Fat Versus Fit, Continued

One of the perennial debates in obesity research is about the relativecontributions of fatness and fitness to morbidity and mortality. Both obesityand physical inactivity are linked to mortality. Some suggest that physicalactivity and fitness have a stronger influence on cardiovascular death thanweight, that it might be possible to be “fat andfit.”

Researchers at the Cooper Institute in Dallas, among the leading proponentsof the fat-and-fit concept, recently reported a study of 2,316 men withdiabetes showing that low fitness—determined by treadmill test—isassociated with increased risk of cardiovascular mortality across a range ofbody mass index (BMI) levels.

Data were derived from participants in the Aerobics Center LongitudinalStudy, which included men 21–99 years old with no history of stroke orheart attack who had type 1 or type 2 diabetes. Participants were followed foran average of 15.9 years, during which 179 cardiovascular deaths wereidentified.

The men had a BMI of 18.5–35 and were categorized as normal (BMI18.5–24.9), overweight (BMI 25–29.9), or obese (BMI 30–35,class 1 obesity). Fitness was based on performance at low, moderate, or highlevels. When other factors were controlled for, men in the lowest fitnesslevel were almost three times more likely to suffer cardiovascular death thanthose in the highest level of fitness.

The results emphasize the need for clinicians to address the fitness andphysical activity of their patients with diabetes, the group concludes.

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