Being unfit carried more risk than any cardiac risk factor
In 750,302 US veterans aged 30–95, the least fit had about 4× the mortality risk of the extremely fit. The pattern held for men, women, all races and people in their 70s and 80s.
What they studied
- Design
- Observational cohort
- People
- 750,302 US veterans aged 30–95, mean age 61, including 45,232 women
- Follow-up
- Median 10.2 years, 174,807 deaths
- Measure
- Peak METs on a standardised treadmill test
What they found
- Mortality fell steadily with higher fitness across age, sex and race, including people in their 70s and 80s.
- Risk was lowest at about 14 METs, for men (HR 0.24) and women (HR 0.23).
- The least fit (20th percentile) had about 4× the risk of the extremely fit (HR 4.09).
- Extreme fitness showed no increase in risk, and being unfit carried more risk than any cardiac risk factor examined.
How strong is the evidence
Cohort · n≈750k
What this design cannot tell us:
- Observational: it cannot prove that raising fitness lowers risk by the same amount.
- US veterans, mostly men; only 6% were women.
- Fitness was measured once.
What it means for your training
- It is never too late to move up a fitness category. Each step down the ladder costs years.
- Around 14 METs is a useful long-term target; a VO₂max test tells you where you stand.
Our summary of the published abstract. Read the original paper for full details.