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Peer-reviewedCC BY 4.0Diabetes, Obesity & Metabolism

Higher Cardiorespiratory Fitness Is Associated With a Lower Burden of Metabolic Syndrome Traits: A Cross‐Sectional Analysis of 39 197 UK Adults

  • Scott A. Willis1,2,3
  • Annalena Phillipp1,4
  • Kevin Deighton1,5
  • Christopher Goodwin5
  • Daniel J. Cuthbertson6,7
  • Shelley E. Keating8
  • Christopher J. A. Pugh9
  • Jonathan G. Stine10
  • Gaël Ennequin11,12
  • Alexis Couret11,12
  • David J. Stensel1,2,13
  • Guruprasad P. Aithal14,15
2 more authors
  • Thomas Yates2,3
  • James A. King1,2
15 affiliations
  1. 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
  2. 2NIHR Leicester Biomedical Research Centre University Hospitals of Leicester NHS Trust and the University of Leicester Leicester UK
  3. 3Diabetes Research Centre, College of Life Sciences University of Leicester Leicester UK
  4. 4Department for Physical Activity in Public Health Institute of Movement and Neurosciences, German Sport University Cologne Cologne Germany
  5. 5Nuffield Health Research Group Nuffield Health Epsom UK
  6. 6Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool Liverpool UK
  7. 7Liverpool University Hospitals NHS Foundation Trust Liverpool UK
  8. 8School of Human Movement and Nutrition Sciences The University of Queensland St Lucia Queensland Australia
  9. 9School of Life Course & Population Health Sciences King's College London London UK
  10. 10Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health Milton S. Hershey Medical Center Hershey Pennsylvania USA
  11. 11Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P) Clermont Auvergne University Clermont‐Ferrand France
  12. 12International Research Chair Health in Motion Clermont Auvergne University Foundation Clermont‐Ferrand France
  13. 13Faculty of Sport Sciences Waseda University Tokorozawa Japan
  14. 14Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine University of Nottingham Nottingham UK
  15. 15NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and the University of Nottingham Nottingham UK
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Abstract

Aims: To investigate associations of cardiorespiratory fitness (CRF) with metabolic syndrome (MetS) trait count, MetS prevalence and individual MetS traits in a large population‐based cohort.

Materials and Methods: This cross‐sectional study analysed data for 39 197 adults from a UK‐based independent healthcare charity (mean ± SD: age, 45.8 ± 9.0 years; BMI, 26.3 ± 4.1 kg⋅m−2; 31% female). CRF was estimated as peak oxygen uptake from submaximal treadmill or cycle ergometer protocols and analysed continuously and as sex‐ and mode‐specific quintiles. MetS was defined using established criteria, with outcomes examined as trait count (0–5), presence (≥ 3 traits) and individual traits. Associations were assessed using negative binomial regression for trait count and Poisson regression for MetS presence. Models were sequentially adjusted for demographics (primary model), adiposity (BMI) and hepatic steatosis (fatty liver index [FLI]).

Results: Each 1 mL⋅kg−1⋅min−1 higher CRF was associated with a 2.9% lower MetS trait count and 6.0% lower MetS prevalence (p < 0.001). Compared with the highest CRF quintile, the lowest quintile had a 2.4‐fold higher MetS trait count and 5.4‐fold higher MetS prevalence (p < 0.001). Associations persisted after BMI and FLI adjustment, although attenuated. Spline analyses demonstrated graded, non‐linear inverse associations, steepest at lower CRF levels. Higher CRF was inversely associated with all individual MetS traits, strongest for central obesity.

Conclusions: Higher CRF was associated with lower metabolic risk burden and MetS prevalence, which remained after adjustment for adiposity‐related measures. These findings support the potential public health relevance of modest fitness improvements, particularly among the least fit adults, as a strategy that may help reduce MetS burden even when adiposity changes are limited.

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Cite

BibTeXRIS
BibTeX
@article{willis2026higher,
  title = {{Higher Cardiorespiratory Fitness Is Associated With a Lower Burden of Metabolic Syndrome Traits: A Cross‐Sectional Analysis of 39 197 UK Adults}},
  author = {Scott A. Willis and Annalena Phillipp and Kevin Deighton and Christopher Goodwin and Daniel J. Cuthbertson and Shelley E. Keating and Christopher J. A. Pugh and Jonathan G. Stine and Gaël Ennequin and Alexis Couret and David J. Stensel and Guruprasad P. Aithal and Thomas Yates and James A. King},
  journal = {Diabetes, Obesity \& Metabolism},
  year = {2026},
  month = sep,
  doi = {10.1111/dom.71367},
  url = {https://doi.org/10.1111/dom.71367},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Higher Cardiorespiratory Fitness Is Associated With a Lower Burden of Metabolic Syndrome Traits: A Cross‐Sectional Analysis of 39 197 UK Adults
AU  - Scott A. Willis
AU  - Annalena Phillipp
AU  - Kevin Deighton
AU  - Christopher Goodwin
AU  - Daniel J. Cuthbertson
AU  - Shelley E. Keating
AU  - Christopher J. A. Pugh
AU  - Jonathan G. Stine
AU  - Gaël Ennequin
AU  - Alexis Couret
AU  - David J. Stensel
AU  - Guruprasad P. Aithal
AU  - Thomas Yates
AU  - James A. King
PY  - 2026
DA  - 2026/09/17
JO  - Diabetes, Obesity & Metabolism
DO  - 10.1111/dom.71367
UR  - https://doi.org/10.1111/dom.71367
AB  - Aims: To investigate associations of cardiorespiratory fitness (CRF) with metabolic syndrome (MetS) trait count, MetS prevalence and individual MetS traits in a large population‐based cohort.  Materials and Methods: This cross‐sectional study analysed data for 39 197 adults from a UK‐based independent healthcare charity (mean ± SD: age, 45.8 ± 9.0 years; BMI, 26.3 ± 4.1 kg⋅m−2; 31% female). CRF was estimated as peak oxygen uptake from submaximal treadmill or cycle ergometer protocols and analysed continuously and as sex‐ and mode‐specific quintiles. MetS was defined using established criteria, with outcomes examined as trait count (0–5), presence (≥ 3 traits) and individual traits. Associations were assessed using negative binomial regression for trait count and Poisson regression for MetS presence. Models were sequentially adjusted for demographics (primary model), adiposity (BMI) and hepatic steatosis (fatty liver index [FLI]).  Results: Each 1 mL⋅kg−1⋅min−1 higher CRF was associated with a 2.9% lower MetS trait count and 6.0% lower MetS prevalence (p < 0.001). Compared with the highest CRF quintile, the lowest quintile had a 2.4‐fold higher MetS trait count and 5.4‐fold higher MetS prevalence (p < 0.001). Associations persisted after BMI and FLI adjustment, although attenuated. Spline analyses demonstrated graded, non‐linear inverse associations, steepest at lower CRF levels. Higher CRF was inversely associated with all individual MetS traits, strongest for central obesity.  Conclusions: Higher CRF was associated with lower metabolic risk burden and MetS prevalence, which remained after adjustment for adiposity‐related measures. These findings support the potential public health relevance of modest fitness improvements, particularly among the least fit adults, as a strategy that may help reduce MetS burden even when adiposity changes are limited.
SN  - 1462-8902
SN  - 1463-1326
ER  -