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The recent article from Church et al¹ adds to their previous work² examining the relationship between cardiorespiratory fitness and mortality among men with type 2 diabetes mellitus. The authors conclude that lower levels of fitness increase the risk for death due to cardiovascular disease (CVD), independent of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters), with men considered class I obese (BMI, 30.0-34.9) or overweight (BMI, 25.0-29.9) and moderately fit having equal risk for CVD death as those categorized as having normal weight (BMI, 18.5-24.9) and a high fitness level. We question this conclusion, based on the analyses presented in Table 3 of their article.¹

The absence of a referent group within each BMI category confounds the dose-response relationship of BMI and fitness. By defining only 1 reference group (low BMI–high fitness) across all BMI-fitness strata, the hazard ratios (HRs) do . . . [Full Text of this Article]

AUTHOR INFORMATION
Steven T. Johnson, MSc; Dean T. Eurich, BSP, MSc; Jeffrey A. Johnson, PhD

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