This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (38)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in this journal  Topic Collections  • Men's Health  • Exercise  • Alert me on articles by topic  Social Bookmarking   What's this?

Timothy S. Church, MD, MPH, PhD; Michael J. LaMonte, PhD; Carolyn E. Barlow, MS; Steven N. Blair, PED

Arch Intern Med. 2005;165:2114-2120.

Background  Questions remain as to whether higher levels of cardiorespiratory fitness, a measure of regular physical activity, are associated with lower risk of cardiovascular disease (CVD) mortality in overweight and obese individuals with diabetes. Our objective was to quantify the independent and joint relations of cardiorespiratory fitness (hereafter, fitness) and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) with CVD mortality in men with diabetes.

Methods  This study was conducted using prospective observational data from the Aerobics Center Longitudinal Study. Study participants comprised 2316 men with no history of stroke or myocardial infarction and who were diagnosed as having diabetes (mean [SD] age, 50 [10] years); had a medical examination, including a maximal exercise test during 1970 to 1997 with mortality surveillance to December 31, 1998; and had a BMI of 18.5 or greater and less than 35.0. The main outcome measure was CVD mortality across levels of fitness with stratification by BMI.

Results  We identified 179 CVD deaths during a mean (SD) follow-up of 15.9 (7.9) years and 36 710 man-years of exposure. In a model containing age, examination year, fasting glucose level, systolic blood pressure, parental history of premature CVD, total cholesterol level, cigarette smoking, abnormal resting, and exercise electrocardiograms, a significantly higher adjusted risk of mortality was observed in men with a low fitness level who were normal weight (hazard ratio, 2.7 [95% confidence interval, 1.3-5.7]), overweight (hazard ratio, 2.7 [95% confidence interval, 1.4-5.1]), and class 1 obese (hazard ratio, 2.8 [95% confidence interval, 1.4-5.1]) compared with normal weight men with a high fitness level.

Conclusion  In this cohort of men with diabetes, low fitness level was associated with increased risk of CVD mortality within normal weight, overweight, and class 1 obese weight categories.

Author Affiliations: The Cooper Institute, Dallas, Tex.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTERS

Diabetes, Fitness, and Body Mass Index
Steven T. Johnson, Dean T. Eurich, and Jeffrey A. Johnson
Arch Intern Med. 2006;166(12):1326-1327.
EXTRACT | FULL TEXT  

Diabetes, Fitness, and Body Mass Index—Reply
Timothy S. Church, Michael J. LaMonte, Carolyn E. Barlow, and Steven N. Blair
Arch Intern Med. 2006;166(12):1327.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Income Disparities in Body Mass Index and Obesity in the United States, 1971-2002
Virginia W. Chang and Diane S. Lauderdale
Arch Intern Med. 2005;165(18):2122-2128.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Joint Associations of Adiposity and Physical Activity With Mortality: The National Institutes of Health-AARP Diet and Health Study
Koster et al.
Am J Epidemiol 2009;169:1344-1351.
ABSTRACT | FULL TEXT  

Systematic analysis of adaptations in aerobic capacity and submaximal energy metabolism provides a unique insight into determinants of human aerobic performance
Vollaard et al.
J. Appl. Physiol. 2009;106:1479-1486.
ABSTRACT | FULL TEXT  

Exercise Capacity and All-Cause Mortality in African American and Caucasian Men With Type 2 Diabetes
Kokkinos et al.
Diabetes Care 2009;32:623-628.
ABSTRACT | FULL TEXT  

Does physical activity ameliorate the health hazards of obesity?
Lee et al.
Br. J. Sports. Med. 2009;43:49-51.
ABSTRACT | FULL TEXT  

Management of cardiovascular disease in patients with diabetes: the 2008 Canadian Diabetes Association guidelines
Bhattacharyya et al.
CMAJ 2008;179:920-926.
FULL TEXT  

Physical Activity and Cardiovascular Disease Prevention: Current Recommendations
Kokkinos
ANGIOLOGY 2008;59:26S-29S.
ABSTRACT  

Update on Obesity
Bessesen
J. Clin. Endocrinol. Metab. 2008;93:2027-2034.
ABSTRACT | FULL TEXT  

Maximal Exercise Electrocardiography Responses and Coronary Heart Disease Mortality Among Men With Diabetes Mellitus
Lyerly et al.
Circulation 2008;117:2734-2742.
ABSTRACT | FULL TEXT  

Cardiorespiratory Fitness as a Predictor of Cancer Mortality Among Men With Pre-Diabetes and Diabetes
Thompson et al.
Diabetes Care 2008;31:764-769.
ABSTRACT | FULL TEXT  

Brief Supported Lifestyle Counseling: Modest Interventions Yield Modest Effects
McManus and Ockene
Arch Intern Med 2008;168:129-130.
FULL TEXT  

Clinic-Based Support to Help Overweight Patients With Type 2 Diabetes Increase Physical Activity and Lose Weight
Christian et al.
Arch Intern Med 2008;168:141-146.
ABSTRACT | FULL TEXT  

Association of Exercise Capacity on Treadmill With Future Cardiac Events in Patients Referred for Exercise Testing
Peterson et al.
Arch Intern Med 2008;168:174-179.
ABSTRACT | FULL TEXT  

Aerobic Fitness Attenuates the Metabolic Syndrome Score in Normal-Weight, at-Risk-for-Overweight, and Overweight Children
DuBose et al.
Pediatrics 2007;120:e1262-e1268.
ABSTRACT | FULL TEXT  

Exercise Capacity and Cardiovascular/Metabolic Characteristics of Overweight and Obese Individuals With Type 2 Diabetes: The Look AHEAD clinical trial
Ribisl et al.
Diabetes Care 2007;30:2679-2684.
ABSTRACT | FULL TEXT  

Effects of Physical Activity and Weight Loss on Skeletal Muscle Mitochondria and Relationship With Glucose Control in Type 2 Diabetes
Toledo et al.
Diabetes 2007;56:2142-2147.
ABSTRACT | FULL TEXT  

Exercise Capacity and Body Mass as Predictors of Mortality Among Male Veterans With Type 2 Diabetes
McAuley et al.
Diabetes Care 2007;30:1539-1543.
ABSTRACT | FULL TEXT  

Muscle and Liver Insulin Resistance Indexes Derived From the Oral Glucose Tolerance Test
Abdul-Ghani et al.
Diabetes Care 2007;30:89-94.
ABSTRACT | FULL TEXT  

Walking Faster: Distilling a complex prescription for type 2 diabetes management through pedometry
Johnson et al.
Diabetes Care 2006;29:1654-1655.
FULL TEXT  

Diabetes, Fitness, and Body Mass Index--Reply
Church et al.
Arch Intern Med 2006;166:1327-1327.
FULL TEXT  

Diabetes, fitness, and body mass index.
Johnson et al.
Arch Intern Med 2006;166:1326-1327.
FULL TEXT  

Dyspnea and stress testing.
Haji et al.
NEJM 2006;354:871-873.
FULL TEXT  

Fat Versus Fit, Continued
DOC News 2006;3:12-12.
FULL TEXT