The DOI matches its Crossref record; 63 of the 63 references it cites were found in a registry or an index.
Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review
Abstract
Summary: The purpose of this systematic review was to study the relative health risks of poor cardio‐respiratory fitness (or physical inactivity) in normal‐weight people vs. obesity in individuals with good cardio‐respiratory fitness (or high physical activity). The core inclusion criteria were: publication year 1990 or later; adult participants; design prospective follow‐up, case–control or cross‐sectional; data on cardio‐respiratory fitness and/or physical activity; data on BMI (body mass index), waist circumference or body composition; outcome data on all‐cause mortality, cardiovascular disease mortality, cardiovascular disease incidence, type 2 diabetes or cardiovascular and type 2 diabetes risk factors. Thirty‐six publications filled the criteria for inclusion. The data indicate that the risk for all‐cause and cardiovascular mortality was lower in individuals with high BMI and good aerobic fitness, compared with individuals with normal BMI and poor fitness. In contrast, having high BMI even with high physical activity was a greater risk for the incidence of type 2 diabetes and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity. The conclusions of the present review may not be applicable to individuals with BMI > 35.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Poor fitness or low PA in physically unfit individuals is a greater all-cause and cardiovascular mortality risk than obesity in physically fit individual (185).”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [185]
In the citing paper
“for individuals with BMI of 25–35 having high BMI even with high physical activity were at a greater risk for the incidence of T2D and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [185]
In the citing paper
“one of the mechanisms by which physical fitness and activity reduce health risk associated with high BMI is by decreasing fat-to-lean mass ratio and also by decreasing visceral-to-subcutaneous fat ratio.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [185]
In the citing paper
“decreasing VAT is particularly important for BMIs between 25 and 30 (185).”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [185]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
HASKELL, W. L., LEE, I.-M., PATE, R. R., POWELL, K. E., BLAIR, S. N., FRANKLIN, B. A., MACERA, C. A., HEATH, G. W., THOMPSON, P. D., & BAUMAN, A. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3180616b27 · Cited by 4,616
The anti-inflammatory effect of exercise
Petersen, A. M. W., & Pedersen, B. K. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00164.2004 · Cited by 3,100 · cited 1×
“Moreover, the working muscle acts as an endocrine organ by producing interleukin-6 that has anti-inflammatory properties (51,53).”
BackgroundPhysical activity and reduced occurrence of non–insulin-dependent diabetes mellitus
Helmrich, S. P., Ragland, D. R., Leung, R. W., & Paffenbarger, R. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107183250302 · Cited by 1,634
Effects of the amount and intensity of exercise on plasma lipoproteins
Kraus, W. E., Houmard, J. A., Duscha, B. D., Knetzger, K. J., Wharton, M. B., McCartney, J. S., Bales, C. W., Henes, S., Samsa, G. P., Otvos, J. D., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020194 · Cited by 1,554
Effect of Exercise on Coronary Endothelial Function in Patients with Coronary Artery Disease
Hambrecht, R., Wolf, A., Gielen, S., Linke, A., Hofer, J., Erbs, S., Schoene, N., & Schuler, G. (2000) · New England Journal of Medicine · doi:10.1056/nejm200002173420702 · Cited by 1,340
Wei, M. (1999) · JAMA · doi:10.1001/jama.282.16.1547 · Cited by 1,168
Is physical activity or physical fitness more important in defining health benefits?
