Comparative Relevance of Physical Fitness and Adiposity on Life Expectancy

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Comparative Relevance of Physical Fitness and Adiposity on Life Expectancy
A UK Biobank Observational Study
Francesco Zaccardi
Correspondence
Correspondence: Address to Francesco Zaccardi, MD, PhD, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Rd, Leicester LE5 4PW, United Kingdom.
Diabetes Research Centre, University of Leicester, United Kingdom
University Hospitals of Leicester NHS Trust, United Kingdom
Diabetes Research Centre, University of Leicester, United Kingdom
University Hospitals of Leicester NHS Trust, United Kingdom
NIHR Leicester Biomedical Research Centre, United Kingdom
Diabetes Research Centre, University of Leicester, United Kingdom
NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) East Midlands, United Kingdom
Diabetes Research Centre, University of Leicester, United Kingdom
NIHR Leicester Biomedical Research Centre, United Kingdom
Abstract
Objective
To investigate the extent to which 2 measures of physical fitness—walking pace and handgrip strength—are associated with life expectancy across different levels of adiposity, as the relative importance of physical fitness and adiposity on health outcomes is still debated.
Patients and Methods
Usual walking pace (self-defined as slow, steady/average, brisk), dynamometer-assessed handgrip strength, body mass index (BMI), waist circumference, and body-fat percentage determined at baseline in the UK Biobank prospective cohort study (March 13, 2006, to January 31, 2016). Life expectancy was estimated at 45 years of age.
Results
The median age and BMI of the 474,919 participants included in this analysis were 58.2 years and 26.7 kg/m2, respectively; over a median follow-up of 6.97 years, 12,823 deaths occurred. Participants reporting brisk walking pace had longer life expectancies across all levels of BMIs, ranging from 86.7 to 87.8 years in women and 85.2 to 86.8 years in men. Conversely, subjects reporting slow walking pace had shorter life expectancies, being the lowest observed in slow walkers with a BMI less than 20 kg/m2 (women: 72.4 years; men: 64.8 years). Smaller, less consistent differences in life expectancy were observed between participants with high and low handgrip strength, particularly in women. The same pattern of results was observed for waist circumference or body-fat percentage.
Conclusion
Brisk walkers were found to have longer life expectancies, which was constant across different levels and indices of adiposity. These findings could help clarify the relative importance of physical fitness and adiposity on mortality.
Abbreviations and Acronyms:
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Published online: May 09, 2019
Footnotes
For editorial comment, see page 942
Grant Support: Drs Davies and Yates received funding from National Institute for Health Research (NIHR), Leicester Biomedical Research Centre , Leicester, UK. Dr Khunti received funding from NIHR Collaboration for Leadership in Applied Health Research and Care, East Midlands. Dr Zaccardi is a clinical research fellow, funded with an unrestricted educational grant from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East Midlands to the University of Leicester; the funding source had no role in study design, data collection, data analysis, data interpretation or writing of the report. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.
Potential Competing Interests: Dr Khunti is on speaker bureaus for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier, and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis , Novo Nordisk , Sanofi-Aventis , Lilly , Pfizer , Boehringer Ingelheim , and Merck Sharp & Dohme and funds for research and honoraria for speaking at meetings and advisory boards for Lilly, Sanofi-Aventis, Merck Sharp & Dohme, and Novo Nordisk. Dr Davies is a consultant, advisory board member, and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, and Janssen and speaker for Mitsubishi Tanabe Pharma Corporation. She has received grants in support of investigator and investigator-initiated trials from Novo Nordisk , Sanofi-Aventis , and Lilly . Drs Zaccardi and Yates have no potential competing interests to report.
Publication dates: Received for publication September 13, 2018; revisions received October 24, 2018; accepted for publication October 31, 2018.
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