Measuring physical fitness in the German National Cohort-methods, quality assurance, and first descriptive results

Physical fitness is defined as an individual's ability to be physically active. The main components are cardiorespiratory fitness (CRF), muscle strength, and flexibility. Regardless of physical activity level, physical fitness is an important determinant of morbidity and mortality. The aim of the current study was to describe the physical fitness assessment methodology in the German National Cohort (NAKO) and to present initial descriptive results in a subsample of the cohort. In the NAKO, hand grip strength (GS) and CRF as physical fitness components were assessed at baseline using a hand dynamometer and a submaximal bicycle ergometer test, respectively. Maximum oxygen uptake (VO2max) was estimated as a result of the bicycle ergometer test. The results of a total of 99,068 GS measurements and 3094 CRF measurements are based on a data set at halftime of the NAKO baseline survey (age 20-73 years, 47% men). Males showed higher values of physical fitness compared to women (males: GSx202f;= 47.8x202f;kg, VO2max& x202f;= 36.4x202f;ml center dot min(-1)& x202f;center dot kg(-1); females: GSx202f;= 29.9x202f;kg, VO(2max)x202f;= 32.3x202f;mlx202f;center dot min(-1)& x202f;center dot kg(-1)). GS declined from the age of 50 onwards, whereas VO2max levels decreased continuously between the age groups of 20-29 and >= 60 years. GS and VO2max showed a linear positive association after adjustment for body weight (males beta& x202f;= 0.21; females beta& x202f;= 0.35). These results indicate that the physical fitness measured in the NAKO are comparable to other population-based studies. Future analyses in this study will focus on examining the independent relations of GS and CRF with risk of morbidity and mortality.