Having high levels of physical fitness in middle age appears to counteract the increased risk of developing chronic kidney disease (CKD) associated with low socioeconomic status, new research suggests.
The researchers analyzed data from men in Finland who participated in the Kuopio Ischemic Heart Disease Risk Factor (KIHD) study. The mean age at enrollment was 53 years and the participants were followed for approximately 25 years.
Socio-economic status was determined on the basis of self-reported income, education, occupation, standard of living and housing conditions. Cardiorespiratory fitness was determined based on peak oxygen uptake (VO2 max) during a stationary cycling test at the time of study participants.
As expected, men with low socioeconomic status had a greater risk of developing CKD between the ages of 60 and 70 than men with high socioeconomic status, while men with high cardiorespiratory fitness had a lower risk of CKD than men with high socioeconomic status. low cardiorespiratory fitness.
Men with low values for both socioeconomic status and cardiorespiratory fitness had a greater risk of developing CKD during follow-up than men with high values for these measures after adjusting for multiple factors associated with the risk of kidney disease.
However, men with low socioeconomic status and high cardiorespiratory fitness had no increased risk of developing CKD, compared to men with high values for these measures.
The study is published in The American Journal of Medicine.
Regular exercise reduces disease risk in all organs
“Regular physical activity is a powerful strategy that can reduce the risk of disease in all organ systems in the human body, including the kidneys,” summarized lead author Setor Kunutsor, MD, PhD, senior lecturer in Evidence Synthesis, Bristol University, United Kingdom, in a statement from the university.
“Despite the benefits of physical activity that is widely promoted, regular exercise is still low around the world,” he said. “More needs to be done to promote physical activity participation among all populations, regardless of age, gender, disability and socioeconomic status.”
“The findings are expected to be similar in women as the benefits of physical activity extend to women as well,” Knutsor speculated in an email to Medscape medical news.
The results suggest the need for regular exercise even as people get older, he said, in light of the World Health Organization’s recommendations (150 to 300 minutes of moderate exercise per week or 75 to 150 minutes of vigorous exercise per week). week or an equivalent combination of both).
However, recent global studies show that most people do not meet the recommended goals.
“You can increase your physical activity if your health condition allows you,” advises Knutsor.
“It’s a lifelong lifestyle and it prevents the risk of developing several diseases, such as hypertension, heart disease, heart failure and diabetes, as well as chronic kidney disease,” he said. “It even slows the progression of these diseases if you already have them.
“Populations at high risk for these chronic diseases, including the socio-economically disadvantaged, need more education about the substantial benefits of physical activity” to lower the risk of chronic disease and slow disease progression, Kunutsor said.
More public health posts about this modifiable risk factor for disease are needed, he continued, along with subsidized or possibly even free gym memberships for underprivileged people.
Primary care providers have an important role to play in promoting physical activity, he added, as they are “the first point of contact while providing health care.”
Socio-economic status, fitness and CKD risk
It is well known that lower socioeconomic status and low cardiorespiratory fitness are each associated with an increased risk of CKD, Kunutsor and colleagues write in their paper.
They hypothesized that high cardiorespiratory fitness might counteract the increased risk of CKD due to low socioeconomic status.
They analyzed data from 2,099 men in the KIHD study who lived in and around Kuopio, Finland, and were 42 to 61 years old between 1984 and 1989 when they entered the study.
The analysis was limited to men with normal renal function who had completed lifestyle and demographic questionnaires and who had undergone exercise testing to measure cardiorespiratory fitness.
The men’s socioeconomic status score averaged 8.5 (with scores ranging from 0 to 25, with 25 indicating the lowest socioeconomic status), and their VO2 max was 30.3 ml/kg/min.
At a median follow-up of 25.8 years, there were 197 CKD events defined as renal injury or estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m22 for 3 months or longer.
Low socioeconomic status was associated with a significantly increased risk of CKD (hazard ratio [HR]1.55) compared with high socioeconomic status after adjusting for age, systolic blood pressure, type 2 diabetes, smoking, hypertension, coronary artery disease, total cholesterol, alcohol consumption, eGFR, and physical activity.
High cardiorespiratory fitness was associated with a significantly reduced risk of CKD compared to low fitness (HR 0.66) after adjusting for multiple variables, including socioeconomic status.
Compared to men of high socioeconomic status and high cardiorespiratory fitness, men with low values for both measures had a significantly increased risk of CKD (HR, 1.88).
However, there was no significant association between low socioeconomic status/high cardiorespiratory fitness and risk of CKD.
The researchers acknowledge that since this was an observational study, there may be residual confounding or reverse causality, so it cannot prove cause and effect.
Nevertheless, the study suggests that “when you compare physical activity to income, physical activity is a more protective factor against chronic disease,” Knutsor concluded.
The study was supported by the Finnish Foundation for Cardiovascular Research, Helsinki, Finland. The authors have not disclosed any relevant financial relationships.
Ben J Med. Published online July 22, 2022. Full text
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