Large Study Finds Not Exercising is Worse than Smoking; Diabetes

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By : Suvarna Sheth

If you have trouble getting on the treadmill, a new study — which finds that not exercising can be more detrimental for your health then smoking, having diabetes or heart disease — may convince you that it’s time to change your habits.

Researchers at the Cleveland Clinic studied more than 122, 007 people who underwent exercise treadmill testing Jan. 1, 1991, and Dec. 31, 2014, to measure mortality relating to the benefits of exercise and fitness.

According to a Cleveland Clinic press release, the study found that increased cardiorespiratory fitness was “directly associated with reduced long-term mortality, with no limit on the positive effects of aerobic fitness.”

Extreme aerobic fitness was associated with the greatest benefit, particularly in patients 70 and older, and in those with hypertension.

“Aerobic fitness is something that most patients can control,” said Dr. Wael Jaber, senior author of the study.  “And we found in our study there is no limit to how much exercise is too much,” he said in the press release.

He says everyone should be encouraged to achieve and maintain high fitness levels. The benefits of exercise were seen across all ages in both men and women.

“Increased cardiorespiratory fitness was associated with reduced long-term mortality with no observed upper limit of benefit,” the authors conclude.

The authors acknowledge several limitations to the study, the main one being that the study is retrospective and that the association between cardiorespiratory fitness and mortality does not prove causation.

They also recognize that the study population may not reflect the general population distribution of estimated functional capacity for the purpose of identifying elite performers.

The researchers state in their conclusion, that the adjusted mortality risk of reduced cardiorespiratory fitness was greater than or equal to traditional clinical risk factors, such as cardiovascular disease, diabetes, and smoking.

They found that extreme aerobic fitness was associated with the greatest survival and was notably beneficial in older patients and those with hypertension.

The study’s findings emphasize the long-term benefits of exercise and fitness, even to extreme levels, regardless of age or coexistent cardiovascular disease.

The study was published last week in the Journal of the American Medical Association Network Open.


  1. Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Network Open.2018;1(6):e183605. doi:10.1001/jamanetworkopen.2018.3605