Exercise for Longevity: Study breakdown shows incredible results

 “Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing”

• https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428

• • “Cohort study of 122 007 consecutive patients undergoing exercise treadmill testing, cardiorespiratory fitness was inversely associated with all-cause mortality without an observed upper limit of benefit”

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• The methods used to quantify cardiorespiratory fitness was a MET on treadmill testing 

• Patients would go on a treadmill slow to begin with and over time the incline and speed of the treadmill gradually increased until the patient stopped because of fatigue or inability to tolerate symptoms 

• The data around their max speed and incline was used to estimate MET’s which are metabolic equivalents 

• 1 MET represents energy expenditure at rest

• An increase in MET represents increased energy expenditure (ex. 2 MET’s = energy expenditure twice that at rest) 

• Patients were then assigned performance groups by age and sex 

• Elite (≥97.7th percentile)

• High (75th-97.6th percentile)

• Above average (50th-74th percentile)

• Below average (25th-49th percentile)

• Low (<25th percentile).

• From the figure above we can see the group being discussed (with variable) vs other groups (ex. Smoking vs non smoking or low cardiorespiratory fitness vs elite cardiorespiratory fitness)

• Hazard ratio (HR) represents the increase (or decrease if < 1) of a group experiencing an event (all cause mortality AKA dying regardless of cause) compared to another group. In this case it is either having a certain variable (smoking, having heart disease, ect) vs not (not smoking, not having heart disease) 

• Smoking, which we know is bad for you, increased all cause mortality by 40% (HR = 1.41) compared to individuals who don’t smoke 

• High blood pressure (hypertension) increased all cause mortality by 20% compared to not having hypertension. 

• Having low cardiovascular fitness compared to high cardiovascular fitness increased your risk of death by 290%

• Now across the board you can see that you are far worse off having low cardiovascular fitness compared to improved cardiovascular fitness 

• Hypothetically, you could be in the elite category for cardiorespiratory fitness AND be a cigarette smoker but still be expected to live a substantially longer life compared to if you were just low fitness level who doesn't smoke

• Why does this matter?

• Think about it, we all know we should exercise because it’s “good for us”, but “good” is an absolute understatement from what these findings show

• Again with the cigarette smoking. Quitting smoking is single handedly one of the best things you can do to improve your health. Smoking is considered a modifiable risk factor for disease, meaning you are in a group of people that will have worse health outcomes for the rest of your life. Something like your race or sex are non-modifiable, you will live every moment of your life as someone who is biologically male or female (not including intersex people because they represent a fraction of the population though do exist) no matter what.  But hypothetically someone who smokes for 10 years and then quits and goes the rest of their life not smoking will no longer be considered a smoker. But not being a cigarette smoker can still put you in a worse bucket for health and longevity if you have low cardiorespiratory fitness. But having low or even average cardiorespiratory fitness is a modifiable risk factor! Of course some people are naturally more fit than others but with adequate training and lifestyle most anyone can achieve an extremely high cardiorespiratory fitness level. And I think this is absolutely incredible. Often we feel hopeless over the things we cannot change especially in terms of the things we care most about. And when it comes to our health not much is more important. Obviously living a long healthy life is really only worth it if we are surrounded by loved ones and we can do the things we love. But what if we could keep doing the things we loved and be there for our loved ones for as long as we can? We can. For me personally my belief is that it is my duty to take care of my health in order to serve others to my highest potential for as long as I can. I take care of myself through a number of ways and I reap the benefits every day. While not every day is perfect and neither is my lifestyle, I take honest efforts to guide my approach. I’m doing very well but I can always do better, and I believe that applies to every individual as well. Others have a much harder time taking care of themselves, often through no fault of their own, and instead work themselves to death being there for others or ruminate on their hardships. I still can’t exactly label this behavior, it’s selfless on the basis that you try to take yourself out of the picture but selfish on the basis that if you realized the interplay between the caregivers wellbeing and the caree’s well being and did nothing to change that and instead focused one pointedly on the carree’s wellbeing, you would worsen there outcomes. It’s complicated and I don’t know half of it but this study sure is something.