Blair, S. N., Cheng, Y. J., & HOLDER, J. S. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200106001-00007 · Cited by 1,140
Adiposity as Compared with Physical Activity in Predicting Mortality among Women
Hu, F. B., Willett, W. C., Li, T., Stampfer, M. J., Colditz, G. A., & Manson, J. E. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa042135 · Cited by 820
A Prospective Study of Exercise and Incidence of Diabetes Among US Male Physicians
Manson, J. E. (1992) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1992.03490010065031 · Cited by 778
BLAIR, S. N., & BRODNEY, S. (1999) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199911001-00025 · Cited by 704
Cited by
Sorted by citations
Items 401–500 of 512
Carpentier, J. (2014) · Le dépôt institutionnel (Université du Québec à Trois-Rivières)
Cooper, R. J. (2013) · Tuwhera (Auckland University of Technology)
Moschonis, G., Mougios, V., Lionis, C. D., Chrousos, G. P., & Μanios, Y. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2013.08.003
My personal diagnostic delay: ‘Physician, prevent thyself’
Smith, B. H. (2015) · British Journal of General Practice · doi:10.3399/bjgp15x684529
Scores in der Allgemeinen Inneren Medizin
Huber, U., Rösli, A., Ballmer, P. E., & Rippin, S. (2013) · Therapeutische Umschau · doi:10.1024/0040-5930/a000447
Authors' reply to Metcalf and Wilkin
Puder, J. J., Marques-Vidal, P. M., Schindler, C., Zahner, L., Niederer, I., Bürgi, F., Ebenegger, V., Nydegger, A., & Kriemler, S. (2012) · BMJ · doi:10.1136/bmj.e717
Kawada, T. (2012) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2012.36.4.314
Mahoney, C. (2013) · Sussex Research Online (University of Sussex)
Activity levels inversely associated with weight gain in women only when BMI is less than 25
Stommel, M. (2010) · Evidence-Based Nursing · doi:10.1136/ebn.13.4.110
Short- and long-term effects of a multi-component physical activity intervention in primary school
Meyer, U. (2012) · edoc (University of Basel) · doi:10.5451/unibas-006077544
Choose-to-move+ physical activity program
Peterson, J. A., & Ward-Smith, P. A. (2015) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v6n1p118
The Epidemiology of Coronary Artery Disease in Older Adults
Newman, A. B., Newman, A. B., & Newman, A. B. (2012) · Springer eBooks · doi:10.1007/978-94-007-5061-6_23
Exploring Walking Activity at Large: Patterns Revealed and Lessons Learned
Fujiki, Y., Uyanik, I., & Pavlidis, I. T. (2014)
NAVIGATOR: physical activity for cardiovascular health?
Yates, T. E. (2014)
The Lancet journals: a change in Ombudsman
Lw, G., Kampert, J. B., Mz, N., & Blair, S. N. (2014)
Parviainen, J. (2015) · Jyväskylä University Digital Archive (University of Jyväskylä)
Kiš, R. K. (2014) · Hrvatski časopis za javno zdravstvo
Bell, J. A. (2015) · UCL Discovery (University College London)
EFFECT OF ACUTE ENDURANCE EXERCISE ON SERUM ADIPONECTIN LEVELS AMONG ELDERLY OVERWEIGHT MEN
Bashiri, J. (2014) · Medical Journal of Tabriz University of Medical Sciences and Health Services
Associations of socioeconomic position and self-rated physical fitness in Finnish population
Pulkkinen, K. (2012) · Jyväskylä University Digital Archive (University of Jyväskylä)
Ramírez‐Vélez, R., de Plata, A. C. A., Mosquera, M., Ortega, J. G., Salazar, B., Echeverri, I., & Saldarriaga, W. (2011) · DOAJ (DOAJ: Directory of Open Access Journals)
Li, Q. (2011) · University of Groningen research database (University of Groningen / Centre for Information Technology)
Ahn, N., & Kim, K. (2015) · Exercise Science · doi:10.15857/ksep.2015.24.3.253
Rincón, A. R., Andréa, P., Martínez, M., Monsalve, C., & Henao, N. A. (2013)
Behjati, M. (2016) · Europe PMC (PubMed Central)
Kaas, K. V. (2013) · NORA - Norwegian Open Research Archives
Relative Importance of Fitness and Fatness in Obesity Intervention
