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      Fitness vs. fatness on all-cause mortality: a meta-analysis.

      Progress in cardiovascular diseases
      Body Mass Index, Cardiovascular Diseases, mortality, physiopathology, Cause of Death, Exercise Test, Female, Health Status, Heart Function Tests, Humans, Male, Obesity, Physical Fitness, physiology, Proportional Hazards Models, Reference Values, Risk Assessment, Survival Analysis

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          Abstract

          The purpose of this study was to quantify the joint association of cardiorespiratory fitness (CRF) and weight status on mortality from all causes using meta-analytical methodology. Studies were included if they were (1) prospective, (2) objectively measured CRF and body mass index (BMI), and (3) jointly assessed CRF and BMI with all-cause mortality. Ten articles were included in the final analysis. Pooled hazard ratios were assessed for each comparison group (i.e. normal weight-unfit, overweight-unfit and -fit, and obese-unfit and -fit) using a random-effects model. Compared to normal weight-fit individuals, unfit individuals had twice the risk of mortality regardless of BMI. Overweight and obese-fit individuals had similar mortality risks as normal weight-fit individuals. Furthermore, the obesity paradox may not influence fit individuals. Researchers, clinicians, and public health officials should focus on physical activity and fitness-based interventions rather than weight-loss driven approaches to reduce mortality risk. © 2013.

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