Fitness May Cut Death
Risk in Metabolic Syndrome

Being fit seems to counter the effects of having the so-called metabolic syndrome, a cluster of risk factors for diabetes and cardiovascular disease, a large study suggests.

People with metabolic syndrome have several disorders -- such as abdominal obesity, high blood pressure, elevated blood sugar and unhealthy cholesterol levels -- that set the stage for type 2 diabetes, heart disease and stroke. Up to one in four U.S. adults have such a cluster of risk factors.

Researchers with the new study -- involving more than 19,000 men followed for up to 17 years -- found that those with the metabolic syndrome who were fit were less likely to die during the study period.

Among the nearly 3,800 men with the condition, those who were deemed to be out of shape during treadmill tests were twice as likely as those who were fit to die of cardiovascular disease, or any other cause.

And while men with metabolic syndrome were 89 percent more likely than healthy men to die of cardiovascular disease over the years, this difference was slashed when researchers factored in the men's fitness levels at the start of the study.

Healthy men also showed the benefits of fitness: those who were out of shape at the outset were more than three times as likely as their fit peers to die of cardiovascular disease, according to findings published in the Archives of Internal Medicine.

Dr. Peter T. Katzmarzyk of Queen's University in Kingston, Ontario, Canada, led the study.

Overall, he and his colleagues report, fitness appeared to lower men's death risk regardless of body weight. Those who had metabolic syndrome but were fit were generally overweight and carried much of their fat in the abdomen.

The study participants had all attended the Cooper Clinic in Dallas for evaluations between 1979 and 1995. Previous research there has supported the notion that people can be "fat but fit," and that they can still reap the health benefits of fitness.

In one recent study that followed 2,200 men for 15 years, Cooper researchers found that diabetic men who were overweight yet fit had a death risk similar to that of their fit, healthy peers. They estimated that moderate exercise -- such as walking for 30 minutes five times per week -- would be enough to achieve protective fitness levels.

Exactly why physical fitness may cut death risk even in the face of the metabolic syndrome is unclear, according to Katzmarzyk and his colleagues. Regardless, they conclude, this study "strengthens the argument for aggressive public health campaigns aimed at increasing physical activity levels in the population."

SOURCE: Archives of Internal Medicine, May 2004.

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