Walking Pace Addresses Fit versus Fat Debate Interview with:
sneakers-walkingFrancesco Zaccardi, MD, PhD

Clinical Epidemiologist
Assistant Director Leicester Real World Evidence Unit
Leicester Diabetes Centre
UK What is the background for this study?

Response: The role of excess body weight on mortality has been extensively investigated during the last decades. Studies from several countries have also shown, however, that the risk of death in persons who are overweight or obese is lower if their fitness, a parameter indicating cardio-pulmonary health, is higher.

Most of these studies reported the beneficial effect of fitness in terms of relative risk reduction, for example 20% reduction of risk of death. Relative estimates, though, are difficult to interpret. What are the main findings? 

Response: In this context, we quantified the comparative importance of excess of body fat, assessed with the body mass index (BMI), and fitness on the risk of death, to better interpret and clarify the so-called “fit vs fat” question. For this study we used walking pace, which is a good measure of fitness and overall physical function.

Using a large database of around 500,000 people in UK, we observed that participants reporting a fast walking pace, have a long life expectancy regardless of the levels of BMI, from normal weight to overweight and obesity. By reporting the effect of BMI and fitness in terms years of life gained (or lost) we hope to facilitate the comparison of the absolute (rather than relative) impact of the two parameters on the risk of death. What should readers take away from your report?

Response: This investigation further underlines that information on body weight or obesity should be complemented with that on cardiorespiratory fitness to have a better estimation of the risk of death is.

In particular, our results also indicated that persons at lower BMI (<20 kg/m2) with concomitant lower fitness are at the highest risk of death. What recommendations do you have for future research as a result of this work?

Response: Future research is required to:

1) Confirm these results in ethnically different population, as UK Biobank includes for the most part white Caucasians;

2) Formally assess the prognostic relevance of fitness compared to other well-established risk factors, such as smoking or high levels of cholesterol. Is there anything else you would like to add?

Response: This study has been supported by the National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, UK, and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East Midlands. The funding sources had no role in study design, data collection, data analysis, data interpretation or writing of the report.

Comparative Relevance of Physical Fitness and Adiposity on Life Expectancy
Zaccardi, Francesco et al.
Mayo Clinic Proceedings , Volume 0 , Issue 0

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May 16, 2019 @ 2:15 pm 

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