For Pre-Diabetes, Being Fit Beats Being Thin

Prediabetes patients who were fit were more likely to live longer no matter how heavy they were

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) When it comes to improving health in people with pre-diabetes, fitness may matter more than fatness. In fact, a heavy person who is fit may have just as good a chance of survival as a normal weight person who is fit.

About 80 percent of people with type 2 diabetes are overweight, and being above normal weight is certainly a risk factor for getting diabetes, according to the American Diabetes Association.

A recent study found that cardiovascular fitness may be more important than fatness, regardless of weight. People in the study with pre-diabetes who had good cardiovascular health had a lower risk of death than those who were less fit.

"Exercise regularly to improve pre-diabetes."

Paul McAuley, PhD, associate professor of health education in the Department of Human Performance and Sport Sciences at Winston-Salem State University in North Carolina, led this analysis of 17,044 individuals with pre-diabetes. About 9 out of 10 of these individuals were men.

People with pre-diabetes are heading toward getting diabetes. They have blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes.

Having pre-diabetes, however, doesn’t mean that a person will automatically develop diabetes. The American Diabetes Association says that those with pre-diabetes can lower the chances of getting type 2 diabetes by lowering body weight by at least 7 percent and exercising moderately for at least 30 minutes, five days a week.

According to the results of Dr. McAuley’s study, exercise may be the more important factor.

Participants all completed at least one maximal exercise tolerance test between 1974 and 2002 to measure their cardiorespiratory fitness. Cardiorespiratory fitness is a measure of how well the body supplies oxygen to the muscles and how well the muscles are able to use that oxygen.

For this study, researchers used time on a standard treadmill test to categorize patients as "fit" or "unfit." For example, a male in his 40s registered as unfit if he could not walk on a treadmill for several minutes at 3 miles per hour at a 5 percent incline.

The participants did not have a history of diabetes, cardiovascular disease or cancer.

After following patients for an average of 14 years, the investigators counted 832 deaths, 246 due to cardiovascular disease.

Those classified as normal weight but unfit were 70 percent more likely to die and 88 percent more likely to die from cardiovascular disease compared to those who were normal weight and fit.

Those who were overweight or obese but evaluated as fit were no different from the reference group of those who were normal weight and fit.

Dr. McAuley told dailyRx News, “Our findings indicate that being fit is more important than being thin in terms of mortality risk. But our findings should not be misinterpreted. Being unfit and obese was the worst combination. Study participants who were unfit and obese had the highest cardiovascular disease mortality risk — more than three times higher compared to the fit and normal weight reference group.”

He advised that fitness is a key factor for longevity regardless of body fatness for people at risk for diabetes, so exercise should not be for the sole purpose of losing weight.

This study appears in the October issue of Diabetes Care and was published online September 23.

Review Date: 
September 26, 2013
Last Updated:
September 26, 2013