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Cardiorespiratory Fitness as a Predictor of Cancer Mortality Among Men With Pre-Diabetes and Diabetes

¹ Pennington Biomedical Research Center, Baton Rouge, Louisiana
² School of Kinesiology and Health Studies and Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada
³ Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

Address correspondence and reprint requests to Timothy S. Church, Pennington Biomedical Research Center, 4600 Perkins Rd., Baton Rouge, LA 70808-4124. E-mail: tim.church{at}pbrc.edu

OBJECTIVE—The purpose of this article was to examine the risk of cancer mortality across levels of fitness and to examine the fitness-mortality relation for site-specific cancers in men with pre-diabetes and diabetes.

RESEARCH DESIGN AND METHODS—We examined the fitness-mortality relation for all-cause and site-specific cancer mortality among 18,858 men with pre-diabetes and 2,805 men with diabetes (aged 46.3 ± 9.7 years [mean ± SD]) from the Aerobics Center Longitudinal Study. We identified 719 cancer deaths during 354,558 person-years of risk. The duration of follow-up was 16.4 ± 7.8 years (range <1–30.0 years).

RESULTS—In men with pre-diabetes, moderate (hazard ratio 0.71 [95% CI 0.57–0.88]) and high fitness (0.76 [0.60–0.96]) were associated with lower risks of cancer mortality compared with the low-fit group in a model adjusted for age, examination year, smoking, alcohol use, fasting glucose concentration, previous cancer, and BMI. Similarly, for individuals with diabetes, moderate (0.53 [0.35–0.82]) and high fitness (0.44 [0.26–0.73]) were associated with lower risks of cancer mortality compared with the low-fit group. Among all men, being fit was associated with a lower risk of mortality from gastrointestinal (0.55 [0.39–0.77]), colorectal (0.53 [0.30–0.96]), liver (0.22 [0.07–0.71]), and lung cancer (0.43 [0.30–0.60]).

CONCLUSIONS—In men with pre-diabetes and diabetes, higher levels of cardiorespiratory fitness were associated with lower risk of cancer mortality, particularly as a result of cancers of the gastrointestinal tract, compared with those who had low levels of fitness.

Abbreviations: ACLS, Aerobics Center Longitudinal Study • CVD, cardiovascular disease • IFG, impaired fasting glucose • IGF, insulin-like growth factor • IGT, impaired glucose tolerance

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