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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pulmonary function is a fundamental aspect of respiratory health&#44; achieving its highest levels in young adulthood&#44; around the ages of 20&#8211;25&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> Tobacco smoke exposure is a well-documented major risk factor for &#8220;impaired respiratory health&#8221;&#8212;a condition that can progress to chronic lung disease due to diminished lung growth and function&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> Furthermore&#44; recent research also suggests associations between impaired respiratory health and factors such as air pollution&#44; obesity&#44; and low physical fitness levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;3</span></a> A reduction in lung function not only limits exercise capacity but also increases the risk of respiratory and cardiovascular diseases&#44; lowers health-related quality of life &#40;HRQoL&#41;&#44; and results in increased respiratory hospitalizations&#44; mortality&#44; and healthcare demands&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">4&#8211;6</span></a> Therefore&#44; it is crucial to identify and address these modifiable risk factors to preserve and enhance lung function&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical fitness serves as a critical indicator of health outcomes and influences long-term health&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> Studies have evaluated physical fitness through cardiorespiratory fitness &#40;CRF&#41; and muscular fitness&#44; using various tests to measure them either separately or together&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a> Research suggests that enhanced aerobic fitness in childhood and adolescence plays a significant role in lung development&#44; leading to improvements in FEV<span class="elsevierStyleInf">1</span> and FVC from ages 9 to 26&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Additionally&#44; young adults with higher baseline CRF levels&#44; as measured by treadmill tests&#44; showed reduced declines in FEV<span class="elsevierStyleInf">1</span> and FVC over 20 years&#44; according to the Coronary Artery Risk Development in Young Adults &#40;CARDIA&#41; study&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a> While these findings suggest that CRF contributes to lung development and may help protect against future declines in lung function&#44; the relatively small effect sizes reported indicate that the impact of fitness on lung function requires further clarification&#46; Furthermore&#44; the causal relationship between improved lung function and gains in fitness remains lacking&#46; In the cohort&#44; when the data was analyzed with lung function as the independent variable and fitness as the dependent variable&#44; it yielded similar results&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> These results suggest a bidirectional relationship&#58; individuals with superior lung function might be predisposed to higher physical fitness levels&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Muscular fitness&#44; characterized by both muscular endurance &#40;repeated force exertion&#41; and muscular strength &#40;single maximal effort&#41;&#44; is essential for sustained activity and peak performance&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a> In children and adolescents&#44; higher muscular fitness correlates with lower obesity rates&#44; diminished cardiometabolic risks&#44; and improved HRQoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">12&#44;13</span></a> A meta-analysis highlighted that strong muscular fitness during these early years is associated with less body fat and better cardiometabolic health later in life&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> Additionally&#44; a recent study has found a positive link between muscular strength &#40;measured by handgrip strength and chair stand tests&#41; and lung function in a community general population&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> However&#44; the exact relationship between CRF&#44; muscular endurance fitness &#40;MEF&#41;&#44; and their impact on lung function&#44; especially among physically active individuals&#44; is not fully understood&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The Cardiorespiratory Fitness and Health In Armed Forces &#40;CHIEF&#41; Lung Study aims to evaluate the association between CRF &#40;time for a 3000-m run&#41; and MEF &#40;2-min push-ups and 2-min sit-ups numbers&#41; with pulmonary function&#44; and to clarify their individual impacts on the respiratory health of active young adults&#46; We hypothesize that superior CRF and MEF levels are positively associated with pulmonary function&#44; with each type of fitness making a unique correlation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">The CHIEF Lung Study meticulously assessed lung function in 1231 military recruits&#44; both male and female&#44; aged 19&#8211;38&#44; across Taiwan from 2017 to 2019 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Participants underwent medical exams for military enlistment&#44; with no history of pulmonary tuberculosis&#44; chronic lung conditions &#40;e&#46;g&#46;&#44; lung abscess&#44; emphysema&#44; asthma&#41;&#44; diaphragmatic or pleural disorders&#44; chest wall deformities&#44; or surgeries for pneumothorax or segmentectomy&#46; They participated in a rigorous daily exercise regimen at a military base for six months&#44; focusing on muscular endurance training and cardiovascular fitness&#46; The regimen required all military personnel to complete a 3000-m run twice daily at 6&#58;00<span class="elsevierStyleHsp" style=""></span>AM and 4&#58;00<span class="elsevierStyleHsp" style=""></span>PM&#44; led by the captain at a pace of 120<span class="elsevierStyleHsp" style=""></span>m per minute on weekdays&#46; Following each run&#44; all participants were required to perform 20 consecutive push-ups and sit-ups within 30<span class="elsevierStyleHsp" style=""></span>min&#46; This training course lasted until the end of June&#46; Before the mid-term physical test in July&#44; all participants underwent an annual health checkup in June&#44; which included laboratory tests and physical evaluations&#46; They also filled out a questionnaire about substance use habits&#44; such as cigarette smoking &#40;active and former&#47;never&#41;&#44; alcohol consumption&#44; and betel nut chewing at the Hualien Armed Forces General Hospital&#46; Furthermore&#44; participants underwent pulmonary function testing to assess their FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and the ratio of FEV<span class="elsevierStyleInf">1</span>&#47;FVC before undergoing the annual military exercise tests&#46; The study adhered to stringent ethical standards and was approved by the Institutional Review Board of Mennonite Christian Hospital in Hualien City &#40;No&#46; 16-05-008&#41;&#44; ensuring that all participants provided informed consent&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Blood pressure and anthropometric measurements</span><p id="par0030" class="elsevierStylePara elsevierViewall">Blood pressure &#40;BP&#41; was measured once on each participant&#39;s right arm after a 15-min rest&#44; using an automatic device &#40;FT201&#41; via the oscillometric method&#46; Mean Arterial Pressure &#40;MAP&#41; was calculated using the formula&#58; MAP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>diastolic BP<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1&#47;3 &#40;systolic BP<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>diastolic BP&#41;&#46; Anthropometric data&#44; including waist circumference &#40;WC&#41;&#44; height&#44; and weight&#44; were recorded for standing participants&#44; with body mass index &#40;BMI&#41; calculated as weight &#40;kg&#41; divided by height squared &#40;m<span class="elsevierStyleSup">2</span>&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">MEF and CRF assessments</span><p id="par0035" class="elsevierStylePara elsevierViewall">MEF in participants was assessed using 2-min push-up and sit-up tests&#44; adhering to protocols from previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> These evaluations were scheduled between 14&#58;00 and 15&#58;00 at the Military Physical Training and Testing Center&#44; allowing for a flexible sequence&#46; Performance was recorded on sponge pads with electronic or infrared sensors&#58; sit-ups required elbow contact with thigh-mounted sensors&#44; with hands near ears and feet fixed&#59; push-ups demanded correct elbow motion and a straight body alignment&#44; confirmed by sensors&#44; disqualifying any touch outside of hands or toes before time&#46; CRF was gauged through a 3000-m run&#44; performed outdoors on level ground after an hour&#39;s rest from MEF tests&#46; This field test&#44; held outdoors on flat terrain at the Military Physical Training and Testing Center&#44; was scheduled for 16&#58;00&#44; following an hour&#39;s rest after the muscular endurance tests&#46; Participants wore standard sweat suits and carried no extra items&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a> The entire run for each participant was video-recorded and monitored by eight military sports officers&#46; The run was contingent upon certain environmental factors&#58; the coefficient&#44; determined by the product of the outdoor temperature &#40;in Celsius&#41; and the relative humidity &#40;&#37;&#41; multiplied by 0&#46;1&#44; had to be below 40&#44; and there should not have been any significant rainfall&#46; The completion time of the 3000-m run was used to assess each participant&#39;s cardiorespiratory endurance capacity&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pulmonary function assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Lung function was measured with a Jaeger VyntusTM Pneumo spirometer as per the American Thoracic Society&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> Participants&#44; seated with a nose clip&#44; performed the test thrice for accurate FVC&#44; FEV<span class="elsevierStyleInf">1</span>&#44; and FEV&#47;FVC ratios&#44; inhaling fully and exhaling rapidly for 6<span class="elsevierStyleHsp" style=""></span>s&#46; The best effort was recorded via a flow-volume curve&#46; Lung function is expressed as <span class="elsevierStyleItalic">Z</span>-scores using the Global Lung Initiative reference equations&#44; accounting for height&#44; sex at birth&#44; age&#44; and Asian ethnicity&#46; In addition&#44; the predicted percentage of lung function was also presented&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analyses</span><p id="par0045" class="elsevierStylePara elsevierViewall">Continuous variables were presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; and categorical ones as frequencies and percentages &#40;&#37;&#41;&#46; Descriptive statistics described demographics and clinical characteristics&#46; The fitness data are presented as the median &#40;interquartile range&#41;&#46; Pearson&#39;s correlation and scatter plots with <span class="elsevierStyleItalic">r</span> and <span class="elsevierStyleItalic">p</span> values analyzed the relationship between pulmonary parameters and the performance of each physical test&#46; Multivariable linear regression analysis was used to examine the associations between physical performance measurements and lung functions&#46; The analysis was stratified into four distinct models&#44; each designed to incrementally build upon the previous by integrating additional variables&#46; Model 1 served as the baseline&#44; adjusting for demographic and physiological factors including age&#44; gender&#44; height&#44; weight&#44; waist circumference&#44; mean arterial pressure&#44; and smoking status&#46; Model 2 expanded on this by incorporating the 3000-m run time and the number of 2-min push-ups&#44; aiming to assess their specific impacts&#46; Model 3 followed a similar format but focused on the 3000-m run time and 2-min sit-ups&#46; Finally&#44; Model 4&#44; the most comprehensive of the series&#44; combined all the metrics from the previous models to provide a holistic view of the effects of combined physical activities on lung function&#46; Results across these models were expressed through standardized beta coefficients&#44; with significance levels noted for key findings &#40;&#42;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; &#42;&#42;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; The <span class="elsevierStyleItalic">p</span>-interaction value was calculated to assess whether there are sex differences in the association between physical fitness and lung function&#46; Analysis was performed using SPSS &#40;version 29&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Out of the initial cohort&#44; four were excluded due to acute illnesses&#44; leaving 1227 participants in the final analysis&#46; Clinical characteristics of participants are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The participants&#44; primarily male at 88&#46;2&#37;&#44; had an average age of 27&#46;4 years&#46; They maintained a healthy physique with an average BMI of 24&#46;6<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; and a waist circumference of 82&#46;3<span class="elsevierStyleHsp" style=""></span>cm&#46; Smoking status varied&#44; with 38&#37; currently smoking and 54&#37; either former smokers or having never smoked&#46; Regarding physical fitness&#44; the participants completed a 3000-m run in an average time of 15<span class="elsevierStyleHsp" style=""></span>min and 12<span class="elsevierStyleHsp" style=""></span>s and demonstrated considerable strength and endurance by performing an average of 44&#46;1 push-ups and 44&#46;6 sit-ups within a two-minute timeframe for each exercise&#46; In the study comparing clinical and physiological characteristics between sexes&#44; notable differences were observed&#46; Males were older&#44; taller&#44; and heavier than females&#44; with correspondingly higher BMI and waist circumferences&#46; Significant differences in smoking habits were evident&#44; with a higher percentage of males being active or former smokers compared to females&#44; where a majority were never smokers&#46; Physical fitness assessments showed that males performed better in muscular endurance exercises like push-ups and sit-ups&#44; and demonstrated superior cardiorespiratory fitness&#44; evidenced by shorter times in the 3000-m run compared to females&#46; Lung function measurements revealed higher absolute values of FEV<span class="elsevierStyleInf">1</span> and FVC&#44; but no differences were observed in standardized lung function metrics such as predicted percentages and <span class="elsevierStyleItalic">Z</span>-scores&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Pearson&#39;s correlation coefficients were used to assess the relationship between spirometer parameters and physical performance tests&#44; specifically focusing on CRF and MEF&#46; The relationship between pulmonary function and performance in the 3000-m run test&#44; as well as the outcomes of the 2-minute push-up and sit-up tests&#44; is illustrated in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; There is a negative correlation between the time for a 3000-m run and pulmonary function&#44; with FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41; both decreasing as the run time increases &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;29&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;27&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; No significant correlation is observed with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; Furthermore&#44; there is a positive correlation between the number of 2-min push-ups and pulmonary function&#44; with both FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>D&#41; increasing as the number of push-ups increases &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;32&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;29&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; Again&#44; no significant correlation is observed with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; Similarly&#44; a positive correlation is shown between the number of 2-minute sit-ups and pulmonary function&#44; with FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>E&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>F&#41; both increasing with a greater number of sit-ups performed &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;25&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;24&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; The FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio does not show a significant correlation&#46; These results suggest that better performance in fitness tests&#44; specifically faster run time and higher numbers of push-ups and sit-ups&#44; is associated with better pulmonary function&#44; as measured by FEV<span class="elsevierStyleInf">1</span> and FVC&#46; However&#44; these fitness performances do not appear to affect the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio significantly&#46; We also analyzed the correlation between physical fitness and standardized lung function using <span class="elsevierStyleItalic">Z</span>-scores&#46; The results showed that when lung function was presented as <span class="elsevierStyleItalic">Z</span>-scores&#44; there was no significant correlation between physical fitness and lung function &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E1&#44; Supplementary material</a>&#41;&#46; To ensure the results were not influenced by outlier effects&#44; we excluded outliers defined by more than 3 standard deviations from the mean for physical fitness and lung function&#46; Despite this&#44; the correlation between absolute lung function measurements and physical fitness remains significant &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E2&#44; Supplementary material</a>&#41;&#46; Given the established correlation between tobacco consumption and physical capacity&#44; we stratified physical fitness by cigarette smoking status&#46; The results show that active smokers exhibited better physical fitness performance in activities such as the 3000-m run&#44; 2-min push-ups&#44; and 2-min sit-ups &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E3&#44; Supplementary material</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">To elucidate the relationship between CRF and MEF&#44; data from scatter plots depicted in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A reveal a notable negative correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;48&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between the number of 2-min push-ups and time for a 3000-m run&#46; Higher numbers of push-ups correlate with shorter run times&#44; suggesting enhanced CRF&#46; Similarly&#44; a negative correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;40&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between 2-minute sit-up numbers and run time is shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>B&#44; indicating that greater muscular endurance fitness from sit-ups is associated with improved CRF&#46; The relationship is further underscored in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C&#44; which shows a strong positive correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;752&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between performance in push-ups and sit-ups&#44; indicating a consistent link between these two forms of exercise&#46; Collectively&#44; these findings highlight the interrelation of MEF and CRF&#44; as well as the association between endurance in upper and lower limb exercises&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">To determine the distinct impacts of various physical fitness modalities on pulmonary function&#44; we utilized Multivariable linear regression analyses&#44; as depicted in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In Model 1&#44; after adjusting for variables such as age&#44; gender&#44; height&#44; weight&#44; WC&#44; MAP&#44; and smoking status&#44; the results showed that time for a 3000-m run was inversely associated with both FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;117&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Additionally&#44; 2-min push-ups positively correlated with both FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;093&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;096&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41;&#46; In contrast&#44; 2-min sit-ups were only positively associated with FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;063&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;034&#41; and not with FEV<span class="elsevierStyleInf">1</span>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">To explore the potential associations between these physical activities and lung function&#44; we formulated Model 2&#8211;4&#46; These models incorporated the same variables as Model 1&#44; with the addition of either a 3000-m run&#44; 2-min push-ups&#44; or 2-min sit-ups&#46; In both Model 2 and Model 3&#44; the duration of the 3000-m run consistently demonstrated an inverse correlation with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;071&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;026&#59; standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;089&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;087&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;008&#59; standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;093&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#41;&#46; Nevertheless&#44; 2-min push-ups only positively correlated with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;067&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;043&#41; but not with FVC after adjusting for time for the 3000-m run&#46; After making the same adjustment&#44; the relationship between 2-min sit-ups and lung functions became non-significant&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">After adjusting for all covariates and incorporating the three physical activities into the Model 4&#44; time for the 3000-m run continued to show a negative relationship with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;078&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;015&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;086&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009&#41;&#46; Notably&#44; the number of 2-min push-ups maintained its positive relationship with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;014&#41; even after adjusting for time for the 3000-m run and 2-min sit-ups&#44; indicating its unique and independent association&#46; In contrast&#44; when considering the performances of time for the 3000-m run and 2-min push-ups&#44; the number of 2-min sit-ups lacked a significant relationship with both FEV<span class="elsevierStyleInf">1</span> and FVC&#46; In addition&#44; we also calculated a <span class="elsevierStyleItalic">p</span>-interaction value in <a class="elsevierStyleCrossRef" href="#sec0075">Table E1 &#40;Supplementary material&#41;</a> to determine whether sex moderates the association between physical fitness and lung function&#46; The results showed that sex has no interaction effect on the association between physical fitness and lung function&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">To investigate the contribution of lung function to maximum physical fitness&#44; we conducted a multivariate linear regression analysis&#44; adjusting for covariates such as age&#44; gender&#44; height&#44; weight&#44; MAP&#44; and smoking status&#46; The analysis revealed that pulmonary function measures&#44; when expressed as <span class="elsevierStyleItalic">Z</span>-scores&#44; did not show significant correlations with physical fitness tests &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Table E2&#44; Supplementary material</a>&#41;&#46; In contrast&#44; the absolute values of FEV<span class="elsevierStyleInf">1</span> and FVC were positively correlated with enhanced performance in the 3000-m run and push-ups &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Table E3&#44; Supplementary material</a>&#41;&#46; Additionally&#44; FVC&#44; but not FEV<span class="elsevierStyleInf">1</span>&#44; was associated with improved sit-up performance&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">In this cross-sectional study of 1227 active young adults&#44; we explored how physical fitness levels affect lung function&#46; Results showed that better performance in CRF&#44; via 3000-m run times&#44; and MEF&#44; assessed through 2-min push-ups and sit-ups&#44; correlated positively with FEV<span class="elsevierStyleInf">1</span> and FVC&#44; but not