Exercise capacity: a crystal ball in forecasting future health outcomes?

Although regular physical activity plays an important role in promoting cardiovascular health, Williams(1) reported that a high level of cardiorespiratory fitness (aerobic capacity) markedly reduces one's risk of cardiovascular disease, and the reduction is greater compared with merely being physically active (Figure 1). Moreover, there appears to be an inverse relationship between cardiorespiratory fitness and complications after bariatric surgery among morbidly obese adults. Other provocative data support the hypothesis that aerobic capacity, expressed as milliliters of oxygen per kilogram of body weight per minute (mL O2/kg/min) or as metabolic equivalents (METs; 1 MET 3.5 mL O2/kg/min), is inversely associated with health care costs. Collectively, these findings and other recent reports suggest that the estimation or direct measurement of aerobic capacity can provide independent and additive data in forecasting future health outcomes.