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The World Fitness Study: Estimating VO2max to predict mortality

Comment by Trine Karlsen, EACPR Exercise, Basic and Translational Research Section

A Simple Nonexercise Model of Cardiorespiratory Fitness Predicts Long-Term Mortality
B. Martens Nes, L. J. Vatten, J. Nauman, I. Janszky, U. Wisløff
Medicine & Science in Sports & Exercise 2014 Jun;46(6):1159-65. doi: 10.1249/MSS.0000000000000219


In a recent large, population based cohort study from the K.G Jebsen Center for Exercise in Medicine at the Norwegian University of Science and Technology it was demonstrated that  a simple estimation of VO2max can predict long-term cardiovascular and all-cause mortality. The study was published in Medicine & Science in Sports & Exercise in 2014.

Cardiorespiratory fitness level, measured as peak oxygen uptake (VO2max), is the single best predictor of cardiovascular morbidity and premature cardiovascular mortality. As such testing is costly and time-consuming, an estimation model for VO2max was developed in 2011 (1) on the basis of easily available clinical and self-reported variables such as age, gender, physical activity level, body composition and resting heart rate.

This model was used to estimate VO2max in more than 37,000 men and women who participated in the first wave of the Northern Trøndelag Health Survey (HUNT study) in 1984-86 and followed in national registries until date of death. For each metabolic equivalent (MET, corresponding to oxygen consumption of 3.5 mL•kg-1•min-1) higher estimated VO2max, the risk of cardiovascular mortality was reduced by 21% in both men and women who were below 60 years at baseline. This risk reduction is comparable to what has been reported in studies where fitness has been measured directly on a treadmill or stationary bike.

According to the first author of the publication, Post Doctor Bjarne M Nes;

“This method for assessing fitness is a feasible and practical alternative to identify unfit individuals with increased cardiovascular mortality risk. Base on the results one can help individuals to benefit from structured exercise counselling”.

The prediction model is currently in use in the web-based crowd sourcing project 'the world fitness study', run by the K.G Jebsen Center for Exercise in Medicine. The study allows everyone with internet access to estimate their maximal oxygen uptake, fitness age and prognosis. Currently 200 000 people have contributed data to the worlds fitness study, while 2.5 million have used the fitness calculator.

The study serves as an example of how data from population based studies, with an innovative approach, may be available and useful for both the public and health services internationally.

Estimating VO2peak from a nonexercise prediction model: the HUNT Study, Norway.
Nes BM, Janszky I, Vatten LJ, Nilsen TI, Aspenes ST, Wisløff U.
Med Sci Sports Exerc. 2011 Nov;43(11):2024-30. doi: 10.1249/MSS.0b013e31821d3f6f.