with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; We found a moderate link between 3000-m run times and push-up&#47;sit-up numbers&#44; with a strong association between push-ups and sit-ups&#46; Multivariable linear analysis revealed that shorter run times were correlated with higher FEV<span class="elsevierStyleInf">1</span> and FVC&#44; independent of MEF outcomes&#46; Notably&#44; push-ups positively influenced FEV<span class="elsevierStyleInf">1</span> alone&#44; while sit-ups showed no significant lung function effect in the fully adjusted model&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Our study found that improved CRF positively correlates with FEV<span class="elsevierStyleInf">1</span> and FVC in active young adults&#44; consistent with other research across various demographics&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">9&#44;19&#8211;22</span></a> A longitudinal study tracking children into adulthood affirmed this positive CRF association with FEV<span class="elsevierStyleInf">1</span> and FVC throughout all ages&#44; but not with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Enhancements in CRF during youth were linked to improved FEV<span class="elsevierStyleInf">1</span> and FVC in later life&#46; This beneficial association between CRF and ventilatory lung function has been observed in diverse populations&#44; including middle-aged&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">21</span></a> and elderly cohorts&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> and the general population&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">20&#44;22</span></a> Importantly&#44; CRF might not just enhance lung volume but could also improve lung diffusing capacity &#40;D<span class="elsevierStyleInf">LCO</span>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">19&#44;21</span></a> These consistent findings across studies and among different age groups highlight the substantial and positive impact of CRF on lung function throughout the life span&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The gold standard for assessing CRF is Cardiopulmonary Exercise Testing &#40;CPET&#41;&#44; which evaluates <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> or <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2peak</span>&#44; and can be estimated from work rates or algorithms&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">23</span></a> While previous research has linked CRF to lung function via <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span><a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> or <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2peak</span><a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">19&#8211;22</span></a> measurements through CPET&#44; its requirement for specific facilities and participant mask tolerance during testing limits its practicality&#44; especially for children&#44; the elderly&#44; or large-scale studies&#46;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">24</span></a> The American Heart Association &#40;AHA&#41; endorses CPET and run field tests for assessing <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> in youths&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a> Our prior research has found a significant correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;729&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; between 3000-m run times and <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> scaled to body mass in young adults&#44; indicating that the 3000-m run is an effective&#44; accessible method for estimating CRF&#44; suitable for larger populations or settings with limited resources&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The correlation between decreased pulmonary function and impaired peripheral muscle strength and endurance has been established in patients with chronic obstructive pulmonary disease &#40;COPD&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">26&#8211;30</span></a> A case&#8211;control study showed that handgrip muscle strength decreases as the FEV<span class="elsevierStyleInf">1</span> and FVC decrease in patients with COPD compared to the normal subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a> Moreover&#44; it was observed that COPD patients experienced a pronounced decline in muscle endurance compared to muscle strength&#46; Several studies have also confirmed a positive correlation between handgrip muscle strength and lung function across diverse populations&#44; ranging from adolescents to the elderly&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">15&#44;24&#44;31&#8211;36</span></a> These results suggest that an association between muscular strength and lung function was observed not only in COPD patients but also in the general community population&#46; Nevertheless&#44; the impact of various forms of peripheral muscle endurance on lung function has been poorly investigated in previous studies&#44; yielding inconsistent results&#46; One study found a positive association between muscle endurance&#44; assessed by quadriceps&#44; and FEV<span class="elsevierStyleInf">1</span> in COPD patients&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a> but another study failed to identify a similar association when evaluating muscle endurance through handgrip&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a> These discrepancies might arise from the use of various muscle groups and measurement techniques&#44; variability in the study populations&#44; and small sample sizes&#46; Our study examined the relationship between both upper and lower limb muscle endurance&#44; separately measured by the number of 2-min push-ups and sit-ups&#44; and lung function&#44; revealing a positive correlation in a large cohort of physically active young adults without chronic lung diseases&#46; Initially&#44; both 2-min push-ups and sit-ups showed a positive correlation with FEV<span class="elsevierStyleInf">1</span> and FVC in univariate analysis&#46; Nevertheless&#44; the link between 2-minute sit-ups and FEV<span class="elsevierStyleInf">1</span> became insignificant after adjusting for covariates&#46; In contrast&#44; the 2-min push-ups maintained a positive correlation with FEV<span class="elsevierStyleInf">1</span>&#44; even after accounting for additional physical fitness metrics such as 2-min sit-ups and 3000-m run time&#46; These findings indicate that upper limb muscle endurance has a greater impact on lung function&#44; particularly on FEV<span class="elsevierStyleInf">1</span>&#44; compared to lower limb muscle endurance&#46; Consequently&#44; our findings propose that the 2-min push-ups fitness routine&#44; focused on improving upper limb muscle and pectoral muscle endurance&#44; might be beneficial in managing obstructive lung diseases like COPD or asthma with airflow limitation&#46; Particularly&#44; the performance of the 3000-m run remained positively correlated with both FEV<span class="elsevierStyleInf">1</span> and FVC across all models&#44; indicating its robust impact on overall lung function&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The mechanisms connecting improved or enhanced physical fitness with better lung function are not fully understood&#46; It is plausible that regular exercise training&#44; a determinant of CRF&#44; may strengthen the respiratory muscles&#44; enhance pulmonary perfusion as well as surfactant release&#44; and ultimately lead to increased lung volumes&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">37&#8211;39</span></a> Additionally&#44; enhanced fitness may decrease fat distribution&#44; particularly abdominal and thoracic fat mass&#44; which can constrain vital capacity and lead to expiratory flow limitation by restricting lung expansion during inhalation&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a> Moreover&#44; reduced fat mass may also alleviate lung function decline by reducing inflammatory processes&#44; as adipose tissue is a source of inflammatory mediators that can harm lung tissue and narrow airway diameter&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a> The positive correlation between the enhanced 2-min push-up test and lung function might be attributed to the fact that push-ups activate not only the arms and chest but also the accessory respiratory muscles&#44; including the intercostal muscles&#44; pectoral muscles&#44; and those around the shoulder girdle&#46; Furthermore&#44; the repetitive and sustained strengthening of these muscles could improve their efficiency and capacity&#44; thereby contributing to improved lung function&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the study&#44; we analyzed the correlation between lung function and physical fitness&#44; presenting lung function as either absolute values or <span class="elsevierStyleItalic">Z</span>-scores&#44; which resulted in inconsistent findings&#46; The inconsistency in the correlation results between absolute lung function values and physical fitness versus standardized lung function &#40;<span class="elsevierStyleItalic">Z</span>-scores&#41; could be partly explained by the attenuation of the association when anthropometric variables were accounted for at an individual level&#46; When lung function is presented with absolute lung volumes&#44; the measurements reflect the remaining ventilatory capacity&#44; which may correlate more directly with physical fitness due to the physical demands on lung capacity during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> However&#44; when lung function is standardized into <span class="elsevierStyleItalic">Z</span>-scores&#44; these values are adjusted based on a population mean and standard deviation&#44; accounting for variations due to factors like age&#44; sex&#44; and height&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> This standardization can obscure the raw differences seen with absolute values&#46; For example&#44; in a cross-sectional study&#44; males and females&#44; even when matched on relative lung volume &#40;like FEV<span class="elsevierStyleInf">1</span>&#37; predicted&#41;&#44; had significantly different absolute lung volumes&#44; with males having a higher volume&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> This discrepancy can alter perceptions of lung capacity and its relation to physical fitness when using standardized scores&#46; Therefore&#44; the inconsistency in the results could arise from these underlying differences in measurement and interpretation&#44; highlighting the need for future studies to determine which lung function measurement is appropriate to correlate with physical fitness&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Several strengths and limitations of our study warrant discussion&#46; This research is significant for being the first to investigate the relationship between different physical fitness aspects&#44; including CRF and MEF&#44; and their specific impacts on lung function in a cohort of physically active young adults&#46; It provides valuable benchmarks for physical performance and lung function metrics within this group&#44; known for their peak physiological capacities&#44; including optimal lung and cardiovascular efficiency&#46; Our research uniquely focuses on active young adults without chronic lung conditions&#44; offering clearer insights into the fitness and lung function link&#46; However&#44; the cross-sectional&#44; observational design limits our ability to assert causality&#46; Although enhanced lung function may be attributed to factors common to both exercise capacity and pulmonary metrics&#44; the FEV<span class="elsevierStyleInf">1</span> measurement remains positively correlated in the fully adjusted model&#44; underscoring a distinct connection between push-ups and FEV<span class="elsevierStyleInf">1</span>&#46; Furthermore&#44; our results indicate that active smokers demonstrated superior physical fitness performance in activities such as the 3000-m run&#44; 2-min push-ups&#44; and 2-min sit-ups&#46; Nevertheless&#44; it is important to note that our participant group is predominantly young&#44; and detailed quantitative data on cigarette consumption and smoking duration are not available&#46; Consequently&#44; we are unable to conclusively determine the effects of smoking on physical performance&#46; This limitation underscores the need for further research with more comprehensive smoking data to robustly assess the impact of tobacco use on physical