Not exercising worse for your health than smoking, diabetes and heart disease, study reveals
Replies
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OldAssDude wrote: »Regular exercise is a lot more important than most people think, in not only maintaining a healthy body weight, but for total health. And that includes joint, bone, muscles, heart, lungs, skin, all other organs, and even brain health.
Just look at the world around us.
The medical, care giver, and mental health industries are thriving.
We are slowly becoming fat, lazy, and helpless.
If you look at how humans evolved over time, were are actually becoming far, lazy and helpless pretty quickly.3 -
Packerjohn wrote: »OldAssDude wrote: »Regular exercise is a lot more important than most people think, in not only maintaining a healthy body weight, but for total health. And that includes joint, bone, muscles, heart, lungs, skin, all other organs, and even brain health.
Just look at the world around us.
The medical, care giver, and mental health industries are thriving.
We are slowly becoming fat, lazy, and helpless.
If you look at how humans evolved over time, were are actually becoming far, lazy and helpless pretty quickly.
Compared to a couple million years of evolution, yes.
But slowly if you consider the time since man invented the couch and technology.2 -
NorthCascades wrote: »"Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker," Jaber told CNN. "We've never seen something as pronounced as this and as objective as this."
...
Researchers retrospectively studied 122,007 patients who underwent exercise treadmill testing at Cleveland Clinic between January 1, 1991 and December 31, 2014 to measure all-cause mortality relating to the benefits of exercise and fitness.
...
What made the study so unique, beyond the sheer number of people studied, he said was that researchers weren't relying on patients self-reporting their exercise. "This is not the patients telling us what they do," Jaber said. "This is us testing them and figuring out objectively the real measure of what they do."
https://www.cnn.com/2018/10/19/health/study-not-exercising-worse-than-smoking/index.html
Nice thing is one can start exercising as long as they are not messed up by the side effects the other listed health issues that often lead to a premature death anyway.2 -
CarvedTones wrote: »I think there are other correlations that affect it; people who exercise regularly are more likely to be people who also have a reasonably healthy diet and don't smoke. So I don't think it is just exercise alone that makes such a huge difference. I am exercising regularly, BTW. This not me being defensive, just making an observation.
I agree....so many studies never take into account the overall habits of a person. These studies villify a single action (drinking for example) or exhalt another (exercise) without looking at the whole picture.
Yes, if someone exercises on a regualr basis, chances are they care about their diet, take supplements, and pay attention to environmental factors that impact health, and therefore live longer. That's a big surprise?5 -
kshama2001 wrote: »But... Worse prognosis, as far as death meaning what exactly? We all die at the end anyway.
I assume that means dying younger.
Let's talk about quality of life, though. My extremely active 80 year old mom has a great quality of life, while other people her age I know do not. Also, I met a 92 year old Senior Olympian last year who was truly inspirational.
This notorious octogenarian works out twice per week.
That's exactly my point. I would rather they'd said morbidity rather than mortality.2 -
kshama2001 wrote: »But... Worse prognosis, as far as death meaning what exactly? We all die at the end anyway.
I assume that means dying younger.
Let's talk about quality of life, though. My extremely active 80 year old mom has a great quality of life, while other people her age I know do not. Also, I met a 92 year old Senior Olympian last year who was truly inspirational.
This notorious octogenarian works out twice per week.
That's exactly my point. I would rather they'd said morbidity rather than mortality.
I may have to go back and reread, but I believe it was people who died during the 14 year study period from any cause.
EDIT - I did reread it. I still believe that's what they mean exactly because they used the word mortality. The mortality rate of a study is determined by deaths during the study period.2 -
lynn_glenmont wrote: »NorthCascades wrote: »"Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker," Jaber told CNN. "We've never seen something as pronounced as this and as objective as this."
...
Researchers retrospectively studied 122,007 patients who underwent exercise treadmill testing at Cleveland Clinic between January 1, 1991 and December 31, 2014 to measure all-cause mortality relating to the benefits of exercise and fitness.
...
