2D, grant number 643774; LifeCycle, grant number 733206].
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(643774) iHealth-T2D - Family-based intervention to improve healthy lifestyle and prevent Type 2 Diabetes amongst South Asians with central obesity and prediabetes
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
Academy of Finland Grant Number: 267435
Detailed Information: 267435 (Academy of Finland Funding decision)
285547 (Academy of Finland Funding decision)
Copyright information: © 2019 ACSM. This is an accepted manuscript version of an article available online at