Int J Sports Med
DOI: 10.1055/a-1562-6014
Clinical Sciences

Effect Modification of Cardiorespiratory Fitness, Obesity, and Physical Activity in Adults

1   Department of Human Movement Sciences, Federal University of Sao Paulo, Santos, Sao Paulo, Brazil
Fernando Cesar Wehrmeister
2   Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
Marcello Romiti
3   Angiocorpore Institute of Cardiovascular Medicine, Santos, Sao Paulo, Brazil
Antonio Ricardo de Toledo Gagliardi#
3   Angiocorpore Institute of Cardiovascular Medicine, Santos, Sao Paulo, Brazil
1   Department of Human Movement Sciences, Federal University of Sao Paulo, Santos, Sao Paulo, Brazil
Rodolfo Leite Arantes
3   Angiocorpore Institute of Cardiovascular Medicine, Santos, Sao Paulo, Brazil
Victor Zuniga Dourado
1   Department of Human Movement Sciences, Federal University of Sao Paulo, Santos, Sao Paulo, Brazil
4   Lown Scholars Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
› Author Affiliations
Funding We are thankful to the EPIMOV team and the ATS MECOR Latin America. This work was funded by the Sao Paulo Research Foundation – FAPESP (grant # 2011/07282-6 and 2018/11817-1), and in part by FAPESP/ Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) (grant # 2018/21536-0).


We investigated if cardiorespiratory fitness modifies the association between obesity and the level of physical activity. In this cross-sectional study, we analyzed data from 746 adults, free of diagnosed cardiorespiratory or locomotor diseases. We analyzed sociodemographic and clinical information, cardiovascular risk factors, cardiorespiratory fitness, anthropometry, and level of physical activity (time spent in moderate-to-vigorous physical activity). Those that spent more time in moderate-to-vigorous physical activity were younger, male, with lower body mass index, without self-reported arterial blood hypertension, diabetes and dyslipidemia, non-smokers, and presented with better cardiorespiratory fitness. The linear regression coefficients showed that cardiorespiratory fitness changes according to the level of physical activity and body mass index (obesity in low cardiorespiratory fitness: β 6.0, p=0.213, 95%CI-3.5 to 15.6; in intermediate cardiorespiratory fitness: β 6.3, p=0.114, 95%CI-1.5 to 14.2; in high cardiorespiratory fitness: β-6.3, p=0.304, 95%CI-18.4 to 5.8). This effect modification trend was present after adjusting the model by covariates. Cardiorespiratory fitness potentially modifies the association between body mass index and the level of physical activity. It should be routinely assessed to identify persons with overweight/ obesity with low/ intermediate cardiorespiratory fitness to prescribe individualized training.

# in memoriam.

Supplementary Material

Publication History

Received: 29 January 2021

Accepted: 30 July 2021

Accepted Manuscript online:
30 July 2021

Article published online:
14 January 2022

© 2022. Thieme. All rights reserved.

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