ABSTRACT
This chapter reviews the evidence linking greater physical activity and fitness with primary prevention of cardiovascular and metabolic disease through effective risk factor management. Physical fitness, specifically cardiorespiratory fitness, is defined as the ability to deliver and utilize oxygen during sustained activity and typically quantified as maximal oxygen uptake. The association between physical activity or inactivity and prevalence of the metabolic syndrome is not clear, at least based on cross-sectional studies. The clustering of risk factors known as the metabolic syndrome is predictive of both T2DM and cardiovascular disease (CVD). CVD, in all its forms, represents the greatest threat, by far, to health and longevity in the United States and the world. In contrast, a 2004 meta-analysis of 30 longitudinal studies examining the impact of physical activity on the risk for CVD in women showed a dose-response relationship with a 20–40% reduction in risk for CVD in the most active women, compared to those who were sedentary.
