On Your Marks, Get Set, Measure Heart Health
How fast can you run a mile?
For people in midlife, this simple measure of fitness may help predict their risk of heart problems as they age.
In two separate studies, researchers from the University of Texas Southwestern Medical School and the Cooper Institute in Dallas analyzed fitness levels for more than 66,000 people. Over all, the research showed that a personís fitness level at midlife is a strong predictor of long-term heart health, proving just as reliable as traditional risk factors like cholesterol level or high blood pressure. The two reports were published last month in Circulation and The Journal of the American College of Cardiology.
In the studies, fitness was measured using carefully monitored treadmill testing to gauge cardiovascular endurance and muscle fatigue. But in analyzing the data, the researchers suggested that the treadmill results could be translated to average mile times, offering a simple formula for doctors and individuals to rate their fitness level at midlife and predict long-term heart risk.
"When you try to boil down fitness, what does fitness mean?" said Dr. Jarett D. Berry, assistant professor of internal medicine and cardiology at Southwestern Medical School and a co-author of both papers. "In both these studies, how fast you can run in midlife is very strongly associated with heart disease risk when youíre old. The exercise you do in your 40s is highly relevant to your heart disease risk in your 80s."
Dr. Berry cautioned that more study is needed before mile times could be used as an accepted benchmark of cardiovascular risk. Still, he noted that the pace at which a person runs is a measure of fitness to which people can easily relate, and a good starting point for measuring overall fitness.
From the study data, Dr. Berry calculated that a man in his 50s who can run a mile in 8 minutes or less, or a woman who can do it in 9 minutes or less, shows a high level of fitness. A 9-minute mile for a man and 10:30 for a woman are signs of moderate fitness; men who canít run better than a 10-minute mile, and women slower than 12 minutes, fall into the low-fitness category.
The categories make a big difference in risk for heart problems, the study found: Subjects in the high-fitness group had a 10 percent lifetime risk, compared with 30 percent for those in the low-fitness group.
Dr. Berry notes that fitness varies greatly with age and sex, and that mile-time estimates are just easy benchmarks for patients and doctors to begin a discussion about fitness. Over all, he said, a 10-minute mile for a middle-aged man and a 12-minute mile for a woman suggest a good level of fitness.
"The principal finding of these studies is that your fitness level when youíre young is highly predictive of heart disease risk 30 to 40 years later," he said. "If weíre trying to boil this down into practical implications, itís the speed at which you can run. Heart disease risk increases markedly for every minute longer it takes you to run a mile."
Dr. Timothy Church, a professor at the Pennington Biomedical Research Center in Baton Rouge, La., said more research was needed to validate the notion that a personís mile time correlates with the risk categories in the original study. But he agreed that exercise experts needed to come up with a better way to communicate exactly what fitness represents.
"You canít look at someone and judge whether or not they are fit," said Dr. Church. "What is fitness? From a risk-factor standpoint, itís about avoiding low fitness."
And he sounded another note of caution about the mile-time benchmarks. "Iím nervous about people testing fitness on their own," he said. "I donít want a 45-year-old sedentary male to go out and run a mile as fast as he can."
Even so, Dr. Church noted that most of the health benefits of exercise come with moving from low fitness to moderate fitness, and the challenge is finding a way to communicate with and motivate people in the low-fitness category.
"You know whether youíre in the unfit category," he said. "If youíre physically inactive, if you sit 18 hours a day, if you get exhausted walking up a flight of stairs. If youíve got a choice between walking two blocks or taking a taxi and you wait 20 minutes to take a taxi, youíre unfit."
Dr. Berry agreed that mile-time benchmarks might not be good indicators for every individual, given that some highly fit people have physical limitations that prevent them from running fast. The larger issue, he said, is that most people donít have a clear sense of where they fall on the fitness spectrum, and donít appreciate the risks that poor fitness poses for overall health.
Even people who take regular walks three times a week may have an inflated sense of their level of fitness, he said, adding, "Youíre meeting the guidelines for physical activity, but youíre not necessarily fit."
While modest levels of exercise are better than nothing, he went on, "getting off the couch is the first step, but vigorous activity has a much more dramatic effect on fitness level."
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