Study Links Fitness in Midlife with Lower Risk of Chronic Diseases

EMBARGOED FOR RELEASE: 3 P.M. (CT), MONDAY, AUGUST 27, 2012

Media Advisory: To contact corresponding author Jarrett D.Berry, M.D., M.S., call Remekca Owens at 214-648-3404 or email remekca.owens@utsouthwestern.edu. To contact commentary author Diane E. Bild, M.D., M.P.H., call the National Heart, Lung and Blood Institute communications office at 301-496-4236 or email nhlbi_news@nhlbi.nih.gov.


CHICAGO– Fitness in midlife appears to be associated with a lower risk of common chronic health conditions later in life in men and women older than 65 years and enrolled in Medicare, according to a study published Online First by Archives of Internal Medicine, a JAMA Network publication.

Benjamin L. Willis, M.D., M.P.H., of the Cooper Institute, Dallas, and colleagues examined the association between midlife fitness and chronic disease outcomes later in life by linking Medicare claims with participant data from the Cooper Center Longitudinal Study, a large group of individuals who were examined at the Cooper Clinic from 1970 to 2009.

The study of 14,726 healthy men and 3,944 healthy woman (overall median age 49 years at baseline) used eight chronic conditions (CCs) for the analysis: congestive heart failure, ischemic heart disease, stroke, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer.

“In the present study, higher fitness measured in midlife was strongly associated with a lower incidence of CCs decades later,” the authors note.

With a median follow-up of 26 years, the highest level of midlife fitness (quintile 5) was associated with a lower incidence of CCs compared with the lowest midlife fitness (quintile 1) in men 15.6 vs. 28.2 per 100 person-years and in women 11.4 vs. 20.1 per 100 person years, according to the study results. Age- and sex-specific quintiles of fitness were based on treadmill times.

Researchers suggest a moderate increase in fitness may mean a reduction in CCs in older age.

“For example, a 1- to 2-MET [metabolic equivalent] improvement in fitness resulting in promotion from the first to the second fitness quintile at age 50 years was associated with a 20 percent reduction in the incidence of CCs at ages 65 and older,” according to the study.

Among those participants who died, researchers note that higher midlife fitness appeared to be more strongly associated with a delay in the development of CCs than with survival.

“Compared with participants with lower midlife fitness, those with higher midlife fitness appeared to spend a greater proportion of their final five years of life with a lower burden of CCs,” the authors comment.

(Arch Intern Med. Published online August 27, 2012. doi:10.1001/archinternmed.2012.3400. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: The corresponding author disclosed financial compensation from Merck, as well as funding and grant support from other sources. The Cooper Institute is a 501(c)(3) nonprofit research institute and provided internal funding for this study. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: Thriving of the Fittest

In a commentary, Diane E. Bild, M.D., M.P.H., of the National Heart, Lung and Blood Institute,Bethesda,Md., writes: “Willis and colleagues provide further evidence for physical fitness as a contributor to healthy aging and the compression of morbidity.”

“Fitness may be a key to healthy aging, but the interpretation and translation of the findings of this article require some caution. …Yet, fitness is a function of both exercise and genetics. Because genetics likely plays a role in longevity and certainly plays a role in disease avoidance, if some of the same genes are involved in longevity and fitness, they may serve as major confounders in the attractive interpretation that exercise leads to fitness, which leads to healthy aging,” Bild continues.

“Research on healthy aging is important for its insights into living longer, healthier and more active lives and, potentially, reducing health care costs. In addition to observational studies such as the present one, clinical trials are needed to establish definitively the benefits and risks of approaches that have been shown in observational studies to be associated with extending health and life,” Bild concludes.

(Arch Intern Med. Published online August 27, 2012. doi:10.1001/archinternmed.2012.3406. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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