What made the study so unique, beyond the sheer number of people studied, he said was that researchers weren't relying on patients self-reporting their exercise. "This is not the patients telling us what they do," Jaber said. "This is us testing them and figuring out objectively the real measure of what they do."
https://www.cnn.com/2018/10/19/health/study-not-exercising-worse-than-smoking/index.html
Well, no. It's researchers testing people and making an assumption about what the stress test results indicated about their exercise. The CNN headline and some of the quotes from the researchers assume that stress test results are accurate indicators of ... how much people exercise?? How hard they exercise?? It's not really clear. Somebody needs to study what kind of exercise, in what amounts (duration and frequency), and at what intensity best improves your results on a stress test.
They’re testing aerobic fitness regardless of training regimen. Do you know a way to improve aerobic fitness without appropriate aerobic exercise?6 -
Just thought I'd mention I am 83. I walk the dog daily, mow the grass, garden, run my own home, do my own cooking, I've just made the weekly bread by hand, and I don't drink alcohol or smoke anything. Never take the flu shot - only had flu once, way back in 1957. All my generation of family and friends are now either pushing up daisies or in old folk homes. I did yoga once, but have never been to a gym. Not sure why I'm still around, active and more or less free of arthritis. Think it might be moderation in all things ?20
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The article:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428?resultClick=3
I believe the data was collected from 1991 to 2014 with the average length of time a patient was tracked being about 8 years.
It was interesting. I think they are right in saying fitness helps improve how long you will live, especially in the elderly. For younger people, I'm not sure how much it helps.
I think their conclusions may have been a bit too sweeping though. For instance, does someone have CVD because they don't exercise or do they not exercise due to health issues like CVD, obesity, etc.? There is no information on why someone is not as fit.
I used to be very fit. I could play sports, bench press my weight and ran half marathons on the weekends. A reconstructed knee, spinal injury, a few autoimmune diseases and hip and knee arthritis later, and I am not nearly as fit as I used to be. I can't exercise like I used to due to heath issues. My fitness is limited by my health. It makes me wonder in that study, how many people had their fitness limited by health issues, and not just health (or mortality) limited by their fitness?
Good to see that high levels of exercise do not appear to affect mortality though. That's a nice myth to have die off.8 -
Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.8
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Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.5 -
Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
It's a matter of correlation vs causation.8 -
Just thought I'd mention I am 83. I walk the dog daily, mow the grass, garden, run my own home, do my own cooking, I've just made the weekly bread by hand, and I don't drink alcohol or smoke anything. Never take the flu shot - only had flu once, way back in 1957. All my generation of family and friends are now either pushing up daisies or in old folk homes. I did yoga once, but have never been to a gym. Not sure why I'm still around, active and more or less free of arthritis. Think it might be moderation in all things ?
Possibly genes, possibly your healthy habits, possibly luck. More likely a mix of these things. It's all about increasing or decreasing risk; we are just trying to adjust the odds. I am doing all I can to make it more likely that I will live a long and healthy life but I understand there is no way I can guarantee it.
May the odds be ever in your favor.8 -
Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.
I was obese and so unfit that i had trouble putting my shoes on, walking stairs, and getting in and out of my car. I was diagnosed with diverticulitis when i was 56 and was in and out of the hospital several times over the next year for an abscessed colon. I wound up having to get surgery to remove a section of my colon when i was 57.
Because i was obese and so unfit they told me i had to have testing done on my heart and lungs to see if i could survive the surgery.
The testing of my lungs uncovered that i had COPD (i was a heavy smoker for over 40 years and was smoking 3 packs a day).
They did a stress test of my heart and it did not turn out good, so they had to do a catheterization. That uncovered that at some point in time i had a heart attack.
I survived the surgery, but they told me that if i did not start exercising, lose weight, and quit smoking that i would not be around much longer. They recommended walking to start.
I tried walking a mile at a slow pace and it damn near killed me. I had to lie down for an hour just to recover from it. I felt so pathetic that i asked my wife to shoot me in the head and put me out of my misery. I was a fitness instructor in the army back in the 1980's so i had the knowledge of what i had to do to beat this thing, so i just kept walking and laying down. 2, 3, sometimes 4 times a day. I got a fitness tracker, set it up to lose 1 lb per week, and started logging my food until i taught myself how to eat properly. The food part was easy because i burned a lot of calories walking every day, so i was actually eating more than before.
I got to the point that i could not get my heart rate up enough just walking so i started adding run intervals into my power walking. I also got a bike and a kayak along the way and started doing that too.