fitness&#46; Finally&#44; the participant demographic&#44; primarily Asian males&#44; may not reflect the diversity needed for broader applicability&#46; These points highlight the necessity for future studies with a prospective design&#44; encompassing a wide range of ethnic backgrounds and a balanced gender distribution&#44; to comprehensively understand the causal relationship between MEF and pulmonary function&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In conclusion&#44; this study demonstrated that improved CRF and MEF are positively associated with pulmonary function in active young adults&#46; It notably suggests that push-ups are distinctly associated with increased FEV<span class="elsevierStyleInf">1</span>&#44; highlighting the potential of specific physical activities to influence lung health&#46; Further research is required to determine whether routine exercises like push-ups can consistently enhance lung function among various demographic and health backgrounds&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Sources of funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">This research was funded by <span class="elsevierStyleGrantSponsor" id="gs1">TSGH</span>&#44; through awards <span class="elsevierStyleGrantNumber" refid="gs1">TSGH-D-113114</span>&#44; and supported by the <span class="elsevierStyleGrantSponsor" id="gs2">Medical Affairs Bureau of the Ministry of National Defense</span>&#44; under awards <span class="elsevierStyleGrantNumber" refid="gs2">MND-MAB-D-113200</span>&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Author&#39;s contributions</span><p id="par0130" class="elsevierStylePara elsevierViewall">G&#46;M&#46;L&#46; designed the study&#46; C&#46;H&#46;L&#46; performed the data analysis&#46; C&#46;H&#46;L&#46; and G&#46;M&#46;L&#46; interpreted the results of statistical analysis&#46; C&#46;H&#46;L&#46; wrote the manuscript&#46; G&#46;M&#46;L&#46;&#44; Y&#46;C&#46;L&#46;&#44; W&#46;C&#46;H&#46;&#44; X&#46;S&#46;&#44; and C&#46;J&#46;L&#46; revised the manuscript critically for important intellectual contents&#46; All authors contributed to the interpretations of the findings&#46; All authors reviewed the manuscript&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Role of the sponsors</span><p id="par0135" class="elsevierStylePara elsevierViewall">The sponsors and funders of the study had no involvement or any influence in the study design&#44; in the collection&#44; analysis&#44; and interpretation of data&#44; in the writing of the manuscript&#44; and in the decision to submit the manuscript for publication&#46; The corresponding author confirms that he had full access to all the data and had the final responsibility for the decision to submit for publication&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Data sharing statement</span><p id="par0140" class="elsevierStylePara elsevierViewall">The datasets supporting the conclusions of this article will be made available by the authors upon reasonable request&#44; subject to necessary approvals and confidentiality agreements&#46; Specific data that are not publicly available due to privacy or ethical restrictions will be accessible subject to conditions outlined by the corresponding author&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">No conflicts exist for the authors&#46;</p></span></span>"
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              "titulo" => "Study population"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Blood pressure and anthropometric measurements"
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              "identificador" => "sec0025"
              "titulo" => "MEF and CRF assessments"
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              "titulo" => "Pulmonary function assessment"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2024-02-19"
    "fechaAceptado" => "2024-06-12"
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            0 => "Cardiorespiratory fitness"
            1 => "Muscular endurance fitness"
            2 => "Lung function"
            3 => "FEV<span class="elsevierStyleInf">1</span>"
            4 => "FVC"
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    "resumen" => array:1 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Rationale</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">While the beneficial effects of physical fitness on general health are well-documented&#44; the specific relationship between different types of physical fitness&#44; particularly cardiorespiratory fitness &#40;CRF&#41; and muscular endurance fitness &#40;MEF&#41;&#44; and lung function in physically active young adults remains less explored&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objective</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This study investigated the relationship between CRF and MEF&#44; and their correlation with lung function in physically active young adults&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This cross-sectional study involved a cohort of 1227 physically active young adults without lung diseases&#46; Lung function was assessed using FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC measurements&#46; The 3000-m run was used to assess CRF&#44; and the 2-min push-up and sit-up tests were used to assess MEF&#46; Multivariable linear regression analysis was used to evaluate the relationships between these fitness measures and lung function&#44; adjusting for potential covariates&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Enhanced CRF was associated with superior FEV<span class="elsevierStyleInf">1</span> and FVC after adjusting for covariates &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;&#46;078&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;015 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;&#46;086&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009 for FVC&#41;&#46; Push-ups were positively associated with FEV<span class="elsevierStyleInf">1</span> &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;014&#41;&#44; but not with FVC&#46; In contrast&#44; sit-ups showed no significant correlation with lung function in the fully adjusted model&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The study demonstrated a clear association between improved physical fitness and better lung function in physically active young adults&#44; with various exercises showing distinct associations with lung metrics&#46; Notably&#44; push-ups were particularly associated with higher FEV<span class="elsevierStyleInf">1</span>&#46; A future prospective study is necessary to determine whether routine exercises&#44; such as push-ups&#44; might lead to greater lung function&#46;</p></span>"
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            "apendice" => "<p id="par0160" class="elsevierStylePara elsevierViewall">The followings are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The flow diagram of participant selection and evaluation process for the CHIEF Lung Study&#46;</p>"
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          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Scatter plots representing relationships between lung function metrics and physical tests&#58; &#40;A&#8211;C&#41; Correlations of FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC with 3000-m run time&#46; &#40;D&#8211;F&#41; FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC with 2-min push-up count&#46; &#40;G&#8211;I&#41; FEV<span class="elsevierStyleInf">1</span> and FVC with 2-min sit-ups&#46; The correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; and <span class="elsevierStyleItalic">p</span>-value for each relationship are indicated above each plot&#46; FEV<span class="elsevierStyleInf">1</span>&#44; forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s&#59; FVC&#44; forced vital capacity&#59; s&#44; seconds&#46; Time is represented in seconds &#40;s&#41;&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scatter plots illustrating relationships&#58; &#40;A&#41; 3000-m run time vs&#46; 2-min push-ups&#44; &#40;B&#41; 3000-m run time vs&#46; 2-min sit-ups&#44; and &#40;C&#41; 2-min push-ups vs&#46; 2-min sit-ups&#46; The correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; and <span class="elsevierStyleItalic">p</span>-value for each relationship are indicated above each plot&#46; Time is represented in seconds &#40;s&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">FEV<span class="elsevierStyleInf">1</span>&#44; forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s&#59; FVC&#44; forced vital capacity&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data are presented as number &#40;percent&#41; for smoking&#44; alcohol&#44; and betel nut&#46; Physical function measurements were presented as median &#40;interquartile range&#41;&#46; For all other variables&#44; means<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD are reported&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total population &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1227&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1082&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Height &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">170&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">160&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleBold">2</span></span><span class="elsevierStyleBold">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Waist &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Mean arterial pressure &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Smoking</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Active smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">464 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">437 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Former smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Never smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">600 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">497 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Alcohol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">426 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">407 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Betel nut</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Physical function measurements</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">3000-m run &#40;s&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">878 &#40;840&#8211;959&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">870 &#40;834&#8211;930&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1027 &#40;985&#8211;1084&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">2-min push-ups numbers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;21&#8211;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">2-min sit-ups numbers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;30&#8211;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Lung function measurements</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">FEV</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">1</span></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Actual &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;926&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Z</span>-score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;494&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">FVC</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Actual &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;587&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Z</span>-score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;54<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">FEV</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">1</span></span><span class="elsevierStyleItalic">&#47;FVC &#37;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Actual &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;205&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;254&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Z</span>-score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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Original Article
Associations of Cardiorespiratory Fitness and Muscular Endurance Fitness With Pulmonary Function in Physically Active Young Adults
Chia-Hsin Liua, Yen-Chen Linb, Wei-Chun Huangc,d, Xuemei Suie, Carl J. Lavief, Gen-Min Ling,h,
Corresponding author
farmer507@yahoo.com.tw

Corresponding author.
a Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
b Department of Internal Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan
c College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
d Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
e Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
f John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
g Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan
h Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pulmonary function is a fundamental aspect of respiratory health&#44; achieving its highest levels in young adulthood&#44; around the ages of 20&#8211;25&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> Tobacco smoke exposure is a well-documented major risk factor for &#8220;impaired respiratory health&#8221;&#8212;a condition that can progress to chronic lung disease due to diminished lung growth and function&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> Furthermore&#44; recent research also suggests associations between impaired respiratory health and factors such as air pollution&#44; obesity&#44; and low physical fitness levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;3</span></a> A reduction in lung function not only limits exercise capacity but also increases the risk of respiratory and cardiovascular diseases&#44; lowers health-related quality of life &#40;HRQoL&#41;&#44; and results in increased respiratory hospitalizations&#44; mortality&#44; and healthcare demands&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">4&#8211;6</span></a> Therefore&#44; it is crucial to identify and address these modifiable risk factors to preserve and enhance lung function&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical fitness serves as a critical indicator of health outcomes and influences long-term health&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> Studies have evaluated physical fitness through cardiorespiratory fitness &#40;CRF&#41; and muscular fitness&#44; using various tests to measure them either separately or together&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a> Research suggests that enhanced aerobic fitness in childhood and adolescence plays a significant role in lung development&#44; leading to improvements in FEV<span class="elsevierStyleInf">1</span> and FVC from ages 9 to 26&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Additionally&#44; young adults with higher baseline CRF levels&#44; as measured by treadmill tests&#44; showed reduced declines in FEV<span class="elsevierStyleInf">1</span> and FVC over 20 years&#44; according to the Coronary Artery Risk Development in Young Adults &#40;CARDIA&#41; study&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a> While these findings suggest that CRF contributes to lung development and may help protect against future declines in lung function&#44; the relatively small effect sizes reported indicate that the impact of fitness on lung function requires further clarification&#46; Furthermore&#44; the causal relationship between improved lung function and gains in fitness remains lacking&#46; In the cohort&#44; when the data was analyzed with lung function as the independent variable and fitness as the dependent variable&#44; it yielded similar results&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> These results suggest a bidirectional relationship&#58; individuals with superior lung function might be predisposed to higher physical fitness levels&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Muscular fitness&#44; characterized by both muscular endurance &#40;repeated force exertion&#41; and muscular strength &#40;single maximal effort&#41;&#44; is essential for sustained activity and peak performance&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a> In children and adolescents&#44; higher muscular fitness correlates with lower obesity rates&#44; diminished cardiometabolic risks&#44; and improved HRQoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">12&#44;13</span></a> A meta-analysis highlighted that strong muscular fitness during these early years is associated with less body fat and better cardiometabolic health later in life&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> Additionally&#44; a recent study has found a positive link between muscular strength &#40;measured by handgrip strength and chair stand tests&#41; and lung function in a community general population&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> However&#44; the exact relationship between CRF&#44; muscular endurance fitness &#40;MEF&#41;&#44; and their impact on lung function&#44; especially among physically active individuals&#44; is not fully understood&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The Cardiorespiratory Fitness and Health In Armed Forces &#40;CHIEF&#41; Lung Study aims to evaluate the association between CRF &#40;time for a 3000-m run&#41; and MEF &#40;2-min push-ups and 2-min sit-ups numbers&#41; with pulmonary function&#44; and to clarify their individual impacts on the respiratory health of active young adults&#46; We hypothesize that superior CRF and MEF levels are positively associated with pulmonary function&#44; with each type of fitness making a unique correlation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">The CHIEF Lung Study meticulously assessed lung function in 1231 military recruits&#44; both male and female&#44; aged 19&#8211;38&#44; across Taiwan from 2017 to 2019 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Participants underwent medical exams for military enlistment&#44; with no history of pulmonary tuberculosis&#44; chronic lung conditions &#40;e&#46;g&#46;&#44; lung abscess&#44; emphysema&#44; asthma&#41;&#44; diaphragmatic or pleural disorders&#44; chest wall deformities&#44; or surgeries for pneumothorax or segmentectomy&#46; They participated in a rigorous daily exercise regimen at a military base for six months&#44; focusing on muscular endurance training and cardiovascular fitness&#46; The regimen required all military personnel to complete a 3000-m run twice daily at 6&#58;00<span class="elsevierStyleHsp" style=""></span>AM and 4&#58;00<span class="elsevierStyleHsp" style=""></span>PM&#44; led by the captain at a pace of 120<span class="elsevierStyleHsp" style=""></span>m per minute on weekdays&#46; Following each run&#44; all participants were required to perform 20 consecutive push-ups and sit-ups within 30<span class="elsevierStyleHsp" style=""></span>min&#46; This training course lasted until the end of June&#46; Before the mid-term physical test in July&#44; all participants underwent an annual health checkup in June&#44; which included laboratory tests and physical evaluations&#46; They also filled out a questionnaire about substance use habits&#44; such as cigarette smoking &#40;active and former&#47;never&#41;&#44; alcohol consumption&#44; and betel nut chewing at the Hualien Armed Forces General Hospital&#46; Furthermore&#44; participants underwent pulmonary function testing to assess their FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and the ratio of FEV<span class="elsevierStyleInf">1</span>&#47;FVC before undergoing the annual military exercise tests&#46; The study adhered to stringent ethical standards and was approved by the Institutional Review Board of Mennonite Christian Hospital in Hualien City &#40;No&#46; 16-05-008&#41;&#44; ensuring that all participants provided informed consent&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Blood pressure and anthropometric measurements</span><p id="par0030" class="elsevierStylePara elsevierViewall">Blood pressure &#40;BP&#41; was measured once on each participant&#39;s right arm after a 15-min rest&#44; using an automatic device &#40;FT201&#41; via the oscillometric method&#46; Mean Arterial Pressure &#40;MAP&#41; was calculated using the formula&#58; MAP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>diastolic BP<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1&#47;3 &#40;systolic BP<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>diastolic BP&#41;&#46; Anthropometric data&#44; including waist circumference &#40;WC&#41;&#44; height&#44; and weight&#44; were recorded for standing participants&#44; with body mass index &#40;BMI&#41; calculated as weight &#40;kg&#41; divided by height squared &#40;m<span class="elsevierStyleSup">2</span>&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">MEF and CRF assessments</span><p id="par0035" class="elsevierStylePara elsevierViewall">MEF in participants was assessed using 2-min push-up and sit-up tests&#44; adhering to protocols from previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> These evaluations were scheduled between 14&#58;00 and 15&#58;00 at the Military Physical Training and Testing Center&#44; allowing for a flexible sequence&#46; Performance was recorded on sponge pads with electronic or infrared sensors&#58; sit-ups required elbow contact with thigh-mounted sensors&#44; with hands near ears and feet fixed&#59; push-ups demanded correct elbow motion and a straight body alignment&#44; confirmed by sensors&#44; disqualifying any touch outside of hands or toes before time&#46; CRF was gauged through a 3000-m run&#44; performed outdoors on level ground after an hour&#39;s rest from MEF tests&#46; This field test&#44; held outdoors on flat terrain at the Military Physical Training and Testing Center&#44; was scheduled for 16&#58;00&#44; following an hour&#39;s rest after the muscular endurance tests&#46; Participants wore standard sweat suits and carried no extra items&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a> The entire run for each participant was video-recorded and monitored by eight military sports officers&#46; The run was contingent upon certain environmental factors&#58; the coefficient&#44; determined by the product of the outdoor temperature &#40;in Celsius&#41; and the relative humidity &#40;&#37;&#41; multiplied by 0&#46;1&#44; had to be below 40&#44; and there should not have been any significant rainfall&#46; The completion time of the 3000-m run was used to assess each participant&#39;s cardiorespiratory endurance capacity&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pulmonary function assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Lung function was measured with a Jaeger VyntusTM Pneumo spirometer as per the American Thoracic Society&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> Participants&#44; seated with a nose clip&#44; performed the test thrice for accurate FVC&#44; FEV<span class="elsevierStyleInf">1</span>&#44; and FEV&#47;FVC ratios&#44; inhaling fully and exhaling rapidly for 6<span class="elsevierStyleHsp" style=""></span>s&#46; The best effort was recorded via a flow-volume curve&#46; Lung function is expressed as <span class="elsevierStyleItalic">Z</span>-scores using the Global Lung Initiative reference equations&#44; accounting for height&#44; sex at birth&#44; age&#44; and Asian ethnicity&#46; In addition&#44; the predicted percentage of lung function was also presented&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analyses</span><p id="par0045" class="elsevierStylePara elsevierViewall">Continuous variables were presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; and categorical ones as frequencies and percentages &#40;&#37;&#41;&#46; Descriptive statistics described demographics and clinical characteristics&#46; The fitness data are presented as the median &#40;interquartile range&#41;&#46; Pearson&#39;s correlation and scatter plots with <span class="elsevierStyleItalic">r</span> and <span class="elsevierStyleItalic">p</span> values analyzed the relationship between pulmonary parameters and the performance of each physical test&#46; Multivariable linear regression analysis was used to examine the associations between physical performance measurements and lung functions&#46; The analysis was stratified into four distinct models&#44; each designed to incrementally build upon the previous by integrating additional variables&#46; Model 1 served as the baseline&#44; adjusting for demographic and physiological factors including age&#44; gender&#44; height&#44; weight&#44; waist circumference&#44; mean arterial pressure&#44; and smoking status&#46; Model 2 expanded on this by incorporating the 3000-m run time and the number of 2-min push-ups&#44; aiming to assess their specific impacts&#46; Model 3 followed a similar format but focused on the 3000-m run time and 2-min sit-ups&#46; Finally&#44; Model 4&#44; the most comprehensive of the series&#44; combined all the metrics from the previous models to provide a holistic view of the effects of combined physical activities on lung function&#46; Results across these models were expressed through standardized beta coefficients&#44; with significance levels noted for key findings &#40;&#42;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; &#42;&#42;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; The <span class="elsevierStyleItalic">p</span>-interaction value was calculated to assess whether there are