Fit elderly have reduced cardiovascular risk even if they sit a lot

The PhD thesis of Silvana Bucher Sandbakk highlights the importance of high physical capacity to prevent cardiovascular disease in the elderly.


  1. Elderly men and women with cardiovascular disease have significantly lower cardiorespiratory fitness than healthy elderly.
  2. High cardiorespiratory fitness eliminates the adverse effects of prolonged sedentary time on cardiovascular health in the elderly. Oxygen uptake seems to be more important for cardiovascular health than fulfilling the recommendations for physical activity given by the health authorities.
  3. Combined low fitness and high fatness cumulatively associate with cardiovascular risk factor clustering in men and women aged 70–77 years.


Thesis: Fitness and Health in Older Adults. High Cardiorespiratory Fitness as a Mediator of the Cardiovascular Risk Associated with Sedentariness and Adiposity
Candidate: Silvana Bucher Sandbakk
Time: October 12, 2017 at 12:15
Place: Medical Technical Research Centre, St. Olavs Hospital: Auditorium MTA
Link to university website (in Norwegian)


(1) The first of Sandbakk’s studies provides the world’s largest reference data for cardiorespiratory fitness in elderly. In The Generation 100 studyoxygen uptake was measured in more than 1500 men and women aged 70–77 years.

Mean results were 31.3 mL/(kg*min) for men and 26.2mL/(kg*min) for women. Men with cardiovascular disease had 19 % lower oxygen uptake than men without cardiovascular disease. For women the difference was 14 %.

(2) Data from more than 900 of the Generation 100 participants was included in Sandbakk’s two cross sectional association studies. Individuals with high cardiovascular risk were identified as those who had at least three of the five risk factors that constitute the metabolic syndrome.

Each hour of sedentary time was associated with increased odds of risk factor clustering. Also, low cardiorespiratory fitness was independently linked to high cardiovascular risk. However, the participants who sat a lot, but still had high cardiorespiratory fitness, did not have increased odds of risk factor clustering compared to the similarly fit elderly who sat less. All associations were independent of gender, age, smoking and alcohol consumption, and also independent of meeting the physical activity consesus recommendations.

(3) Elderly with the combination of an unhealthy body composition and low cardiorespiratory fitness had a substantially increased odds of cardiovascular risk factor clustering. Compared to fit and lean elderly, the likelyhood of poor cardiovascular health was six-fold higher in individuals with high body mass index and low fitness. Moreover, the combination of low oxygen uptake and high fat percentage or a high waist circumference was associated with five-fold increased odds of risk factor clustering.

Being lean did not attenuate all the negative consequences of low cardiorespiratory fitness. Also, elderly who were both fit and fat had higher cardiovascular risk than similarly fit non-obese participants.


(2) Sandbakk, S. B., Nauman, J., Zisko, N., Sandbakk, Ø., Aspvik, N. P., Stensvold, D., & Wisløff, U. (2016, November). Sedentary Time, Cardiorespiratory Fitness, and Cardiovascular Risk Factor Clustering in Older Adults–the Generation 100 Study. In Mayo Clinic Proceedings (Vol. 91, No. 11, pp. 1525-1534). Elsevier.

(1) Stensvold, D., Sandbakk, S. B., Viken, H., Zisko, N., Reitlo, L. S., Nauman, J., Gaustad, S. E., Hassel, E., Moufack, M., Brønstad, E., Aspvik, N. P., Malmo, V., Steinshamn, S. L., Støylen, A., Anderssen, S. A., Helbostad, J. L., Rognmo, Ø., & Wisløff, U. (2017). Cardiorespiratory Reference Data in Older Adults: The Generation 100 StudyMedicine and science in sports and exercise.

(3) Sandbakk, S. B., Nauman, J., Lavie, C. J., Wisløff, U., & Stensvold, D. (2017). Combined Association of Cardiorespiratory Fitness and Body Fatness With Cardiometabolic Risk Factors in Older Norwegian Adults: The Generation 100 StudyMayo Clinic Proceedings: Innovations, Quality & Outcomes1(1), 67-77.

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