Obesity versus Physical Activity In Predicting CHD and Mortality: Epi Inquiry Accolade 02/5/2006

[Epidemiologic Inquiry 2006, 1: 12]

In the past few years, some researchers have suggested that adiposity is not an important risk factor of disease and mortality as long as individuals maintain high levels of physical activity (in other words," it is okay to be fat as long as you're active"). However, such assertion has been refuted by many other epidemiologists as highly inaccurate and woefully irresponsible for public health.

Notably, in December 2004 in the New England Journal of Medicine, investigators from the Nurse's Health Study jointly stratified by levels of adiposity and physical activity. Results indicated that adiposity and physical activity were clearly independent risk factors for overall mortality (in fact, opposite of the refuted theory, those lean and inactive were at relatively lower risk compared to those obese and active).

Moreover, a similar analysis was published this past week in the journal Circulation, to assess the independence of adiposity and physical activity for risk of coronary heart disease (CHD). As found in the mortality analysis, increasing adiposity and decreasing physical activity again independently predicted CHD risk. The authors noted that most studies in the literature supported such independent results, and the few dissensing studies were often conducted among those with very short follow-up, relatively fewer number of cases, and among those with pre-existing cardiovascular disease.

Thus, for clearly highlighting such important issues, the editors select as the Epidemiologic Inquiry Accolade: Investigation of the Week...

Obesity as compared with physical activity in predicting risk of coronary heart disease in women.
Li TY, Rana JS, Manson JE, Willett WC, Stampfer MJ, Colditz GA, Rexrode KM, Hu FB.
Circulation. 2006 Jan 31;113(4):499-506.

and also recognize...
Adiposity as compared with physical activity in predicting mortality among women.
Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE.
N Engl J Med. 2004 Dec 23;351(26):2694-703.