Date of Award


Document Type


Degree Name

Master of Science (MS)


Kinesiology & Public Health Education

First Advisor

Grant R. Tomkinson


Objective: To estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of adults, and examine relationships between CRF trends and trends in socioeconomic and health-related indicators.

Methods: Data were obtained from a systematic search of studies that explicitly reported temporal trends in the CRF of apparently healthy adults aged 18–59. Sample-weighted temporal trends were estimated using best-fitting regression models relating the year of testing to mean CRF. Post-stratified population-weighted mean changes in percent and standardized CRF were estimated. Pearson’s correlations were used to describe associations between linear trends in CRF and linear trends in socioeconomic and health-related indicators.

Results: 2,525,827 adults representing eight high- and upper-middle-income countries between 1967 and 2016 collectively showed a moderate decline of 7.7% (95%CI: –8.4 to –7.0), [1.6% per decade (95%CI: –1.7 to –1.5)]. Internationally, CRF improved in the 1960s and 1970s, and progressively declined at an increasing rate in subsequent decades. Declines were larger for men than women, and for young adults (<40 years) than middle-aged adults (≥40 years). All countries experienced declines in CRF with a strong negative correlation between obesity trends and CRF trends.

Conclusions: There has been a meaningful decline in the CRF of adults from high- and upper-middle-income countries since 1980, which has progressively increased in magnitude over time, suggestive of a meaningful decline in population health. Continuous national and international surveillance systems are needed in order to monitor trends in health and fitness, especially among low- and middle-income countries for which data do not currently exist.

ThesisSupplement 1-LitSearch.pdf (5 kB)
Literature Search Details

ThesisSupplement 2IncRef.pdf (266 kB)
Included Studies References