Fitness, Fatness, and Mortality: The FIT (Henry Ford Exercise Testing) Project

McAuley, Paul; Blaha, Michael J.; Keteyian, Steven J.; Brawner, Clinton A.; Rifai, Mahmoud Al; Dardari, Zeina; Ehrman, Jonathan K.; Al-Mallah, Mouaz

doi:10.1016/j.amjmed.2016.04.007

Cited by 31 publications

(31 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is the first long-term prospective study demonstrating that fitness may reduce or eliminate the increased risk of SCD in overweight/obese individuals. These findings are compatible with previous reports that obese, fit individuals have similar mortality risks as normal weight, fit individuals 5,6,7 and extend the prophylactic role of fitness to incident SCD in overweight/obese individuals. In particular, our results further substantiate existing evidence regarding the "fat but fit" protective paradox, 8 demonstrating that increased fitness appears to attenuate the risk of SCD in overweight/obese Finnish men, using conventional BMI criteria to define body habitus.…”

Section: Discussionsupporting

confidence: 92%

Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

Jae

Franklin

Kurl

et al. 2018

The American Journal of Cardiology

View full text Add to dashboard Cite

The purpose of this study was to examine the subject and combined associations of cardiorespiratory fitness (fitness) and body mass index (BMI) with the risk of sudden cardiac death (SCD) in middle-aged men. This prospective study was based on a population sample of 2,357 men aged 42 to 60 years, who were followed up in the Kuopio Ischemic Heart Disease cohort study. Fitness was directly measured by peak oxygen uptake (VO) during progressive exercise testing to volitional fatigue. Participants were divided into 4 groups (fit-normal weight, unfit-normal weight, fit-overweight/obese, and unfit-overweight/obese) based on the median values of fitness and BMI. A total of 253 (10.7%) SCDs occurred during an average follow-up of 22 years. After adjusting for potential confounders, the hazard ratio (HR) and 95% confidence interval (CI) for SCD was 1.80 (95% CI 1.21 to 2.68) for BMI ≥30.0 kg/m versus normal weight cohort, that is, BMI corresponding to 18.5 to 24.9 kg/m. However, these associations were no longer statistically significant after adjusting for VO (1.49, 95% CI 0.98 to 2.24). Compared with the lower levels of fitness, upper levels of fitness had a 39% lower risk of SCD (HR 0.61, 95% CI 0.40 to 0.92) after adjusting for potential confounders, including BMI. In the combined associations of fitness and BMI with the risk of SCD, unfit-overweight/obese men had 1.80 times (95% CI 1.06 to 3.06) increased risk of SCD, but fit-overweight/obese men were not at increased risk of SCD (HR 1.22, 95% CI 0.66 to 2.25) as compared with their fit-normal weight counterparts. In conclusion, both overweight/obesity and fitness were independently associated with the risk of SCD; however, fitness appears to attenuate the risk of SCD in overweight/obese men, suggesting that improving fitness may reduce the risk of SCD in this population.

show abstract

Section: Discussionsupporting

confidence: 92%

Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

Jae

Franklin

Kurl

et al. 2018

The American Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…Indeed, it has been shown that smokers have worse fitness than nonsmokers. 26 Since exercise capacity-which was not measured in this cohort-is an important risk factor for all-cause mortality, 27 it would be interesting to explore this further. Finally, it has been suggested that smokers may be less compliant patients than nonsmokers, 28 which could also, in part, explain their worsened survival.…”

Section: Discussionmentioning

confidence: 99%

Effect of smoking on survival of patients with hepatocellular carcinoma

Kolly

Knöpfli

Dufour

2017

Liver International

View full text Add to dashboard Cite

show abstract

“…For example, in study of more than 29,000 ethnically diverse participants, McAuley et al 81 identified reduced exercise capacity as a powerful predictor of total mortality independent of the impact of BMI or obesity. Although the endpoint in this was not CHD or CVD mortality, this finding is informative and quite consistent with previous data showing that fitness may reduce the all-cause and cardiovascular hazards of obesity 82 and that low cardiorespiratory fitness and physical inactivity imposes an adverse impact independent of the impact of obesity.…”

Section: Adverse Impact Of Obesity and Diabetesmentioning

confidence: 99%

Decline in Cardiovascular Mortality

Mensah

Wei

Sorlie

et al. 2017

Circulation Research

618

246

View full text Add to dashboard Cite

If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease (CHD) and stroke has been the success story of the century’s last 4 decades. The early phase of this decline in CHD and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the U.S. population aged. However, in 1978 the participants in a conference convened by the National Heart, Lung, and Blood Institute (NHLBI) concluded that a significant recent downtick in CHD and stroke mortality rates had definitely occurred, at least in the U.S. Since 1978, a sharp decline in mortality rates from CHD and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one-third of their 1960s baseline by 2000. Models have shown that this remarkable decline has been fueled by rapid progress in both prevention and treatment, including precipitous declines in cigarette smoking, improvements in hypertension treatment and control, widespread use of statins to lower circulating cholesterol levels, and the development and timely use of thrombolysis and stents in acute coronary syndrome to limit or prevent infarction. However, despite the huge growth in knowledge and advances in prevention and treatment, there remain many questions about this decline. In fact, there is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups. The NHLBI, through a request for information, is soliciting input that could inform a follow-up conference on or near the 40th anniversary of the original landmark conference in order to further explore these trends in cardiovascular mortality in the context of what has come before and what may lie ahead.

show abstract

Fitness, Fatness, and Mortality: The FIT (Henry Ford Exercise Testing) Project

Cited by 31 publications

References 41 publications

Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

Effect of smoking on survival of patients with hepatocellular carcinoma

Decline in Cardiovascular Mortality

Contact Info

Product

Resources

About