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Fitness in Middle Age
Lowers Medical Costs Later: Study
By Ellin Holohan, HealthDay
News
May 10, 2012
Subsidizing exercise and
fitness-related lifestyles in middle age could
significantly reduce the ballooning cost of health
care in later years, a new study of more than 20,000
people suggests.
The study, slated for Thursday presentation at an
American Heart Association meeting in Atlanta, found
that fit middle-aged men and women had significantly
lower medical expenses later in life compared to
people who failed to stay in shape.
The more-fit study participants had 38 percent lower
medical costs many years later, measured by Medicare
and other insurance claims from 1999 through 2009.
"We wanted to determine if higher levels of physical
fitness in middle age are associated with lower costs
later in life," said study author Dr. Justin Bachmann.
"We found that fitness confers dividends later in life
even when other risk factors such as smoking, high
blood pressure and obesity are controlled for."
The implications of the findings give "credence to
efforts like Michelle Obama's 'Let's Move' campaign,"
he said. The First Lady has initiated a project aimed
at reducing childhood obesity through exercise and
proper nutrition.
Levels of fitness were determined by a treadmill test
measuring metabolic equivalents (METs), Bachmann said.
The higher the METs, the more fit a person is. People
who exercise regularly perform better on the test
because they have greater aerobic capacity, which
translates into better cardiorespiratory health and
lower costs later in life, he said.
The study was a collaboration between the University
of Texas-Southwestern Medical Center and the Cooper
Institute, both in Dallas.
Researchers screened participants for previous heart
attacks, strokes and cancer. Of the 20,489 given a
"healthy" designation, 16,186 were men and 4,303 were
women, with an average age of 51. When Medicare costs
and other insurance payments were compared, the
average age was about 72, Bachmann said. The study
participants were drawn from the Cooper Center
Longitudinal Study, a repository of health-related
data from close to 100,000 patients collected over the
past four decades.
Many of the study participants were business
executives who went to the center for physicals and
represent "an unusually healthy cohort," reducing the
effect of confounding factors, Bachmann said.
The analysis controlled for health risks, such as
smoking, diabetes, high blood pressure, cholesterol
levels and body-mass index (BMI). Body-mass index,
used to measure the impact of obesity, is based on a
combination of height and weight in adults.
Even in the presence of risk factors, better fitness
in middle age predicted lower medical costs later.
The least-fit group at the study's onset had higher
risk factors across the board. For example, 31 percent
of the most out-of-shape men smoked, compared with 9
percent of the most-fit men. About 5 percent of the
least fit men had diabetes, vs. less than 2 percent of
men in the best condition. A similar pattern existed
for women in the study.
Average annual claims for medical costs for the
least-fit men, at $5,134, were about 36 percent higher
than the average of $3,277 a year for the most-fit
men. The average medical claims of $4,565 for the
least-fit women were about 40 percent higher than the
$2,755 average for the most fit.
Another expert called the study "quite compelling" and
connected the results of the treadmill tests to
regular exercise, promoting it as a path toward
fitness.
"Exercise is the best medicine we have," said Dr.
Suzanne Steinbaum, a preventive cardiologist at Lenox
Hill Hospital in New York City. Noting that exercise
has an impact on blood pressure, diabetes and even
mood, she said "the positive effect of exercise on the
body is powerful and it's empowering."
Exercise affects "so many chronic conditions leading
to major health care costs," said Steinbaum, who also
is the hospital's director of women and heart disease.
"We should have financial support for people to go to
gym facilities."
People who are more fit should "get some benefit" from
insurers, Steinbaum said. Society should "give them
the ability to become fit," and then "give people a
reward when they demonstrate" fitness, she added.
Because the new study was presented at a medical
meeting, the data and conclusions should be viewed as
preliminary until published in a peer-reviewed
journal.
More information
To learn more about physical fitness, visit U.S.
National Heart, Lung, and Blood Institute.
SOURCES: Justin Bachmann, M.D., cardiology fellow,
University of Texas-Southwestern Medical Center,
Dallas; Suzanne Steinbaum, M.D., preventive
cardiologist and director of women and heart disease,
Lenox Hill Hospital, New York City; May 10, 2012,
presentation, American Heart Association meeting,
Atlanta
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