Jung, S., Moon, S., & Kim, K. (2016) · The Korean Journal of Obesity · doi:10.7570/kjo.2016.25.2.56
APPLICATIONS OF AC4P PRINCIPLES
Geller, E. S. (2015) · Cambridge University Press eBooks · doi:10.1017/cbo9781107785304.012
Cardiac conditioning for healthy individuals: primary prevention of heart disease
Kamil‐Rosenberg, S., & Garber, C. E. (2016) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-016-0130-9
Johnson, S. B., & Geller, E. S. (2015) · Cambridge University Press eBooks · doi:10.1017/cbo9781107785304.017
EFFECT OF HIGH-INTENSITY INTERVAL TRAINING ON CARDIOVASCULAR FUNCTION, _
Astorino, T. A., Allen, R. P., Roberson, D. W., & Jurancich, M. (2012)
Cardiovascular disease and all-cause mortality : influence of fitness, fatness and genetic factors
Högström, G. (2017) · DiVA at Umeå University (Umeå University)
Dietary associations that may reduce metabolic syndrome risk in Mexican young adults
Mosley, M. A. (2012) · Illinois Digital Environment for Access to Learning and Scholarship (University of Illinois at Urbana-Champaign)
The effects of the CHANGE! intervention on children's physical activity and health
Mackintosh, K. A. (2012) · Liverpool John Moores University
Fysisk aktivitet og vektreduksjon
Bjørnarå, H. B., Torstveit, M. K., & Bere, E. T. (2017) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.17.0378
Sanchez, M. (2017) · Institutional Repository of the University of Granada (University of Granada) · doi:10.30827/digibug.45267
Ioffe, O. Y., Кривопустов, М. С., Цюра, Ю. П., Stetsenko, O. P., Tarasiuk, T. V., Овдій, М. О., & Shvets, O. (2017) · Clinical endocrinology and endocrine surgery · doi:10.24026/1818-1384.3(59).2017.110901
Heke, D. (2017) · Tuwhera (Auckland University of Technology)
Metabolic responses to acute and prolonged hypoxic exposure
Duncan, B. (2017)
Relationship of physiological parameters with the fielding skill among the male softball players
Singh, K. M. (2017) · International Journal of Yoga, Physiotherapy and Physical Education
The role of rs1137100 LEPR in pathogenesis of overweight and obesity among study population
Grzeszczak, W., Szejnoga, K., Niemczyk, A., Pyryt, M., Wichary, A., Szweda-Gandor, N., Gola, M., & Śnit, M. (2018) · Annales Academiae Medicae Silesiensis · doi:10.18794/aams/77059
CORRELATION BETWEEN DURATION SPENT IN FITNESS CENTER AND VO2 MAX LEVEL AMONG ADULTS
Tapsir, M. S. B. M., Rahman, P. H. A., & Wahyudi, K. (2017) · JURNAL ILMU FAAL OLAHRAGA INDONESIA · doi:10.51671/jifo.v1i2.25
Physical Fitness and Obesity in Children: The Role of Vigorous Physical ActivityMoncton
Yin, Z. (2017) · Advances in Obesity Weight Management & Control · doi:10.15406/aowmc.2017.07.00187
Mhlanga, S., & Sookan, T. (2018) · Global Journal of Health Science · doi:10.5539/gjhs.v10n10p166
The Association between Physical Activity and Fitness: The Influence of Muslim and Non-Muslim
Ismail, E., Razak, M. R. A., Muhamad, T. A., Kamal, A. A., Khamis, M. A., & Maizi, I. E. H. (2018) · Creative Education · doi:10.4236/ce.2018.914152
Obesities: Controversies in Diagnosis and Classification
Bosello, O., Vanzo, A., Donataccio, M. P., & Cuzzolaro, M. (2018) · Springer eBooks · doi:10.1007/978-3-319-90817-5_13
The Need to Shift Focus Away from the Scale and Towards Lifestyle in Obesity Management
Zeigler, Z. (2018) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2018.08.001612
Protective Effect of Marine Peptides/Toxins in CVD Using Zebrafish Model
Ramachandran, S., & Rajagopal, S. (2019) · Springer eBooks · doi:10.1007/978-981-13-7844-7_5
Verma, J. P., Jaseja, H., Boyadjiev, N., Gurjar, P., Bhojane, A., & Singh, A. (2018) · Journal of Applied Sports Sciences · doi:10.37393/jass.2018.01.8
Weight, chronic disease risk and physical activity levels of rural and urban women in Zimbabwe.
