Redefining Heart Health: The Power of Physical Activity Across All Body Weights
Emerging research underscores that regular physical activity significantly reduces the risk of cardiovascular disease (CVD) and mortality, irrespective of an individual's body weight. This insight shifts the traditional focus from weight loss to the profound benefits of an active lifestyle for heart health.
The study analyzed data from a diverse population, categorizing participants by body mass index (BMI) and physical activity levels. BMI is a standard measure using height and weight to classify individuals as underweight, normal weight, overweight, or obese. Findings revealed that individuals engaging in regular physical activity had a lower risk of developing CVD and reduced mortality rates across all BMI categories. This suggests that maintaining an active lifestyle is crucial for heart health, regardless of body weight.
These findings advocate for a paradigm shift in public health messaging. Emphasizing consistent physical activity over solely focusing on weight loss can empower individuals across all weight categories to enhance cardiovascular health. This approach highlights the profound impact of an active lifestyle on overall well-being and longevity.
Article Information
Physical activity, cardiovascular disease, and mortality across obesity levels
Published in EPMA Journal. By Qiuyue Tian et al.
Abstract
Aims: High physical activity (PA) is associated with decreased risk of cardiovascular disease (CVD) and mortality. However, whether PA can be sufficient to reduce the risk of CVD and mortality contributing to adiposity remains unclear. From the standpoint of predictive, preventive, and personalized medicine (PPPM/3PM), joint assessment of PA and adiposity provides novel insights for individual risk assessment, targeted prevention, and personalized intervention of CVD.
Methods: This prospective cohort study included 92,931 participants in the Kailuan study in Tangshan, followed between the years 2006 and 2020. Adiposity was assessed by body mass index (BMI) and waist circumference (WC). The CVD incidence and all-cause mortality associated with 3 PA levels (low, medium, and high PA) were analyzed by applying Cox regression models to different adiposity subgroups.
Results: After a median follow-up period of 14.02 years, 9997 incident CVD cases and 12,586 deaths occurred. Surprisingly, low PA and lean body mass were at a lower risk for CVD than other phenotypes. Participants with high PA still had a 35% higher CVD risk from obesity (hazard ratio (HR) BMI: 1.35, 95% confidence interval (CI): 1.18-1.54) and a 10% higher CVD risk from central obesity (HRcentral obesity: 1.10, 95% CI: 1.00-1.21) than those with lean. However, only in obese individuals, high PA has a protective effect on CVD (HR: 0.78, 95% CI: 0.64-0.95). Overall obesity and high PA were not associated with increased risk of all-cause mortality, whereas high PA could not attenuate mortality risk associated with central obesity.
Conclusion: High PA did not attenuate the risk of CVD associated with adiposity compared with lean body mass among the Chinese population, whereas the combination of high PA and healthy WC might improve healthy aging and longevity. In addition, this study revealed the importance of maintaining muscle health in obese individuals via PA or other ways. It provides a novel strategy for mitigating the risk of CVD by exercising intervention or maintaining body mass, thereby enhancing effective prevention and targeted intervention.
Supplementary information: The online version contains supplementary material available at 10.1007/s13167-025-00397-5.
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