When it comes to good health, which is more important — maintaining an ideal weight or being fit? It’s a good question, especially for people with diabetes, and one not easy to answer, but a group of researchers at Johns Hopkins School of Medicine have published a new report that sheds some light on the topic.
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The researchers evaluated mortality rates for a period of about 10 years among a group of 8,528 adults with diabetes. Their mean age was approximately 58 and the male-female split was about 50-50. First, the scientists recorded the BMIs of the subjects (body-mass index, or BMI, is a person’s weight in kilograms divided by the square of their height in meters and is used to assess overweight and obesity). Then they evaluated the subjects’ fitness by using a standard treadmill stress test and separated them into high, moderate and low fitness groups.
The researchers reported that “overall, obese patients had a 30% lower mortality hazard compared with normal-weight patients.” How could this be? Fitness, according to Seamus P. Whelton, MD, lead author of the study. As he expressed it, “a higher fitness level was associated with a consistent and significantly lower mortality rate regardless of BMI.”
A main aim of the new study was to evaluate what’s known as “the obesity paradox.” This is a theory that proposes that among certain groups of people (such as those who are very old or who have certain chronic diseases), being overweight might unexpectedly be related to greater survival and lower mortality. The hypothesis has been challenged, but it remains thought-provoking. In this current study the obesity paradox seemed to be relevant, but the researchers reported that the paradox “was less pronounced for patients with the highest fitness level, and these patients also had the lowest risk of mortality.” Nevertheless, as they put it, “Compared with the lowest fitness group, patients with higher fitness had… a lower mortality hazard regardless of BMI.”
This latest research follows a study done last year by the same Johns Hopkins research team. That report was on seniors in general, not only on people with diabetes, and included more than 6,500 people aged 70 and above. In that study, according to Whelton, “We found fitness is an extremely strong risk predictor of survival in the older age group — that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit.”