Now, i'm 61, and i can power walk at over a 4 mph pace for over 10 miles, i can run 5 miles at a slow pace, my resting heart rate went from the high 80's to the high 50's, all my blood work comes back normal now, i cut my bad cholesterol in half, and more than doubled my good cholesterol. I went from a size 40 pants to a size 32, have lost well over 50 lbs., and used electronic cigarettes to quit smoking (have not smoked a cigarette in 2 years).
I recently had another stress test done on my heart and not only is my heart strong and healthy now, but it actually healed itself from the heart attack. The cardiologist told me it was because of all the cardio that i do.
I do at least 1 activity every day, 7 days a week, even if it's only a 1.5 mile power walk.
people with chronic conditions (like me) in most cases could find a way to increase their fitness levels if they really wanted to. Some choose to do so, and some choose not to do so.
The CDC (along with other health organizations) recommend 150 minutes of exercise per week, and double that (300 minutes per week) for older people.
Is that enough causation for ya?20 -
OldAssDude wrote: »Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.
I was obese and so unfit that i had trouble putting my shoes on, walking stairs, and getting in and out of my car. I was diagnosed with diverticulitis when i was 56 and was in and out of the hospital several times over the next year for an abscessed colon. I wound up having to get surgery to remove a section of my colon when i was 57.
Because i was obese and so unfit they told me i had to have testing done on my heart and lungs to see if i could survive the surgery.
The testing of my lungs uncovered that i had COPD (i was a heavy smoker for over 40 years and was smoking 3 packs a day).
They did a stress test of my heart and it did not turn out good, so they had to do a catheterization. That uncovered that at some point in time i had a heart attack.
I survived the surgery, but they told me that if i did not start exercising, lose weight, and quit smoking that i would not be around much longer. They recommended walking to start.
I tried walking a mile at a slow pace and it damn near killed me. I had to lie down for an hour just to recover from it. I felt so pathetic that i asked my wife to shoot me in the head and put me out of my misery. I was a fitness instructor in the army back in the 1980's so i had the knowledge of what i had to do to beat this thing, so i just kept walking and laying down. 2, 3, sometimes 4 times a day. I got a fitness tracker, set it up to lose 1 lb per week, and started logging my food until i taught myself how to eat properly. The food part was easy because i burned a lot of calories walking every day, so i was actually eating more than before.
I got to the point that i could not get my heart rate up enough just walking so i started adding run intervals into my power walking. I also got a bike and a kayak along the way and started doing that too.
Now, i'm 61, and i can power walk at over a 4 mph pace for over 10 miles, i can run 5 miles at a slow pace, my resting heart rate went from the high 80's to the high 50's, all my blood work comes back normal now, i cut my bad cholesterol in half, and more than doubled my good cholesterol. I went from a size 40 pants to a size 32, have lost well over 50 lbs., and used electronic cigarettes to quit smoking (have not smoked a cigarette in 2 years).
I recently had another stress test done on my heart and not only is my heart strong and healthy now, but it actually healed itself from the heart attack. The cardiologist told me it was because of all the cardio that i do.
I do at least 1 activity every day, 7 days a week, even if it's only a 1.5 mile power walk.
people with chronic conditions (like me) in most cases could find a way to increase their fitness levels if they really wanted to. Some choose to do so, and some choose not to do so.
The CDC (long with other health organizations) recommend 150 minutes of exercise per week, and double that (300 minutes per week) for older people.
Is that enough causation for ya?
Congratulations. I hope you have continued success.
The article compares various levels of fitness, and it seems to have had focus on the effect of extreme/elite exercise on mortality. They say that more exercise = more fitness = longest lived. That would not correlate with the people only doing the 150 minutes walking each week, although I am sure there is benefits in doing so and they are better off than those who are unable to exercise, or have chosen not to.
My point is that not everyone can exercise enough to get the correlated benefits, and not everyone can exercise enough, or hard enough, to get the best correlated benefits. Some are exercising less because of their health issues.
I will never again climb mountains after work and run 20-30km on Saturdays. Health issues, which could contribute to an earlier death than I'd prefer , have affected what I am able to do. Is the fact that I am not at a high fitness level cause health problems and my earlier demise, or will the health problems that may lead to an earlier death happen to correlate with the fact that they limit my exercise?
