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Regular motion is more important indicator for health than over / weight

October 20th, 2015 | by Czech Association
Regular motion is more important indicator for health than over / weight
Exercise & Fitness

Fitness, Fatness, and Survival in Adults With Prediabetes

OBJECTIVE The purpose of this study was to examine independent and joint associations of cardiorespiratory fitness (CRF) and different adiposity measures with mortality risk in individuals with prediabetes (or impaired fasting glucose).

RESEARCH DESIGN AND METHODS We examined associations of CRF and fatness with cardiovascular disease (CVD) and all-cause mortality in a cohort of 17,044 participants (89% men) with prediabetes (defined as 100 mg/dL ≤ fasting plasma glucose < 126 mg/dL), who did not have a history of diabetes, CVD, or cancer.

RESULTS We identified 832 deaths (246 from CVD) during 13.9 ± 7.0years (mean ± SD) follow-up. Normal-weight individuals who were unfit (lowest one-third) had a higher risk of all-cause (hazard ratio 1.70 [95% CI 1.32–2.18]) and CVD (1.88 [1.13–3.10]) mortality compared with the normal-weight and fit (upper two-thirds) reference group in a model adjusted for age, sex, examination year, and multiple risk factors. The mortality risk for fit individuals who were overweight or obese did not differ significantly from the reference group. Similar patterns were observed for sex-specific thirds of waist circumference and % body fat.

CONCLUSIONS CRF markedly modifies the relationship between adiposity and mortality in persons with prediabetes. Unfit individuals have a higher and fit individuals have a lower mortality risk irrespective of adiposity level in this high-risk group.


The prevalence of type 2 diabetes mellitus (DM) in the U.S. has increased to nearly 26 million and could double or triple by 2050, according the latest estimates from the American Diabetes Association. It is estimated that another 79 million people have pre-DM or impaired fasting glucose, which progresses to DM at an estimated rate of 5% per year. In addition, prediabetes increases the risk for all-cause and cardiovascular disease (CVD) mortality. Therefore, there is an urgent need to clarify risk factors for mortality that are specific to individuals with pre-DM as part of an overall strategy to reduce the hazards of this condition.

In two recent, large observational studies in adults with type 2 DM who were free of CVD, those who were normal weight had higher mortality risk than those who were overweight or obese (the so-called “obesity paradox”). However, there are limited data on whether the obesity paradox observed in DM extends to pre-DM, which was reported only in women. Furthermore, cardiorespiratory fitness (CRF) modifies the obesity paradox in patients with coronary heart disease and heart failure, but to our knowledge this has not been examined in individuals with pre-DM.

In a previous report from the Aerobics Center Longitudinal Study (ACLS), we examined associations of CRF and adiposity measures with risks of incident impaired fasting glucose. In the present investigation, we extend observations on the relative importance of fitness versus fatness as risk factors in adults with pre-DM by examining independent and joint associations of CRF and three standard clinical measures of adiposity (BMI, waist circumference [WC], and body fat percentage [%BF]) with CVD and all-cause mortality. We hypothesized that the obesity paradox would be present in this population overall but that adiposity level would be a weaker predictor than CRF for CVD mortality and all-cause mortality. Additionally, since there is controversy regarding the impact of different levels of impaired fasting glucose (e.g., <110 vs. >110 mg/dL) on CVD risk, the impact of adiposity and CRF was also assessed at these levels of pre-DM.


This article is commented by prof., MD. Milan Kvapil, CSc., MBA.


For the laymen:

This study was published in the prestigious journal Diabetes Diabetes Care and examined the relationship of physical fitness (ie. cardiorespiratory fitness, so the ability of the heart and vascular system to deliver oxygenated blood to working muscles), thickness and risk of death in people with prediabetes (impaired fasting plasma glucose).

This extensive study with more than a hundred thousand people came to the conclusion that physical fitness is bargain for patients with prediabetes – more or less independently of whether the patient has or has not an optimal body weight.

The difference in mortality from cardiovascular disease among unable-bodied people with overweight or obese and slim able-bodied people was more than three times. Good physical fitness reduces the risk of deaths from diseases of the cardiovascular system and the overall risk of all-cause death.


It is not the same – overweight and obesity. That is the purpose of the outcome cited scientific paper. It is known that if you want to lose your weight you must limit yourself in food. Although it is healthy and good, just that not everyone can do this. The fact which comes from this cited scientific study was confirmed, this idea has been discussed for several years in the scientific circles. From the point of view of our condition and our health, especially in terms of our future is more important movements not the presence of overweight and obesity. This information is extremely important. Almost everybody can add at least some movement during each day into daily routine. Even those who can not observe strict reducing diet. Thus they improve their health very significantly.



Diabetes Care [Internet]. American Diabetes Association (United States). Vol. 37, No. 2, February 2014 – [cited 2015 Oct 20]

Available from: http://care.diabetesjournals.org/content/37/2/529.full?sid=65c353d3-85f8-4b96-b5ac-5afe470402d7

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