Does cardiorespiratory fitness moderate the relationship between overweight, cardiovascular risk markers and mental health among forcibly displaced individuals living in a Greek refugee camp?

Markus Gerber; Konstantinia Filippou; Florian Knappe; Ioannis D Morres; Emmanouil Tzormpatzakis; Elsa Havas; Harald Seelig; Flora Colledge; Sebastian Ludyga; Marianne Meier; Yannis Theodorakis; Roland von Känel; Uwe Pühse; Antonis Hatzigeorgiadis

doi:10.3389/fspor.2024.1334230

Does cardiorespiratory fitness moderate the relationship between overweight, cardiovascular risk markers and mental health among forcibly displaced individuals living in a Greek refugee camp?

Front Sports Act Living. 2024 Oct 21:6:1334230. doi: 10.3389/fspor.2024.1334230. eCollection 2024.

Affiliations

¹ Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
² Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece.
³ Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece.
⁴ Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
⁵ Interdisciplinary Center for Gender Studies, University of Bern, Bern, Switzerland.
⁶ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Abstract

Objectives: Refugees may have an increased risk of developing overweight/obesity as they often experience a nutritional transition. Because maintaining good cardiorespiratory fitness can help reduce the negative impact of excess weight on overall health, the objective of this study was to examine whether fitness moderates the relationship between weight status and cardiovascular and mental health outcomes in forcibly displaced individuals living in a Greek refugee camp.

Methods: A sample of 142 forcibly displaced individuals were recruited. Cardiorespiratory fitness was assessed with the submaximal Åstrand-Rhyming bicycle ergometer test. Blood pressure, blood lipids, blood glucose, and hs-CRP were assessed as physical health outcomes, whereas post-traumatic stress disorder, depression and anxiety symptoms, pain, and quality of life were assessed as mental health outcomes. Main and interaction effects were tested via analyses of covariance (ANCOVAs).

Results: Almost 50% of the participants were overweight/obese, more than 60% presented with very poor fitness levels, and the percentage of participants with very poor fitness levels was particularly high among overweight/obese participants. Whereas overweight/obesity was associated with a less favorable body composition and cardiovascular risk profile, poor fitness was associated with a higher percentage of body fat and a lower percentage of muscle mass. Cardiorespiratory fitness did not moderate the relationship between overweight/obesity and most of the assessed health outcomes.

Conclusions: Only limited support was found for the applicability of the fit-but-fat concept to our population of forcibly displaced individuals. Public health services should prioritize measures to prevent overweight/obesity and associated diseases in refugee camps. Moreover, efforts are needed to improve the fitness of camp residents via exercise/sport interventions.

Keywords: cardiovascular risk factors; fitness; mental health; moderation; refugees.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is partly funded by the Swiss Network for International Studies (SNIS). The funding source has no influence on the design of the study, the collection, management, analysis and interpretation of the data, the writing of the manuscript or on the selection of the journal.