sex differences in the association between physical fitness and lung function&#46; Analysis was performed using SPSS &#40;version 29&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Out of the initial cohort&#44; four were excluded due to acute illnesses&#44; leaving 1227 participants in the final analysis&#46; Clinical characteristics of participants are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The participants&#44; primarily male at 88&#46;2&#37;&#44; had an average age of 27&#46;4 years&#46; They maintained a healthy physique with an average BMI of 24&#46;6<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; and a waist circumference of 82&#46;3<span class="elsevierStyleHsp" style=""></span>cm&#46; Smoking status varied&#44; with 38&#37; currently smoking and 54&#37; either former smokers or having never smoked&#46; Regarding physical fitness&#44; the participants completed a 3000-m run in an average time of 15<span class="elsevierStyleHsp" style=""></span>min and 12<span class="elsevierStyleHsp" style=""></span>s and demonstrated considerable strength and endurance by performing an average of 44&#46;1 push-ups and 44&#46;6 sit-ups within a two-minute timeframe for each exercise&#46; In the study comparing clinical and physiological characteristics between sexes&#44; notable differences were observed&#46; Males were older&#44; taller&#44; and heavier than females&#44; with correspondingly higher BMI and waist circumferences&#46; Significant differences in smoking habits were evident&#44; with a higher percentage of males being active or former smokers compared to females&#44; where a majority were never smokers&#46; Physical fitness assessments showed that males performed better in muscular endurance exercises like push-ups and sit-ups&#44; and demonstrated superior cardiorespiratory fitness&#44; evidenced by shorter times in the 3000-m run compared to females&#46; Lung function measurements revealed higher absolute values of FEV<span class="elsevierStyleInf">1</span> and FVC&#44; but no differences were observed in standardized lung function metrics such as predicted percentages and <span class="elsevierStyleItalic">Z</span>-scores&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Pearson&#39;s correlation coefficients were used to assess the relationship between spirometer parameters and physical performance tests&#44; specifically focusing on CRF and MEF&#46; The relationship between pulmonary function and performance in the 3000-m run test&#44; as well as the outcomes of the 2-minute push-up and sit-up tests&#44; is illustrated in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; There is a negative correlation between the time for a 3000-m run and pulmonary function&#44; with FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41; both decreasing as the run time increases &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;29&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;27&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; No significant correlation is observed with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; Furthermore&#44; there is a positive correlation between the number of 2-min push-ups and pulmonary function&#44; with both FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>D&#41; increasing as the number of push-ups increases &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;32&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;29&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; Again&#44; no significant correlation is observed with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; Similarly&#44; a positive correlation is shown between the number of 2-minute sit-ups and pulmonary function&#44; with FEV<span class="elsevierStyleInf">1</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>E&#41; and FVC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>F&#41; both increasing with a greater number of sit-ups performed &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;25&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;24&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 for FVC&#41;&#46; The FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio does not show a significant correlation&#46; These results suggest that better performance in fitness tests&#44; specifically faster run time and higher numbers of push-ups and sit-ups&#44; is associated with better pulmonary function&#44; as measured by FEV<span class="elsevierStyleInf">1</span> and FVC&#46; However&#44; these fitness performances do not appear to affect the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio significantly&#46; We also analyzed the correlation between physical fitness and standardized lung function using <span class="elsevierStyleItalic">Z</span>-scores&#46; The results showed that when lung function was presented as <span class="elsevierStyleItalic">Z</span>-scores&#44; there was no significant correlation between physical fitness and lung function &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E1&#44; Supplementary material</a>&#41;&#46; To ensure the results were not influenced by outlier effects&#44; we excluded outliers defined by more than 3 standard deviations from the mean for physical fitness and lung function&#46; Despite this&#44; the correlation between absolute lung function measurements and physical fitness remains significant &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E2&#44; Supplementary material</a>&#41;&#46; Given the established correlation between tobacco consumption and physical capacity&#44; we stratified physical fitness by cigarette smoking status&#46; The results show that active smokers exhibited better physical fitness performance in activities such as the 3000-m run&#44; 2-min push-ups&#44; and 2-min sit-ups &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Fig&#46; E3&#44; Supplementary material</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">To elucidate the relationship between CRF and MEF&#44; data from scatter plots depicted in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A reveal a notable negative correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;48&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between the number of 2-min push-ups and time for a 3000-m run&#46; Higher numbers of push-ups correlate with shorter run times&#44; suggesting enhanced CRF&#46; Similarly&#44; a negative correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;40&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between 2-minute sit-up numbers and run time is shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>B&#44; indicating that greater muscular endurance fitness from sit-ups is associated with improved CRF&#46; The relationship is further underscored in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C&#44; which shows a strong positive correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;752&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; between performance in push-ups and sit-ups&#44; indicating a consistent link between these two forms of exercise&#46; Collectively&#44; these findings highlight the interrelation of MEF and CRF&#44; as well as the association between endurance in upper and lower limb exercises&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">To determine the distinct impacts of various physical fitness modalities on pulmonary function&#44; we utilized Multivariable linear regression analyses&#44; as depicted in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In Model 1&#44; after adjusting for variables such as age&#44; gender&#44; height&#44; weight&#44; WC&#44; MAP&#44; and smoking status&#44; the results showed that time for a 3000-m run was inversely associated with both FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;117&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Additionally&#44; 2-min push-ups positively correlated with both FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;093&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;096&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;002&#41;&#46; In contrast&#44; 2-min sit-ups were only positively associated with FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;063&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;034&#41; and not with FEV<span class="elsevierStyleInf">1</span>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">To explore the potential associations between these physical activities and lung function&#44; we formulated Model 2&#8211;4&#46; These models incorporated the same variables as Model 1&#44; with the addition of either a 3000-m run&#44; 2-min push-ups&#44; or 2-min sit-ups&#46; In both Model 2 and Model 3&#44; the duration of the 3000-m run consistently demonstrated an inverse correlation with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;071&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;026&#59; standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;089&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;087&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;008&#59; standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;093&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#41;&#46; Nevertheless&#44; 2-min push-ups only positively correlated with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;067&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;043&#41; but not with FVC after adjusting for time for the 3000-m run&#46; After making the same adjustment&#44; the relationship between 2-min sit-ups and lung functions became non-significant&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">After adjusting for all covariates and incorporating the three physical activities into the Model 4&#44; time for the 3000-m run continued to show a negative relationship with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;078&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;015&#41; and FVC &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#8722;&#46;086&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009&#41;&#46; Notably&#44; the number of 2-min push-ups maintained its positive relationship with FEV<span class="elsevierStyleInf">1</span> &#40;standardized <span class="elsevierStyleItalic">&#946;</span>&#58; &#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;014&#41; even after adjusting for time for the 3000-m run and 2-min sit-ups&#44; indicating its unique and independent association&#46; In contrast&#44; when considering the performances of time for the 3000-m run and 2-min push-ups&#44; the number of 2-min sit-ups lacked a significant relationship with both FEV<span class="elsevierStyleInf">1</span> and FVC&#46; In addition&#44; we also calculated a <span class="elsevierStyleItalic">p</span>-interaction value in <a class="elsevierStyleCrossRef" href="#sec0075">Table E1 &#40;Supplementary material&#41;</a> to determine whether sex moderates the association between physical fitness and lung function&#46; The results showed that sex has no interaction effect on the association between physical fitness and lung function&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">To investigate the contribution of lung function to maximum physical fitness&#44; we conducted a multivariate linear regression analysis&#44; adjusting for covariates such as age&#44; gender&#44; height&#44; weight&#44; MAP&#44; and smoking status&#46; The analysis revealed that pulmonary function measures&#44; when expressed as <span class="elsevierStyleItalic">Z</span>-scores&#44; did not show significant correlations with physical fitness tests &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Table E2&#44; Supplementary material</a>&#41;&#46; In contrast&#44; the absolute values of FEV<span class="elsevierStyleInf">1</span> and FVC were positively correlated with enhanced performance in the 3000-m run and push-ups &#40;<a class="elsevierStyleCrossRef" href="#sec0075">Table E3&#44; Supplementary material</a>&#41;&#46; Additionally&#44; FVC&#44; but not FEV<span class="elsevierStyleInf">1</span>&#44; was associated with improved sit-up performance&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">In this cross-sectional study of 1227 active young adults&#44; we explored how physical fitness levels affect lung function&#46; Results showed that better performance in CRF&#44; via 3000-m run times&#44; and MEF&#44; assessed through 2-min push-ups and sit-ups&#44; correlated positively with FEV<span class="elsevierStyleInf">1</span> and FVC&#44; but not with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46; We found a moderate link between 3000-m run times and push-up&#47;sit-up numbers&#44; with a strong association between push-ups and sit-ups&#46; Multivariable linear analysis revealed that shorter run times were correlated with higher FEV<span class="elsevierStyleInf">1</span> and FVC&#44; independent of MEF outcomes&#46; Notably&#44; push-ups positively influenced FEV<span class="elsevierStyleInf">1</span> alone&#44; while sit-ups showed no significant lung function effect in the