Mhlanga, S. (2017) · ResearchSpace (University of KwaZulu-Natal)
Hâncu, A. M., Mihaltan, F. D., Vladu, I. M., & Moța, M. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.95600
Sayeed, N. (2020) · International Journal of Physiology · doi:10.37506/ijop.v8i4.1707
Abnormal Exercise Test or CVD History on Weight Loss or Fitness: The Look AHEAD Trial
Jakicic, J. M., Horton, E. S., Curtis, J. M., Killean, T., Bray, G. A., Cheskin, L. J., Johnson, K., Middelbeek, R. J. W., Pi-Sunyer, X., Regensteiner, J. G., et al. (2020) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000134
D’auria, B. B., Mezzaroba, C., & dos Santos, S. M. (2021) · Podium Sport Leisure and Tourism Review · doi:10.5585/podium.v10i2.18584
Community-based exercise rehabilitation in a diverse chronic disease population
Skelly, F. (2021) · Dublin City University Open Access Institutional Repository (Dublin City University)
García‐Garcés, L., Sánchez‐López, M. I., Cano, S. L., Meliá, Y. C., Marqués-Azcona, D., Biviá-Roig, G., Lisón, J. F., & Peyró-Gregori, L. (2021) · Research Square · doi:10.21203/rs.3.rs-762841/v1
Cardiovascular Health in Professional Rugby Union Athletes
McHugh, C. (2021) · Arrow@dit (Dublin Institute of Technology)
Epidemiology Including Youth Through Adulthood and Socioeconomic Impact
Looker, H. C. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3314-9_4
(2011) · CRC Press eBooks · doi:10.1201/b10790-15
Orukwowu, U., Chigozie, N., Dennis, W., & John, A. I. (2022) · Journal of Advances in Medicine and Medical Research · doi:10.9734/jammr/2022/v34i131251
Shilpa, S., Kushwaha, S., Rohilla, R., Gupta, D., & Khokhar, A. (2022) · INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH · doi:10.36106/ijsr/7432780
Effects of Fifa 11+ on Body Composition in Obese Women
Rohmansyah, N. A. (2020) · Indian Journal of Public Health Research & Development · doi:10.37506/ijphrd.v11i8.10939
Feo, P. D., Tomaro, E. S., & Annuzzi, G. (2015) · Springer eBooks · doi:10.1007/978-3-319-24532-4_3
Hennig, C. B., Løkling, H. L., Harket, M. S., & Köpp, U. M. S. (2021) · Norsk tidsskrift for ernæring · doi:10.18261/ntfe.19.1.2
Feasibility of a Diabetes Prevention Programme as Part of Cancer Survivorship Care
Eaglehouse, Y. L., Swetts, E., Londen, G. J. V., Balogh, P. A., Yuan, J., & Butler, L. M. (2019) · EMJ Diabetes · doi:10.33590/emjdiabet/10310234
Hwang, I.-W., Choe, J.-P., Hwang, S.-J., Shen, J., & Lee, J. M. (2023) · Research Square · doi:10.21203/rs.3.rs-2885407/v1
Hwang, I.-W., Choe, J.-P., Hwang, S.-J., Shen, J., & Lee, J. M. (2023) · Research Square · doi:10.21203/rs.3.rs-2885407/v2
Picó, C., Lurbe, E., Keijer, J., Kopecký, J., Landrier, J., Álvarez‐Pitti, J., Martin, J., Oliver, P., Palou, A., Palou, M., et al. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2023.1250731
Heidarpoor, P., & Hadyan, S. (2023) · Health and Development Journal · doi:10.34172/jhad.92330
Pascual, M. B. (2019) · Revista Española de Educación Física y Deportes · doi:10.55166/reefd.vi424.728
Arenas-Sánchez, G., Mamani-Tapia, B., Inostroza-Téllez, E., Villacura, L. E. P., Farías‐Valenzuela, C., Orellana-Montini, J., & Espinoza-Salinas, A. (2023) · SPORT TK-Revista EuroAmericana de Ciencias del Deporte · doi:10.6018/sportk.598341
Mujčić, A. K., Mujčić, A., & Skopljak, A. (2023) · World Journal of Advanced Research and Reviews · doi:10.30574/wjarr.2024.21.3.0928