I think exercise is beneficial though. Don't get me wrong.3 -
OldAssDude wrote: »Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.
I was obese and so unfit that i had trouble putting my shoes on, walking stairs, and getting in and out of my car. I was diagnosed with diverticulitis when i was 56 and was in and out of the hospital several times over the next year for an abscessed colon. I wound up having to get surgery to remove a section of my colon when i was 57.
Because i was obese and so unfit they told me i had to have testing done on my heart and lungs to see if i could survive the surgery.
The testing of my lungs uncovered that i had COPD (i was a heavy smoker for over 40 years and was smoking 3 packs a day).
They did a stress test of my heart and it did not turn out good, so they had to do a catheterization. That uncovered that at some point in time i had a heart attack.
I survived the surgery, but they told me that if i did not start exercising, lose weight, and quit smoking that i would not be around much longer. They recommended walking to start.
I tried walking a mile at a slow pace and it damn near killed me. I had to lie down for an hour just to recover from it. I felt so pathetic that i asked my wife to shoot me in the head and put me out of my misery. I was a fitness instructor in the army back in the 1980's so i had the knowledge of what i had to do to beat this thing, so i just kept walking and laying down. 2, 3, sometimes 4 times a day. I got a fitness tracker, set it up to lose 1 lb per week, and started logging my food until i taught myself how to eat properly. The food part was easy because i burned a lot of calories walking every day, so i was actually eating more than before.
I got to the point that i could not get my heart rate up enough just walking so i started adding run intervals into my power walking. I also got a bike and a kayak along the way and started doing that too.
Now, i'm 61, and i can power walk at over a 4 mph pace for over 10 miles, i can run 5 miles at a slow pace, my resting heart rate went from the high 80's to the high 50's, all my blood work comes back normal now, i cut my bad cholesterol in half, and more than doubled my good cholesterol. I went from a size 40 pants to a size 32, have lost well over 50 lbs., and used electronic cigarettes to quit smoking (have not smoked a cigarette in 2 years).
I recently had another stress test done on my heart and not only is my heart strong and healthy now, but it actually healed itself from the heart attack. The cardiologist told me it was because of all the cardio that i do.
I do at least 1 activity every day, 7 days a week, even if it's only a 1.5 mile power walk.
people with chronic conditions (like me) in most cases could find a way to increase their fitness levels if they really wanted to. Some choose to do so, and some choose not to do so.
The CDC (long with other health organizations) recommend 150 minutes of exercise per week, and double that (300 minutes per week) for older people.
Is that enough causation for ya?
Congratulations. I hope you have continued success.
The article compares various levels of fitness, and it seems to have had focus on the effect of extreme/elite exercise on mortality. They say that more exercise = more fitness = longest lived. That would not correlate with the people only doing the 150 minutes walking each week, although I am sure there is benefits in doing so and they are better off than those who are unable to exercise, or have chosen not to.
My point is that not everyone can exercise enough to get the correlated benefits, and not everyone can exercise enough, or hard enough, to get the best correlated benefits. Some are exercising less because of their health issues.
I will never again climb mountains after work and run 20-30km on Saturdays. Health issues, which could contribute to an earlier death than I'd prefer , have affected what I am able to do. Is the fact that I am not at a high fitness level cause health problems and my earlier demise, or will the health problems that may lead to an earlier death happen to correlate with the fact that they limit my exercise?
I think exercise is beneficial though. Don't get me wrong.
Why are you over complicating this.
The very simple point of this whole thing is that if you exercise, you will probably live longer than if you don't. And even if you are not at an elite fitness level, you will still probably live longer.
And with a better quality of life.12 -
OldAssDude wrote: »OldAssDude wrote: »Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.
I was obese and so unfit that i had trouble putting my shoes on, walking stairs, and getting in and out of my car. I was diagnosed with diverticulitis when i was 56 and was in and out of the hospital several times over the next year for an abscessed colon. I wound up having to get surgery to remove a section of my colon when i was 57.
Because i was obese and so unfit they told me i had to have testing done on my heart and lungs to see if i could survive the surgery.
The testing of my lungs uncovered that i had COPD (i was a heavy smoker for over 40 years and was smoking 3 packs a day).
They did a stress test of my heart and it did not turn out good, so they had to do a catheterization. That uncovered that at some point in time i had a heart attack.