fully adjusted model&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Our study found that improved CRF positively correlates with FEV<span class="elsevierStyleInf">1</span> and FVC in active young adults&#44; consistent with other research across various demographics&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">9&#44;19&#8211;22</span></a> A longitudinal study tracking children into adulthood affirmed this positive CRF association with FEV<span class="elsevierStyleInf">1</span> and FVC throughout all ages&#44; but not with the FEV<span class="elsevierStyleInf">1</span>&#47;FVC ratio&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Enhancements in CRF during youth were linked to improved FEV<span class="elsevierStyleInf">1</span> and FVC in later life&#46; This beneficial association between CRF and ventilatory lung function has been observed in diverse populations&#44; including middle-aged&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">21</span></a> and elderly cohorts&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> and the general population&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">20&#44;22</span></a> Importantly&#44; CRF might not just enhance lung volume but could also improve lung diffusing capacity &#40;D<span class="elsevierStyleInf">LCO</span>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">19&#44;21</span></a> These consistent findings across studies and among different age groups highlight the substantial and positive impact of CRF on lung function throughout the life span&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The gold standard for assessing CRF is Cardiopulmonary Exercise Testing &#40;CPET&#41;&#44; which evaluates <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> or <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2peak</span>&#44; and can be estimated from work rates or algorithms&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">23</span></a> While previous research has linked CRF to lung function via <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span><a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> or <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2peak</span><a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">19&#8211;22</span></a> measurements through CPET&#44; its requirement for specific facilities and participant mask tolerance during testing limits its practicality&#44; especially for children&#44; the elderly&#44; or large-scale studies&#46;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">24</span></a> The American Heart Association &#40;AHA&#41; endorses CPET and run field tests for assessing <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> in youths&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a> Our prior research has found a significant correlation &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;729&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; between 3000-m run times and <span class="elsevierStyleItalic">V</span><span class="elsevierStyleInf">O2max</span> scaled to body mass in young adults&#44; indicating that the 3000-m run is an effective&#44; accessible method for estimating CRF&#44; suitable for larger populations or settings with limited resources&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The correlation between decreased pulmonary function and impaired peripheral muscle strength and endurance has been established in patients with chronic obstructive pulmonary disease &#40;COPD&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">26&#8211;30</span></a> A case&#8211;control study showed that handgrip muscle strength decreases as the FEV<span class="elsevierStyleInf">1</span> and FVC decrease in patients with COPD compared to the normal subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a> Moreover&#44; it was observed that COPD patients experienced a pronounced decline in muscle endurance compared to muscle strength&#46; Several studies have also confirmed a positive correlation between handgrip muscle strength and lung function across diverse populations&#44; ranging from adolescents to the elderly&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">15&#44;24&#44;31&#8211;36</span></a> These results suggest that an association between muscular strength and lung function was observed not only in COPD patients but also in the general community population&#46; Nevertheless&#44; the impact of various forms of peripheral muscle endurance on lung function has been poorly investigated in previous studies&#44; yielding inconsistent results&#46; One study found a positive association between muscle endurance&#44; assessed by quadriceps&#44; and FEV<span class="elsevierStyleInf">1</span> in COPD patients&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a> but another study failed to identify a similar association when evaluating muscle endurance through handgrip&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a> These discrepancies might arise from the use of various muscle groups and measurement techniques&#44; variability in the study populations&#44; and small sample sizes&#46; Our study examined the relationship between both upper and lower limb muscle endurance&#44; separately measured by the number of 2-min push-ups and sit-ups&#44; and lung function&#44; revealing a positive correlation in a large cohort of physically active young adults without chronic lung diseases&#46; Initially&#44; both 2-min push-ups and sit-ups showed a positive correlation with FEV<span class="elsevierStyleInf">1</span> and FVC in univariate analysis&#46; Nevertheless&#44; the link between 2-minute sit-ups and FEV<span class="elsevierStyleInf">1</span> became insignificant after adjusting for covariates&#46; In contrast&#44; the 2-min push-ups maintained a positive correlation with FEV<span class="elsevierStyleInf">1</span>&#44; even after accounting for additional physical fitness metrics such as 2-min sit-ups and 3000-m run time&#46; These findings indicate that upper limb muscle endurance has a greater impact on lung function&#44; particularly on FEV<span class="elsevierStyleInf">1</span>&#44; compared to lower limb muscle endurance&#46; Consequently&#44; our findings propose that the 2-min push-ups fitness routine&#44; focused on improving upper limb muscle and pectoral muscle endurance&#44; might be beneficial in managing obstructive lung diseases like COPD or asthma with airflow limitation&#46; Particularly&#44; the performance of the 3000-m run remained positively correlated with both FEV<span class="elsevierStyleInf">1</span> and FVC across all models&#44; indicating its robust impact on overall lung function&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The mechanisms connecting improved or enhanced physical fitness with better lung function are not fully understood&#46; It is plausible that regular exercise training&#44; a determinant of CRF&#44; may strengthen the respiratory muscles&#44; enhance pulmonary perfusion as well as surfactant release&#44; and ultimately lead to increased lung volumes&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">37&#8211;39</span></a> Additionally&#44; enhanced fitness may decrease fat distribution&#44; particularly abdominal and thoracic fat mass&#44; which can constrain vital capacity and lead to expiratory flow limitation by restricting lung expansion during inhalation&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a> Moreover&#44; reduced fat mass may also alleviate lung function decline by reducing inflammatory processes&#44; as adipose tissue is a source of inflammatory mediators that can harm lung tissue and narrow airway diameter&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a> The positive correlation between the enhanced 2-min push-up test and lung function might be attributed to the fact that push-ups activate not only the arms and chest but also the accessory respiratory muscles&#44; including the intercostal muscles&#44; pectoral muscles&#44; and those around the shoulder girdle&#46; Furthermore&#44; the repetitive and sustained strengthening of these muscles could improve their efficiency and capacity&#44; thereby contributing to improved lung function&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the study&#44; we analyzed the correlation between lung function and physical fitness&#44; presenting lung function as either absolute values or <span class="elsevierStyleItalic">Z</span>-scores&#44; which resulted in inconsistent findings&#46; The inconsistency in the correlation results between absolute lung function values and physical fitness versus standardized lung function &#40;<span class="elsevierStyleItalic">Z</span>-scores&#41; could be partly explained by the attenuation of the association when anthropometric variables were accounted for at an individual level&#46; When lung function is presented with absolute lung volumes&#44; the measurements reflect the remaining ventilatory capacity&#44; which may correlate more directly with physical fitness due to the physical demands on lung capacity during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> However&#44; when lung function is standardized into <span class="elsevierStyleItalic">Z</span>-scores&#44; these values are adjusted based on a population mean and standard deviation&#44; accounting for variations due to factors like age&#44; sex&#44; and height&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> This standardization can obscure the raw differences seen with absolute values&#46; For example&#44; in a cross-sectional study&#44; males and females&#44; even when matched on relative lung volume &#40;like FEV<span class="elsevierStyleInf">1</span>&#37; predicted&#41;&#44; had significantly different absolute lung volumes&#44; with males having a higher volume&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> This discrepancy can alter perceptions of lung capacity and its relation to physical fitness when using standardized scores&#46; Therefore&#44; the inconsistency in the results could arise from these underlying differences in measurement and interpretation&#44; highlighting the need for future studies to determine which lung function measurement is appropriate to correlate with physical fitness&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Several strengths and limitations of our study warrant discussion&#46; This research is significant for being the first to investigate the relationship between different physical fitness aspects&#44; including CRF and MEF&#44; and their specific impacts on lung function in a cohort of physically active young adults&#46; It provides valuable benchmarks for physical performance and lung function metrics within this group&#44; known for their peak physiological capacities&#44; including optimal lung and cardiovascular efficiency&#46; Our research uniquely focuses on active young adults without chronic lung conditions&#44; offering clearer insights into the fitness and lung function link&#46; However&#44; the cross-sectional&#44; observational design limits our ability to assert causality&#46; Although enhanced lung function may be attributed to factors common to both exercise capacity and pulmonary metrics&#44; the FEV<span class="elsevierStyleInf">1</span> measurement remains positively correlated in the fully adjusted model&#44; underscoring a distinct connection between push-ups and FEV<span class="elsevierStyleInf">1</span>&#46; Furthermore&#44; our results indicate that active smokers demonstrated superior physical fitness performance in activities such as the 3000-m run&#44; 2-min push-ups&#44; and 2-min sit-ups&#46; Nevertheless&#44; it is important to note that our participant group is predominantly young&#44; and detailed quantitative data on cigarette consumption and smoking duration are not available&#46; Consequently&#44; we are unable to conclusively determine the effects of smoking on physical performance&#46; This limitation underscores the need for further research with more comprehensive smoking data to robustly assess the impact of tobacco use on physical fitness&#46; Finally&#44; the participant demographic&#44; primarily Asian males&#44; may not reflect the diversity needed for broader applicability&#46; These points highlight the necessity for future studies with a prospective design&#44; encompassing a wide range of ethnic backgrounds and a balanced gender distribution&#44; to comprehensively understand the causal relationship between MEF and pulmonary function&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In conclusion&#44; this study demonstrated that improved CRF and MEF are positively associated with pulmonary function in active young adults&#46; It notably suggests that push-ups are distinctly associated with increased FEV<span class="elsevierStyleInf">1</span>&#44; highlighting the potential of specific physical activities to influence lung health&#46; Further research is required to determine whether routine exercises like push-ups can consistently enhance lung function among various demographic and health