The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Does Fitness and Body Weight in Adolescents Predict Later-Life Disability?

Posted in

Thursday, Sep 12, 2019

Can too much fat and too little fitness in teens lead to disability down the road?

It’s no secret that the combination of obesity and a sedentary lifestyle are wreaking havoc on our health. Americans of all ages from childhood to adulthood are suffering because of a lack of physical activity and poor nutrition. 

For kids and teens, the problem has long-reaching effects. Adolescents already get inadequate amounts of physical activity from too much screen time (i.e. social media, video games, and binge-watching TV), driving everywhere, and optional or non-existent P.E. classes in schools. Add to that a never-ending exposure to fast food and it is no wonder why obesity rates among young people are at an all-time high.

This current situation gives rise to an interesting and important question:

Does fitness and body weight status during adolescence have any association with the risk of disability later in life? 

A recent study reported results on over 1 million Swedish male adolescents between the ages of 16 and 19, who were conscripted into the military between 1972 and 1994. Researchers measured their body mass index (BMI)* and cardiorespiratory fitness level (CRF)* at baseline and followed up an average of 28 years later to see if they were receiving disability pensions. 

The results were as follows:

  • Adolescents in the bottom 10% of fitness were four times more likely to be on disability later in life than those in the top 10% of fitness. 
  • Those with a BMI greater than 35 were 2.5 times more likely to receive a disability pension later in life when compared to a “normal” BMI (18.5-24.9 kg/m2).
  • Within each of the six BMI categories, those who were in the High fitness group were substantially less likely to receive a disability pension later in life compared to those who were Low fitness group.

The results indicate that the BMI and CRF status of male adolescents is strongly associated with their future risk of disability. The results also support the position of the American Heart Association that CRF should be considered a clinical vital sign.

The study highlights what we already know - we must prioritize fitness and physical activity to improve the health of our children. The cost of their health comes at great cost to us all.  

*BMI was categorized as:

  • Underweight (<18.5 kg/m2)
  • Normal Weight (18.5 - 24.9 kg/m2)
  • Overweight (25 - 29.9 kg/m2)
  • Class 1 Obese (30 - 34.9 kg/m2)
  • Class 2 Obese (35 - 39.9 kg/m2)
  • Class 3 Obese (>40 kg/m2)

*CRF was classified as:

  • Low (bottom 20%)
  • Moderate (20 - 80%)
  • High (top 20%)  


Henriksson, P., Henriksson, H., Tynelius, P., Beglind, D., Lof, M., Lee, IM, Shiroma, E., Ortega, F. (2019). Fitness and Body Mass Index during Adolescence and Disability Later in Life. Annals of Internal Medicine, doi:10.7326/M18-1861.