I survived the surgery, but they told me that if i did not start exercising, lose weight, and quit smoking that i would not be around much longer. They recommended walking to start.
I tried walking a mile at a slow pace and it damn near killed me. I had to lie down for an hour just to recover from it. I felt so pathetic that i asked my wife to shoot me in the head and put me out of my misery. I was a fitness instructor in the army back in the 1980's so i had the knowledge of what i had to do to beat this thing, so i just kept walking and laying down. 2, 3, sometimes 4 times a day. I got a fitness tracker, set it up to lose 1 lb per week, and started logging my food until i taught myself how to eat properly. The food part was easy because i burned a lot of calories walking every day, so i was actually eating more than before.
I got to the point that i could not get my heart rate up enough just walking so i started adding run intervals into my power walking. I also got a bike and a kayak along the way and started doing that too.
Now, i'm 61, and i can power walk at over a 4 mph pace for over 10 miles, i can run 5 miles at a slow pace, my resting heart rate went from the high 80's to the high 50's, all my blood work comes back normal now, i cut my bad cholesterol in half, and more than doubled my good cholesterol. I went from a size 40 pants to a size 32, have lost well over 50 lbs., and used electronic cigarettes to quit smoking (have not smoked a cigarette in 2 years).
I recently had another stress test done on my heart and not only is my heart strong and healthy now, but it actually healed itself from the heart attack. The cardiologist told me it was because of all the cardio that i do.
I do at least 1 activity every day, 7 days a week, even if it's only a 1.5 mile power walk.
people with chronic conditions (like me) in most cases could find a way to increase their fitness levels if they really wanted to. Some choose to do so, and some choose not to do so.
The CDC (long with other health organizations) recommend 150 minutes of exercise per week, and double that (300 minutes per week) for older people.
Is that enough causation for ya?
Congratulations. I hope you have continued success.
The article compares various levels of fitness, and it seems to have had focus on the effect of extreme/elite exercise on mortality. They say that more exercise = more fitness = longest lived. That would not correlate with the people only doing the 150 minutes walking each week, although I am sure there is benefits in doing so and they are better off than those who are unable to exercise, or have chosen not to.
My point is that not everyone can exercise enough to get the correlated benefits, and not everyone can exercise enough, or hard enough, to get the best correlated benefits. Some are exercising less because of their health issues.
I will never again climb mountains after work and run 20-30km on Saturdays. Health issues, which could contribute to an earlier death than I'd prefer , have affected what I am able to do. Is the fact that I am not at a high fitness level cause health problems and my earlier demise, or will the health problems that may lead to an earlier death happen to correlate with the fact that they limit my exercise?
I think exercise is beneficial though. Don't get me wrong.
Why are you over complicating this.
The very simple point of this whole thing is that if you exercise, you will probably live longer than if you don't. And even if you are not at an elite fitness level, you will still probably live longer.
And with a better quality of life.
I'm just discussing correlation vs causation.
More fitness correlates with a longer life. It may not cause it. But then again it may, but this study doesn't really prove that.
I'm all for fitness for better quality of life and to feel better.
Here is the graph that shows the correlation between fitness and mortality. There is a correlation. They just have not shown whether the exercisers live longer because of the exercise, or are they exercising because they are already healthier?
Either way, exercise seems beneficial.
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CarvedTones wrote: »I think there are other correlations that affect it; people who exercise regularly are more likely to be people who also have a reasonably healthy diet and don't smoke. So I don't think it is just exercise alone that makes such a huge difference. I am exercising regularly, BTW. This not me being defensive, just making an observation.
The study (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428) did account for smoking and some other variables. Not for diet, which I think is understandable in a retrospective study with so many individuals -- not to mention the difficulty of setting parameters for "a reasonably healthy diet.To adjust for differences in baseline characteristics between performance groups, a multivariable Cox proportional hazards regression model was constructed to obtain the risk-adjusted association between all-cause mortality and CRF. Covariates incorporated into the model included age, sex, body mass index, history of CAD, hyperlipidemia, hypertension, diabetes, smoking, ESRD, year of testing, and current use of aspirin, β-blockers, or statins.CarvedTones wrote: »
Lots of conflicting anecdata out there. One of the things that makes this study stand out is that it is 122,000 patients across 14 years. The people who weren't fit were roughly 4 times as likely to die during the study period compared to the ones that were fit. It would be interesting to know how they measured fitness and what the cutoff is to say whether or not someone is fit. It would also be interesting to know how many died.
