Fitness on the Way to Becoming a Vital Sign

It’s about time. A new scientific statement from the American Heart Association recommends that “at a minimum, all adults should have CRF (cardiorespiratory fitness) estimated each year” during health exams. The rationale is pretty compelling:

A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.

In other words, a simple estimate of fitness is probably a better indication of your health outlook than a whole range of other things that your healthcare provider is already watching closely.

So why the lag in paying attention to fitness?

Two reasons come to mind. First, a provider can more readily do something about blood pressure, cholesterol, and diabetes. For each of those conditions, a provider can prescribe a medicine that will help. Prescribing a fitness routine is tougher. Many providers have less confidence they will be effective if they prescribe physical activity.

Second, we still have a largely dysfunctional sick care system. Even now, health plans mostly pay providers for procedures, prescriptions, and monitoring medicines. Compensation for behavioral health counseling has long been lacking. Providers generally make more money by treating sick patients than they do by keeping people healthy. Smart people are working to solve that problem. Progress is evident. But the problem is far from gone.

Cardiorespiratory Fitness ReportKaiser Permanente has long bucked the old system. Kaiser physician Robert Sallis has been a leading advocate for fitness as a Vital sign. He served as a co-author for this new AHA position. Partly due to his work, Kaiser medical records require a couple of basic bits of information from every patient about physical activity. Combined with some basic physiologic data, it provides a good estimate of fitness and opens the door to a conversation about physical activity.

What can you do about it? You can start by getting a handle on your own fitness. It’s pretty simple. At worldfitnesslevel.org you can easily click through six steps that will give you a validated estimate (sample report on the right). Armed with that knowledge you can find ways to take steps for better fitness, better health, and a longer life.

Just a little extra physical activity can help. Over time, it can make a big difference in your health and wellness.

Click here for the AHA Scientific Statement, here for more from the New York Times, and here for more from U.S. News & World Report.

Heartbeat, photograph © stopete60 / flickr

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December 2, 2016

2 Responses to “Fitness on the Way to Becoming a Vital Sign”

  1. December 02, 2016 at 6:08 am, Angela Meadows said:

    It’s also harder to measure. You can test blood pressure in the doctor’s office with a simple piece of equipment in a matter of minutes. Testing CRF is not that straightforward. Wouldn’t it be great if all doctors’ surgeries disposed of all their scales and had a room with a treadmill and an exercise physiologist instead. We can but dream.

    • December 02, 2016 at 7:24 am, Ted said:

      Thanks, Angela!

      Actually, the report points out that even without a treadmill, pretty good estimates are possible. “While avoiding the costs and and modest risk associated with exercise testing, nonexercise algorithms using readily available clinical variables may provide reasonably accurate estimates of CRF.”