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Fitness in Teen Years May Guard Against This

Swedish study found link between aerobic fitness at 18 and lowered heart attack risk in middle age

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However, the fittest obese men ran a 71 percent increased risk of heart attack when compared to men who were unfit but lean. They also had more than four times the heart attack risk faced by the fittest lean men.

"This study helps to address the 'fitness versus fatness' question by indicating that both are important, but they are independently important," Daniels said. "Good fitness can't completely counterbalance the health effects of excess weight. Obviously, the best is to be normal weight and fit, which is what we should be aiming at for the majority of our population."

Muscle strength, which also was tested during induction, did not appear to provide the same heart health benefits as aerobic fitness.

Genetics likely plays a large part in the aerobic fitness of teens and, by extension, their protection against heart attack, Nordstrom said. Another study that focused on twins within this same set of patients found that 78 percent of the variation in their aerobic fitness could be chalked up to genetics.

But it could also be that men who are in good shape in their teens have adopted the sort of lifestyle that will keep them healthy later in life, said Dr. Mark Urman, a member of the American College of Cardiology's Prevention of Cardiovascular Disease Committee.

"If you're fit as a teenager, you're going to be more likely to stay in shape over the course of your life," Urman said. "The better shape you're in, the less apt you are to have cardiovascular problems."

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