{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T09:29:07Z","timestamp":1782206947959,"version":"3.54.5"},"reference-count":43,"publisher":"BMJ","issue":"16","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AG06945"],"award-info":[{"award-number":["AG06945"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK088195"],"award-info":[{"award-number":["DK088195"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HL133069"],"award-info":[{"award-number":["HL133069"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HL62508"],"award-info":[{"award-number":["HL62508"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Restrictive spirometry pattern (RSP) suggests an impairment of lung function associated with a significantly increased risk of premature mortality. We evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index with incident RSP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from the Aerobics Centre Longitudinal Study included 12\u2009360 participants (18\u201382 years). CRF was assessed by maximal treadmill test and categorised into five groups. Body mass index was categorised into normal weight (&lt;25.0\u2009kg\/m<jats:sup>2<\/jats:sup>), overweight (25.0\u201329.9\u2009kg\/m<jats:sup>2<\/jats:sup>) or obesity (\u226530.0\u2009kg\/m<jats:sup>2<\/jats:sup>). RSP was defined as the simultaneous occurrence of forced expiratory volume in 1\u2009s\/force vital capacity \u2265lower limit of normal and forced vital capacity &lt;lower limit of normal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 900 (7.3%) cases of RSP (mean follow-up: 6.9 years). Compared with category 1 (\u2018least fit\u2019), HRs (95% CIs) of RSP were 0.78 (0.63 to 0.96), 0.68 (0.54 to 0.86), 0.70 (0.55 to 0.88) and 0.59 (0.45 to 0.77) in categories 2, 3, 4 and 5 (most fit), respectively, after adjusting for confounders including body mass index. Compared with normal weight, HRs (95% CIs) of RSP were 1.06 (0.91 to 1.23) and 1.30 (1.03 to 1.64) in overweight and obese, respectively. However, the association between obesity and RSP was attenuated when additionally adjusting for CRF (HR 1.08, 95%\u2009CI 0.84 to 1.39). Compared with the \u2018unfit and overweight\/obese\u2019 group, HRs (95% CIs) for RSP were 1.35 (0.98 to 1.85), 0.77 (0.63 to 0.96) and 0.70 (0.56 to 0.87) in the \u2018unfit and normal weight,\u2019 \u2018fit and overweight\/obese\u2019 and \u2018fit and normal weight\u2019 groups, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Low CRF was associated with a greater incidence of RSP, irrespective of body mass index. Future studies are needed to explore potential underlying mechanisms of this association and to prospectively evaluate if improving CRF reduces the risk of developing RSP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2022-106136","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T13:20:17Z","timestamp":1673011217000},"page":"1011-1017","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Associations of cardiorespiratory fitness and body mass index with incident restrictive spirometry pattern"],"prefix":"10.1136","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-9433","authenticated-orcid":false,"given":"Joey M","family":"Saavedra","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Iowa State University, Ames, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2038-389X","authenticated-orcid":false,"given":"Angelique G","family":"Brellenthin","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Iowa State University, Ames, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong Kil","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Iowa State University, Ames, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-5341","authenticated-orcid":false,"given":"Duck-chul","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Iowa State University, Ames, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven N","family":"Blair","sequence":"additional","affiliation":[{"name":"Departments of Exercise Science and Epidemiology & Biostatistics, University of South Carolina, Columbia, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"2025080112295747000_57.16.1011.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-1045"},{"key":"2025080112295747000_57.16.1011.2","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.rmed.2016.10.005","article-title":"Restrictive spirometric pattern in the general adult population: methods of defining the condition and consequences on prevalence","volume":"120","author":"Backman","year":"2016","journal-title":"Respir Med"},{"key":"2025080112295747000_57.16.1011.3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"2025080112295747000_57.16.1011.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00086313"},{"key":"2025080112295747000_57.16.1011.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.088112"},{"key":"2025080112295747000_57.16.1011.6","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2018.1506331"},{"key":"2025080112295747000_57.16.1011.7","unstructured":"World Health Organization (WHO) . 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