Leone, L. A., Vermont, L. N., Tutasi-Lozada, A., & Anderson, L. M. (2024) · Journal of Physical Activity and Health · doi:10.1123/jpah.2023-0292
Coexistence of obesity and unhealthy cardiorespiratory fitness in a cohort of boys
Nassis, G. P., & Figueiredo, P. (2024) · International Journal of Sports Medicine · doi:10.1055/a-2461-2705
Lee, J. H., & Kim, Y. (2024) · Journal of Korean Biological Nursing Science · doi:10.7586/jkbns.24.033
Schweitzer, A. M., Fuller, D., Fliss, M. D., & Mitchell, C. J. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2024.1517355
Ahmed, Y. E., Wadowski, J., & Dhuper, S. (2025) · Pediatric Exercise Science · doi:10.1123/pes.2022-0070
Abreu, T. C. (2025) · doi:10.5463/thesis.1120
Pinelli, E., Zinno, R., Massini, M. S., Baroncini, I., Serafino, F., Simoncini, L., Senesi, G., Pinelli, S., & Bragonzoni, L. (2025) · Applied Sciences · doi:10.3390/app15115942
Resting heart rate in cardiovascular ageing: from risk marker to risk factor
Hartaigh, Ó., & William-John, B. (2013) · University of Birmingham Institutional Research Archive (University of Birmingham)
Dickie, K. (2013) · Open University of Cape Town (University of Cape Town)
Arredondo, E. M., Haughton, J., Ayala, G. X., Slymen, D. J., Sallis, J. F., Perez, L. G., Serrano, N., Ryan, S., Valdivia, R., Lopez, N. V., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20408782
Arredondo, E. M., Haughton, J., Ayala, G. X., Slymen, D. J., Sallis, J. F., Perez, L. G., Serrano, N., Ryan, S., Valdivia, R., Lopez, N. V., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20408779
Mechanisms of Strong Hearts, Healthy Communities-2.0 Effects on Weight: A Mediation Analysis
Rethorst, C. D., Demment, M. M., Graham, M. L., Ha, S., Uribe, A. L. M., Lo, B. K., Szeszulski, J., Githinji, P., Strogatz, D. S., Folta, S. C., et al. (2026) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2025.12.008
Effect of Lifestyle Interventions on Coronary Heart Disease Risk in Patients With Type 2 Diabetes
Franklin, B. A., Miller, W. M., & Brennan, M. R. (2026) · Elsevier eBooks · doi:10.1016/b978-0-323-87862-3.00017-3
Astorino, T. A., Metcalfe, R. S., & Vollaard, N. B. J. (2026) · Trials · doi:10.1186/s13063-026-09647-x
Metadata
- Authors
- Fogelholm, M.
- Affiliations
- Research Council of Finland (FI)
- Corresponding author
- Fogelholm, M.
- ORCID
- Fogelholm, M.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2010-02-22
- Volume
- 11
- Issue
- 3
- Pages
- 202-221
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2041545551
- Cited by
- 517
- References
- 63
- Citations by year
- 2026: 13 · 2025: 14 · 2024: 13 · 2023: 24 · 2022: 22 · 2021: 24 · 2020: 22 · 2019: 31 · 2018: 43 · 2017: 37 · 2016: 31 · 2015: 44 · 2014: 43 · 2013: 54 · 2012: 50
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- cardiorespiratory fitness, physical activity, obesity, body mass index, all-cause mortality, cardiovascular mortality, cardiovascular disease incidence, type 2 diabetes, diabetes risk factors, cardiovascular risk factors, physical inactivity, waist circumference, body composition
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Morbidity, Obesity, Physical Fitness, Risk Factors, Exercise, Body Mass Index, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review