14 May Fitness in Middle Age Lowers Medical Costs Later: Study

By Ellin Holohan
HealthDay Reporter

THURSDAY, May 10 (HealthDay News) — Subsidizing exercise and fitness-related lifestyles in middle age could significantly reduce the ballooning cost of health care in later years, a new study of more than 20,000 people suggests.

The study, slated for Thursday presentation at an American Heart Association meeting in Atlanta, found that fit middle-aged men and women had significantly lower medical expenses later in life compared to people who failed to stay in shape.

The more-fit study participants had 38 percent lower medical costs many years later, measured by Medicare and other insurance claims from 1999 through 2009.

“We wanted to determine if higher levels of physical fitness in middle age are associated with lower costs later in life,” said study author Dr. Justin Bachmann. “We found that fitness confers dividends later in life even when other risk factors such as smoking, high blood pressure and obesity are controlled for.”

The implications of the findings give “credence to efforts like Michelle Obama’s ‘Let’s Move’ campaign,” he said. The First Lady has initiated a project aimed at reducing childhood obesity through exercise and proper nutrition.

Levels of fitness were determined by a treadmill test measuring metabolic equivalents (METs), Bachmann said. The higher the METs, the more fit a person is. People who exercise regularly perform better on the test because they have greater aerobic capacity, which translates into better cardiorespiratory health and lower costs later in life, he said.

The study was a collaboration between the University of Texas-Southwestern Medical Center and the Cooper Institute, both in Dallas.

Researchers screened participants for previous heart attacks, strokes and cancer. Of the 20,489 given a “healthy” designation, 16,186 were men and 4,303 were women, with an average age of 51. When Medicare costs and other insurance payments were compared, the average age was about 72, Bachmann said. The study participants were drawn from the Cooper Center Longitudinal Study, a repository of health-related data from close to 100,000 patients collected over the past four decades.

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 conditions leading to major health care costs,” said Steinbaum, who also is the hospital’s director of women and heart disease. “We should have financial support for people to go to gym facilities.”

People who are more fit should “get some benefit” from insurers, Steinbaum said. Society should “give them the ability to become fit,” and then “give people a reward when they demonstrate” fitness, she added.

Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.