Again, from the published study:
The study population included 122 007 patients (mean [SD] age, 53.4 [12.6] years; 72 173 [59.2%] male). Death occurred in 13 637 patients during 1.1 million person-years of observation.lynn_glenmont wrote: »NorthCascades wrote: »"Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker," Jaber told CNN. "We've never seen something as pronounced as this and as objective as this."
...
Researchers retrospectively studied 122,007 patients who underwent exercise treadmill testing at Cleveland Clinic between January 1, 1991 and December 31, 2014 to measure all-cause mortality relating to the benefits of exercise and fitness.
...
What made the study so unique, beyond the sheer number of people studied, he said was that researchers weren't relying on patients self-reporting their exercise. "This is not the patients telling us what they do," Jaber said. "This is us testing them and figuring out objectively the real measure of what they do."
https://www.cnn.com/2018/10/19/health/study-not-exercising-worse-than-smoking/index.html
Well, no. It's researchers testing people and making an assumption about what the stress test results indicated about their exercise. The CNN headline and some of the quotes from the researchers assume that stress test results are accurate indicators of ... how much people exercise?? How hard they exercise?? It's not really clear. Somebody needs to study what kind of exercise, in what amounts (duration and frequency), and at what intensity best improves your results on a stress test.
They’re testing aerobic fitness regardless of training regimen. Do you know a way to improve aerobic fitness without appropriate aerobic exercise?
I'm not a researcher, but I try to avoid making assumptions that I haven't seen any support for. The assumption here (more by the CNN story, this thread, and quotes in the CNN story by the researchers, rather than the actual study results as published) is that differences in CRF (cardiorespiratory fitness) across individuals as measured in an exercise treadmill test are completely attributable to "exercise," rather than genetics, general activity levels, environmental conditions, or something else not occurring to me now.
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OldAssDude wrote: »OldAssDude wrote: »Why does it matter “why” someone is unfit? The study is pretty clear: lack of fitness correlates with risk of death. The “why” may inform interventions but doesn’t impact the outcome interaction, that lack of fitness may predict risk of death.
Some people are more likely to be less fit, and die younger, due to health problems. They just happen to lose fitness as their health condition progresses.
I'm not saying that lack of fitness does not correlate with risk of death. I'm saying that there may not be much causation. Fitness may drop off if someone has a chronic, possibly life threatening condition. Those without those problems are more likely to be able to achieve a greater level of fitness. IMO
For (a more extreme) example, retirement, wrinkles and grey hair also correlate with an increased risk of death. There's no causation there.
I was obese and so unfit that i had trouble putting my shoes on, walking stairs, and getting in and out of my car. I was diagnosed with diverticulitis when i was 56 and was in and out of the hospital several times over the next year for an abscessed colon. I wound up having to get surgery to remove a section of my colon when i was 57.
Because i was obese and so unfit they told me i had to have testing done on my heart and lungs to see if i could survive the surgery.
The testing of my lungs uncovered that i had COPD (i was a heavy smoker for over 40 years and was smoking 3 packs a day).
They did a stress test of my heart and it did not turn out good, so they had to do a catheterization. That uncovered that at some point in time i had a heart attack.
I survived the surgery, but they told me that if i did not start exercising, lose weight, and quit smoking that i would not be around much longer. They recommended walking to start.
I tried walking a mile at a slow pace and it damn near killed me. I had to lie down for an hour just to recover from it. I felt so pathetic that i asked my wife to shoot me in the head and put me out of my misery. I was a fitness instructor in the army back in the 1980's so i had the knowledge of what i had to do to beat this thing, so i just kept walking and laying down. 2, 3, sometimes 4 times a day. I got a fitness tracker, set it up to lose 1 lb per week, and started logging my food until i taught myself how to eat properly. The food part was easy because i burned a lot of calories walking every day, so i was actually eating more than before.
I got to the point that i could not get my heart rate up enough just walking so i started adding run intervals into my power walking. I also got a bike and a kayak along the way and started doing that too.
