HealthDay News — High midlife fitness levels are associated with a lower risk for developing chronic conditions later in life, study findings indicate.

Among 18,670 healthy participants in the Cooper Center Longitudinal Study, men and women in the highest quintile of fitness had significantly lower incidence of chronic conditions than those in the lowest quintile (15.6 vs. 28.2 and 11.4 vs. 20.1, respectively, per 100 person-years), Benjamin L. Willis, MD, MPH, from the Cooper Institute in Dallas and colleagues reported in the Archives of Internal Medicine.

In metabolic equivalents (METs), this association remained for both men (HR=0.95; 95% CI: 0.94-0.96) and women (HR=0.94; 95% CI: 0.91-0.96), even after adjusting for age, BMI, BP, cholesterol and glucose levels, alcohol use and smoking.

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The study involved 14,726 healthy men and 3,944 healthy woman (overall median age 49 years at baseline) and had a median follow-up of 26 years. The researchers analyzed the effects of exercising on eight chronic conditions: congestive heart failure, ischemic heart disease, stroke, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer.

The study findings indicate that a moderate increase in fitness may mean a reduction in chronic conditions in older age, the researchers suggested.

“For example, a 1- to 2-MET improvement in fitness resulting in promotion from the first to the second fitness quintile at age 50 years was associated with a 20% reduction in the incidence of chronic conditions at ages 65 and older,” the researchers wrote.

Furthermore, among 2,406 participants who died during the study period, higher fitness was associated with lower risk for developing chronic conditions relative to survival (compression HR=0.90; 95% CI: 0.88 -0.92 per MET).

“Compared with participants with lower midlife fitness, those with higher midlife fitness appeared to spend a greater proportion of their final five years of life with a lower burden of chronic conditions,” the researchers wrote.

In an accompanying editorial, Diane E. Bild, MD, MPH, of the National Heart, Lung and Blood Institute in Bethesda, Md., acknowledged that the study by Willis et al provides further evidence for physical fitness as a contributor to healthy aging, but cautioned that the role of genetics cannot be overlooked.

“Because genetics likely plays a role in longevity and certainly plays a role in disease avoidance, if some of the same genes are involved in longevity and fitness, they may serve as major confounders in the attractive interpretation that exercise leads to fitness, which leads to healthy aging,” Bild wrote.

She called for additional clinical trials “to establish definitively the benefits and risks of approaches that have been shown in observational studies to be associated with extending health and life.”


  1. Willis BL et al. Arch Intern Med. doi:10.1001/archinternmed.2012.3400.
  2. Bild DE et al. Arch Intern Med. doi:10.1001/archinternmed.2012.3406.