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
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