backgrounds&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Sources of funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">This research was funded by <span class="elsevierStyleGrantSponsor" id="gs1">TSGH</span>&#44; through awards <span class="elsevierStyleGrantNumber" refid="gs1">TSGH-D-113114</span>&#44; and supported by the <span class="elsevierStyleGrantSponsor" id="gs2">Medical Affairs Bureau of the Ministry of National Defense</span>&#44; under awards <span class="elsevierStyleGrantNumber" refid="gs2">MND-MAB-D-113200</span>&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Author&#39;s contributions</span><p id="par0130" class="elsevierStylePara elsevierViewall">G&#46;M&#46;L&#46; designed the study&#46; C&#46;H&#46;L&#46; performed the data analysis&#46; C&#46;H&#46;L&#46; and G&#46;M&#46;L&#46; interpreted the results of statistical analysis&#46; C&#46;H&#46;L&#46; wrote the manuscript&#46; G&#46;M&#46;L&#46;&#44; Y&#46;C&#46;L&#46;&#44; W&#46;C&#46;H&#46;&#44; X&#46;S&#46;&#44; and C&#46;J&#46;L&#46; revised the manuscript critically for important intellectual contents&#46; All authors contributed to the interpretations of the findings&#46; All authors reviewed the manuscript&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Role of the sponsors</span><p id="par0135" class="elsevierStylePara elsevierViewall">The sponsors and funders of the study had no involvement or any influence in the study design&#44; in the collection&#44; analysis&#44; and interpretation of data&#44; in the writing of the manuscript&#44; and in the decision to submit the manuscript for publication&#46; The corresponding author confirms that he had full access to all the data and had the final responsibility for the decision to submit for publication&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Data sharing statement</span><p id="par0140" class="elsevierStylePara elsevierViewall">The datasets supporting the conclusions of this article will be made available by the authors upon reasonable request&#44; subject to necessary approvals and confidentiality agreements&#46; Specific data that are not publicly available due to privacy or ethical restrictions will be accessible subject to conditions outlined by the corresponding author&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">No conflicts exist for the authors&#46;</p></span></span>"
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              "titulo" => "Blood pressure and anthropometric measurements"
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              "titulo" => "MEF and CRF assessments"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2024-02-19"
    "fechaAceptado" => "2024-06-12"
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            0 => "Cardiorespiratory fitness"
            1 => "Muscular endurance fitness"
            2 => "Lung function"
            3 => "FEV<span class="elsevierStyleInf">1</span>"
            4 => "FVC"
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    "resumen" => array:1 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Rationale</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">While the beneficial effects of physical fitness on general health are well-documented&#44; the specific relationship between different types of physical fitness&#44; particularly cardiorespiratory fitness &#40;CRF&#41; and muscular endurance fitness &#40;MEF&#41;&#44; and lung function in physically active young adults remains less explored&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objective</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This study investigated the relationship between CRF and MEF&#44; and their correlation with lung function in physically active young adults&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This cross-sectional study involved a cohort of 1227 physically active young adults without lung diseases&#46; Lung function was assessed using FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC measurements&#46; The 3000-m run was used to assess CRF&#44; and the 2-min push-up and sit-up tests were used to assess MEF&#46; Multivariable linear regression analysis was used to evaluate the relationships between these fitness measures and lung function&#44; adjusting for potential covariates&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Enhanced CRF was associated with superior FEV<span class="elsevierStyleInf">1</span> and FVC after adjusting for covariates &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;&#46;078&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;015 for FEV<span class="elsevierStyleInf">1</span>&#59; <span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;&#46;086&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009 for FVC&#41;&#46; Push-ups were positively associated with FEV<span class="elsevierStyleInf">1</span> &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;102&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;014&#41;&#44; but not with FVC&#46; In contrast&#44; sit-ups showed no significant correlation with lung function in the fully adjusted model&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The study demonstrated a clear association between improved physical fitness and better lung function in physically active young adults&#44; with various exercises showing distinct associations with lung metrics&#46; Notably&#44; push-ups were particularly associated with higher FEV<span class="elsevierStyleInf">1</span>&#46; A future prospective study is necessary to determine whether routine exercises&#44; such as push-ups&#44; might lead to greater lung function&#46;</p></span>"
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            "apendice" => "<p id="par0160" class="elsevierStylePara elsevierViewall">The followings are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
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          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Scatter plots representing relationships between lung function metrics and physical tests&#58; &#40;A&#8211;C&#41; Correlations of FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC with 3000-m run time&#46; &#40;D&#8211;F&#41; FEV<span class="elsevierStyleInf">1</span>&#44; FVC&#44; and FEV<span class="elsevierStyleInf">1</span>&#47;FVC with 2-min push-up count&#46; &#40;G&#8211;I&#41; FEV<span class="elsevierStyleInf">1</span> and FVC with 2-min sit-ups&#46; The correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; and <span class="elsevierStyleItalic">p</span>-value for each relationship are indicated above each plot&#46; FEV<span class="elsevierStyleInf">1</span>&#44; forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s&#59; FVC&#44; forced vital capacity&#59; s&#44; seconds&#46; Time is represented in seconds &#40;s&#41;&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scatter plots illustrating relationships&#58; &#40;A&#41; 3000-m run time vs&#46; 2-min push-ups&#44; &#40;B&#41; 3000-m run time vs&#46; 2-min sit-ups&#44; and &#40;C&#41; 2-min push-ups vs&#46; 2-min sit-ups&#46; The correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; and <span class="elsevierStyleItalic">p</span>-value for each relationship are indicated above each plot&#46; Time is represented in seconds &#40;s&#41;&#46;</p>"
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                  \t\t\t\t">160&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleBold">2</span></span><span class="elsevierStyleBold">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Waist &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Mean arterial pressure &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Smoking</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Active smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">464 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">437 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Former smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Never smoker</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">600 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">497 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Alcohol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">426 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">407 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Betel nut</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Physical function measurements</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">3000-m run &#40;s&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">878 &#40;840&#8211;959&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">870 &#40;834&#8211;930&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1027 &#40;985&#8211;1084&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">2-min push-ups numbers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;21&#8211;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">2-min sit-ups numbers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;40&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Multivariable linear regression analysis was used to determine the associations between physical performance and lung functions&#44; with the following adjustments&#44; including exposures &#40;different types of physical performance&#41; and confounders&#46; Model 1&#58; age&#44; gender&#44; height&#44; weight&#44; waist&#44; mean blood pressure&#44; smoking&#59; Model 2&#58; age&#44; gender&#44; height&#44; weight&#44; waist&#44; mean blood pressure&#44; smoking&#44; 3000<span class="elsevierStyleHsp" style=""></span>m-run time&#44; and 2-min push-up numbers&#59; Model 3&#58; age&#44; gender&#44; height&#44; weight&#44; waist&#44; mean blood pressure&#44; smoking&#44; 3000<span class="elsevierStyleHsp" style=""></span>m-run time&#44; and 2-min sit-up numbers&#59; Model 4&#58; age&#44; gender&#44; height&#44; weight&#44; waist&#44; mean blood pressure&#44; smoking&#44; 3000<span class="elsevierStyleHsp" style=""></span>m-run time&#44; and 2-min push-up numbers&#44; 2-min sit-up numbers&#59; <span class="elsevierStyleItalic">&#946;</span> denotes standardized <span class="elsevierStyleItalic">&#946;</span> coefficient&#46;</p>"
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                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 1</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 2</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 3</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Model 4</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FEV<span class="elsevierStyleInf">1</span></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FVC</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FEV<span class="elsevierStyleInf">1</span></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FVC</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FEV<span class="elsevierStyleInf">1</span></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FVC</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FEV<span class="elsevierStyleInf">1</span></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FVC</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time for a 3000-m run &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;071&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;026<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;087&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;008<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;089&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;004<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;093&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;003<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;078&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;015<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&#46;086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;009<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2-min push-ups numbers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;093&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;096&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;043<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;096&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;014<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;066&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2-min sit-ups numbers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;244&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;063&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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        "texto" => "<p id="par0150" class="elsevierStylePara elsevierViewall">We extend our deepest gratitude to all participants and collaborators who made this study possible&#46; Special thanks to TSGH and Ministry of National Defense R&#46;O&#46;C&#46; for their financial support&#46;</p>"
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Article information
ISSN: 03002896
Original language: English
DOI:10.1016/j.arbres.2024.06.005
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