Now, i'm 61, and i can power walk at over a 4 mph pace for over 10 miles, i can run 5 miles at a slow pace, my resting heart rate went from the high 80's to the high 50's, all my blood work comes back normal now, i cut my bad cholesterol in half, and more than doubled my good cholesterol. I went from a size 40 pants to a size 32, have lost well over 50 lbs., and used electronic cigarettes to quit smoking (have not smoked a cigarette in 2 years).
I recently had another stress test done on my heart and not only is my heart strong and healthy now, but it actually healed itself from the heart attack. The cardiologist told me it was because of all the cardio that i do.
I do at least 1 activity every day, 7 days a week, even if it's only a 1.5 mile power walk.
people with chronic conditions (like me) in most cases could find a way to increase their fitness levels if they really wanted to. Some choose to do so, and some choose not to do so.
The CDC (long with other health organizations) recommend 150 minutes of exercise per week, and double that (300 minutes per week) for older people.
Is that enough causation for ya?
Congratulations. I hope you have continued success.
The article compares various levels of fitness, and it seems to have had focus on the effect of extreme/elite exercise on mortality. They say that more exercise = more fitness = longest lived. That would not correlate with the people only doing the 150 minutes walking each week, although I am sure there is benefits in doing so and they are better off than those who are unable to exercise, or have chosen not to.
My point is that not everyone can exercise enough to get the correlated benefits, and not everyone can exercise enough, or hard enough, to get the best correlated benefits. Some are exercising less because of their health issues.
I will never again climb mountains after work and run 20-30km on Saturdays. Health issues, which could contribute to an earlier death than I'd prefer , have affected what I am able to do. Is the fact that I am not at a high fitness level cause health problems and my earlier demise, or will the health problems that may lead to an earlier death happen to correlate with the fact that they limit my exercise?
I think exercise is beneficial though. Don't get me wrong.
Why are you over complicating this.
The very simple point of this whole thing is that if you exercise, you will probably live longer than if you don't. And even if you are not at an elite fitness level, you will still probably live longer.
And with a better quality of life.
Why would it be over complicating things to want to drill down on the "why"? Some of us enjoy really digging into stuff like this.
The health/medical community got mired in the low-fat movement for a couple of decades because they didn't dig deeper into the research.
Obviously exercise is beneficial, no one is debating that. But if a study is going to start putting habits in order of how much damage they do, I'd personally like to try to figure out how accurate it is. I've already had a coworker mention seeing this headline and say they're more hopeful than ever that their time on the treadmill is mitigating the damage of their smoking7 -
My point is that not everyone can exercise enough to get the correlated benefits, and not everyone can exercise enough, or hard enough, to get the best correlated benefits. Some are exercising less because of their health issues.
Well your point represents a fundamental misunderstanding of the research.
As has been pointed out, this demonstrates correlation and not causation. This paper does not say that if you "exercise enough" you can achieve the better outcomes. Those who are exercising less due to their health issues are more likely to die sooner/younger, period. There is nothing in this paper that says exercising more will save your life, it says that people who are more fit live longer. Fitness has many attributes, a large one (but not the only one) of which is aerobic exercise.lynn_glenmont wrote: »I'm not a researcher, but I try to avoid making assumptions that I haven't seen any support for. The assumption here (more by the CNN story, this thread, and quotes in the CNN story by the researchers, rather than the actual study results as published) is that differences in CRF (cardiorespiratory fitness) across individuals as measured in an exercise treadmill test are completely attributable to "exercise," rather than genetics, general activity levels, environmental conditions, or something else not occurring to me now.
The bolded part seems to be your assumption, not the assumption of the researchers. Health and fitness are multi-factorial. One factor (aerobic fitness) has a demonstrably strong association with outcomes (death). Other factors are at play for sure, but to discount this study is insane. The other variables - genetics, activity levels, environment - are essentially non-factors due to the tremendous sample size.
Look, a 1970s Caddilac with a V8 engine is less fuel efficient than a VW Golf with a 1.2L 4 cylinder engine. I could demonstrate that a smaller and more efficient engine is strongly correlated with fuel consumption and people would jump in going "well you didn't consider differences in fuel refining techniques, global temperature, and weight of the occupants!" Sure those things impact fuel consumption too, but just because B and C and D are part of the equation does not undermine the role of A.8
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