Obesity is a widespread and growing problem worldwide and is among the most important health challenges of the 21st century. 1 Exercise is an important component in the prevention and treatment of obesity and, thus, an accurate assessment of the patient's cardiorespiratory fitness (CRF) level to determine optimal workout intensities, exercise modes, and exercise routines is critical. 2 Moreover, a proper quantification and interpretation of CRF is important for assessing who has low CRF, underlying comorbidities, and increased disease risk.Peak oxygen uptake ( o 2 peak ) is routinely measured as a means of evaluating CRF by exercise physiologists, allied health-care providers, epidemiologists, Background: The quantifi cation and interpretation of cardiorespiratory fi tness (CRF) in obesity is important for adequately assessing cardiovascular conditioning , underlying comorbidities, and properly evaluating disease risk. We retrospectively compared peak oxygen uptake ( O 2 peak) (ie, CRF) in absolute terms, and relative terms (% predicted) using three currently suggested prediction equations (Equations R, W, and G). Methods: There were 19 nonobese and 66 obese participants. Subjects underwent hydrostatic weighing and incremental cycling to exhaustion. Subject characteristics were analyzed by independent t test, and % predicted O 2 peak by a two-way analysis of variance (group and equation) with repeated measures on one factor (equation).
Results: O 2 peak (L/min) was not different between nonobese and obese adults (2.35 Ϯ 0.80 [SD] vs2.39 Ϯ 0.68 L/min). O 2 peak was higher ( P , .02) relative to body mass and lean body mass in the nonobese (34 Ϯ 8 mL/min/kg vs 22 Ϯ 5 mL/min/kg, 42 Ϯ 9 mL/min/lean body mass vs 37 Ϯ 6 mL/min/lean body mass). Cardiorespiratory fi tness assessed as % predicted was not different in the nonobese and obese (91% Ϯ 17% predicted vs 95% Ϯ 15% predicted) using Equation R, while using Equation W and G, CRF was lower ( P , .05) but within normal limits in the obese (94 Ϯ 15 vs 87 Ϯ 11; 101% Ϯ 17% predicted vs 90% Ϯ 12% predicted, respectively), depending somewhat on sex. Conclusions: Traditional methods of reporting O 2 peak do not allow adequate assessment and quantifi cation of CRF in obese adults. Predicted O 2 peak does allow a normalized evaluation of CRF in the obese, although care must be taken in selecting the most appropriate prediction equation, especially in women. In general, otherwise healthy obese are not grossly deconditioned as is commonly believed, although CRF may be slightly higher in nonobese subjects depending on the uniqueness of the prediction equation.
CHEST 2012; 141(4):1031-1039Abbreviations: CRF 5 cardiorespiratory fi tness; LBM 5 lean body mass; MW 5 measured weight; PW 5 predicted weight; o 2 5 oxygen uptake; o 2 peak 5 peak oxygen uptake.