Physical Fitness in Midlife Delays the Onset of Chronic Medical Conditions in Later Life

by Dr Sam Girgis on August 28, 2012

The beneficial effects of living a healthy lifestyle are well known and documented. A healthy lifestyle consists of dieting to maintain a normal weight, limiting alcohol consumption, smoking cessation, and obtaining regular exercise. The World Health Organization recommends 150 minutes of moderate intensity exercise per week for normal adults. Regular physical activity and exercise can result in better cardiovascular health and overall fitness. Regular exercise, healthy dieting, smoking cessation, and limiting alcohol consumption has been shown to reduce the risk of chronic illnesses such as heart disease, diabetes, obesity, stroke, and cancer. Following a healthy lifestyle can lead to an older life that is less burdened with chronic medical conditions.

Researchers, led by Dr. Jarett D. Berry of the University of Texas Southwestern Medical Center in Dallas, have found that midlife fitness can delay or prevent the onset of chronic medical conditions in later life. The results of their study were published online in the Archives of Internal Medicine. The researchers examined the association between midlife fitness and chronic disease in later life by studying 18,670 healthy participants in the Cooper Center Longitudinal Study. The study participants had a mean age of 49 years and 21.1% were women. Fitness was estimated by Balke treadmill time and assigned a variable in metabolic equivalents (METs). Eight common chronic conditions (congestive heart failure, ischemic heart disease, stroke, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer) were studied for their association with midlife fitness after a median follow up of 26 years. The researchers found that the highest quintile of fitness (in METs) was associated with a lower rate of chronic conditions in later life when compared to the lowest quintile of fitness. This finding was consistent for both men and women, even after adjusting for age, body mass index, blood pressure, cholesterol level, glucose level, alcohol use, and smoking.

The authors wrote, “We observed clinically significant associations between midlife fitness levels and chronic disease burden in later life. At lower fitness levels, where the association was strongest, our data suggest that a modest increase in fitness could translate into marked reduction of [chronic conditions] in older age. For example, a 1- to 2-MET improvement in fitness resulting in promotion from the first to the second fitness quintile at age 50 years was associated with a 20% reduction in the incidence of [chronic conditions] at ages 65 and older”.

The authors concluded, “In summary, midlife fitness was associated with a lower risk of common chronic health conditions in men and women older than 65 years enrolled in Medicare. The finding that higher fitness was more strongly associated with [chronic conditions] than with overall survival suggests that higher midlife fitness may be associated with the compression of morbidity in older age”.

In an accompanying commentary, Dr. Diane E. Bild wrote, “…there was a strong graded relationship of fitness to the rate of development of a set of common chronic conditions, including ischemic heart disease, congestive heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer…Fitness appeared strongly protective against each condition, and there were similar relationships in men and women”.

This study is important because it shows that the more physically fit a person is in midlife the less chance that they will develop a chronic medical condition in later life. Although, the researchers did not find a survival advantage for those who were more physically fit, it was found that fitness can delay the onset of medical problems till later in life. The authors termed this “compression of morbidity in older age”. This has important public health implications especially with the growing number of older individuals in the world. Fitness in midlife could be a way to lessen the health burden of an aging population on society and allow for a more prosperous life in the golden years.



Benjamin L. Willis et al. “Midlife Fitness and the Development of Chronic Conditions in Later LifeArch Intern Med. Published online August 27, 2012. doi:10.1001/archinternmed.2012.3400

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