Abdominal obesity and low inflammation levels independent of body mass index (BMI) are inversely associated with fitness, according to a study published in PLoS One.

Anne-Sophie Wedell-Neergaard, MD, PhD student, from the Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, and colleagues conducted an investigation to determine if there was an association between cardiorespiratory fitness, abdominal obesity, and low-grade inflammation in ranging BMI cohorts.

Data from the Danish National Health Examination Survey 2007-2008 (DANHES 2007-2008) were used to perform a cross-sectional analysis. Citizens of the municipalities where the DANHES 2007-2008 was conducted were asked to answer a series of questions, and some were additionally asked to partake in a health examination. The investigators received some or complete responses from 76,484 volunteers; 18,065 volunteers took part in the health examination that required height measurements, body weight, and circumference of waist. Blood samples were used to examine C-reactive protein (hsCRP), which is used to monitor inflammation levels.

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 A final group of 10,973 provided valid maximal data. In men, who comprised about 60% of the volunteers (aged 18 to 95 years), investigators observed an inverse relationship between fitness (+5 mL/min /kg) and waist measurements (-1.45 cm), as well as hsCRP (-0.22 mg/L).

In women, fitness (+5 mL/min/kg) was still inversely related to waist circumference (-115 cm) and hsCRP -0.26 mg/L). All were BMI-independent, and a positive correlation was observed between waist measurements and C-reactive protein in both genders.

“The present study identified a significant difference in the values for abdominal adiposity, fitness and low-grade inflammation, in people with the same BMI,” the authors reported.

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“However, to obtain a more accurate identification of individuals who are healthy despite obesity and individuals who are at metabolic risk despite normal weight, the presented data suggest that measurements of waist circumference, hsCRP, and fitness should be taken into account,” the researchers continued. “Based on the overall results of the current study, we conclude that high fitness levels are inversely associated with the amount of visceral fat and the level of chronic systemic low-grade inflammation regardless of BMI.”


  1. Wedell-Neergaard AS, Eriksen L, Grønbæk M et al. Low Fitness is associated with abdominal adiposity and low-grade inflammation independent of BMI. PLoS One. 2018 Jan 17. doi:10.1371/journal.pone.0190645