Sustaining Physical Activity With Age Decreases All-Cause Mortality Risk Interview with:
“physical-activity-120112-M-2021D-019” by MilitaryHealth is licensed under CC BY 2.0
Trine Moholdt, PhD
Research Fellow
Department of Circulation and Medical Imaging | Exercise, Cardiometabolic Health and Reproduction
Norwegian University of Science and Technology What is the background for this study?

Response: Although obese individuals have an increased risk of cardiovascular disease, evidence from many observational studies shows that in those who already have cardiovascular disease, being overweight or obese is associated with lower risk of mortality compared to their normal weight counterparts.

This phenomenon is often called the “obesity paradox”. Recently we observed that in individuals who have a high physical activity level, there is no such obesity paradox and body mass index did not associate with survival time in those who with high physical activity (Moholdt et al, American Journal of Medicine, 2017). What are the main findings?

Response: In this study, we were able to investigate how changes in both BMI and changes in physical activity levels related to survival in individuals with coronary heart disease. Sustaining a high level of physical activity over the years was associated with a 36% reduction in all-cause mortality risk. Even in those who did not undertake as much physical activity as recommended (minimum 150 minutes of moderate intensity physical activity per week) had a 19% risk reduction. For individuals who were previously inactive, taking up the recommended level of physical activity associated with a 32% reduction in the risk of dying from cardiovascular diseases.

We observed increased risk of mortality in those who lost weight over the years. However, this finding was only true for those who had a BMI within the normal weight range (18.5-24.9 kg/m2) at baseline. Also, in the normal weight individuals, gaining weight over the years was related to improved survival. Among individuals with a BMI of 25 of more at baseline, we did not observe any relationship between either loss or gain in body weight and survival. What should readers take away from your report?

Response: We think that the most important take away message from our study is the importance of promoting regular physical activity in individuals with coronary heart disease. Finding strategies to increase physical activity levels in those who are not active enough can save many lives. What recommendations do you have for future research as a result of this work?

Response: We need to investigate if intentional weight loss is beneficial in individuals who have coronary heart disease and who are overweight/obese. A limitation with our design was that we did not know the reason for changes in weight over the years. We also need to carry on with finding exercise regimes that people can adhere to and fit into their daily lives. Future research should also focus on how to establish physical activity and cardiovascular fitness as a very important clinical parameter/vital sign in clinical practice.

Disclosure: Carl J Lavie, one of the co-authors on the paper, is the author of the book “The Obesity Paradox”


Journal of the American College of Cardiology 71(10):1094-1101 · March 2018
DOI: 10.1016/j.jacc.2018.01.011

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