Swedish study spotlights the high eventual price of early physical unfitness

A study of health outcomes among more than 1 million men who enlisted in the Swedish Armed Forces decades ago has thrown into sharp relief the connection between poor health habits in adolescence and chronic disabilities later on in life.

The findings were published online online Feb. 12 in Annals of Internal Medicine.

Pontus Henriksson, PhD, of the Karolinska Institute and colleagues analyzed the outcomes of 1,079,128 males who joined the military between 1972 and 1994 when they were 16 to 19 years old. The team’s primary reference points were measurements of cardiorespiratory fitness and body mass index (BMI) as measured at conscription and, years later, subsequent receipts of disability pensions from the government.

They found that, over a median follow-up of 28.3 years, 54,304 men (a little over 5 percent) were granted such a pension.

Drilling down into specific early risk factors and later health problems, they found low cardiorespiratory fitness was strongly associated with later receipt of a disability pension due to all causes as well as to specific causes across numerous disease states. These included psychiatric, musculoskeletal, nervous system, circulatory and cancer diagnoses.

Obesity was similarly associated with receipt of disability pensions for all as well as specific causes, and here the worst outcomes unsurprisingly reflected the most advanced obesities.

Meanwhile, the men who where moderately or highly fit at the time of conscription had a significantly reduced rate of disability claims across BMI categories.

The authors acknowledge as limitations to their study design the cohort’s lack of women and scant data on smoking and drinking. The study also lacked measures of variables and exposures at intervals between the conscriptions and the disability claims.

Still, the outcomes of the once-unfit young military men are striking for their consistency among the disability pensioners.  

“Low cardiorespiratory fitness, obesity, and the combination of the two were strongly associated with later chronic disability due to a wide range of diseases and causes,” the authors underscored. “Although additional well-designed studies are required, these findings support the importance of high cardiorespiratory fitness and healthy body weight during adolescence to prevent later chronic disease.”