Are You Out of Shape? It’s as Dangerous as Being a Smoker

We all know that fitness is important. Why? A new study shows that people who are in shape live longer than those who are not. In fact, even if you never smoked in your life, if you are a couch potato you have about the same risk of early death as if you are a smoker!

A team of Cleveland Clinic researchers and physicians designed a study to verify the common-sense notion that people who are physically in good shape live longer than those who are not.[i] By “in good shape” they are referring to cardiorespiratory (heart-lung) fitness—meaning whatever aerobic activity you do, you are building the ability of your body to burn energy efficiently and last longer while doing it. The results show how aerobically fit a person is.

The researchers wanted an objective way to evaluate if cardiorespiratory fitness is indeed linked with longevity (living longer). They also wanted to know if it’s possible to be “too fit”—to exercise to the point of overusing your body and wrecking your health.

It’s interesting to note that this study did not focus on any particular type of exercise or aerobic routine. Instead, fitness was defined by performance on a treadmill stress test. (If you’ve never had one, it’s jogging on a treadmill that gradually increases the speed and incline, all the while being hooked up to a device that records what’s going on with your heart.)

The research team had stress test records for 122,007 consecutive patients, and access to their health/death records for up to 10 years after they completed the test (median follow-up 8.4 years). Based on their test results, the researchers divided them into fitness categories:

  • low (<25th percentile)
  • below average (25th-49th percentile)
  • above average (50th-74th percentile)
  • high (75th-97.6th percentile)
  • elite (?97.7th percentile or top 2%).

Death occurred in 13,637 persons. Not surprisingly, those who were in the lower fitness categories had higher rates of premature death, while those in the upper categories had longer lifespans. In fact, “The 2 percent of the people with elite fitness lived longer than those with high fitness and were about 80 percent less likely to die prematurely than the men and women with the lowest endurance.”[ii] These elite fitness buffs had the lowest risk-adjusted all-cause mortality compared with all other categories.

If there is any surprise to their findings, it’s this: “The increase in all-cause mortality associated with reduced cardiorespiratory fitness … was comparable to or greater than traditional clinical risk factors” including coronary artery disease, smoking, and diabetes.[iii] Let me put this another way: If you are a fitness slouch, you have about the same chance as a smoker of dying early—even if you never took a puff in your life. Therefore, according to one reporter who wrote an article on the study, “Being in shape may be as important to a long life as not smoking…”[iv]

Of course, there are many factors that influence longevity that this study did not consider. A person’s genetic makeup, their socioeconomic status, their access to healthcare, and an interest in being healthy were not included in the records.

One of the authors, Dr. Wael Jaber, sums up the value of the evidence for all of us. “We know from other research that you can increase fitness with exercise,” he says. “So I think we can say, based on this study and others, that it is a very good idea to exercise if you hope for a long and healthy life.”[v]

All of us at the Sperling Prostate Center encourage you (and all our patients and readers) to commit to vigorous aerobic exercise three times per week. Remember that what’s healthy for your heart is healthy for your prostate, too.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.


[i] Mandsager K, Harb S, Cremer P et al. JAMA Netw Open. 2018;1(6):e183605.

[ii] Gretchen Reynolds. “Being Fit may be as Good for You as Not Smoking.” NY Times, Oct. 31, 2018. https://www.nytimes.com/2018/10/31/well/move/being-fit-may-be-as-good-for-you-as-not-smoking.html

[iii] Mandsager et al., ibid.

[iv] Reynolds, ibid.

[v] Ibid.