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  • Title: Lower extremity strength, systemic inflammation and all-cause mortality: Application to the "fat but fit" paradigm using cross-sectional and longitudinal designs.
    Author: Buckner SL, Loenneke JP, Loprinzi PD.
    Journal: Physiol Behav; 2015 Oct 01; 149():199-202. PubMed ID: 26072175.
    Abstract:
    BACKGROUND: No study has applied the "fat-but-fit" paradigm with respect to muscular strength as an index of fitness, despite muscular strength being independently associated with functional ability and mortality. PURPOSE: To examine the relationship between lower extremity muscular strength, C-reactive protein (CRP), and all-cause mortality among normal weight, overweight and obese individuals. METHODS: Data from the 1999-2002 NHANES were used (N=2740 adults; ≥ 50 years). CRP values were obtained from a blood sample. Lower body isokinetic knee extensor strength (IKES) was assessed using a Kin Kom MP isokinetic dynamometer. Participant data was linked to death certificate data from the National Death Index to ascertain all-cause mortality status. Participants were classified, based on body mass index (BMI) and strength as: normal weight and unfit (<75th IKES percentile); overweight and unfit; obese and unfit: normal weight and fit (≥ 75th IKES percentile); overweight and fit; and obese and fit. RESULTS: Independent of physical activity and other confounders, compared to those who were normal weight and unfit, unfit overweight (β=.14, p=0.009), unfit obese (β=.33, p<0.001), and obese and fit (β=.17, p=0.008) participants, had higher CRP levels. However, there was no difference in CRP levels between normal weight and unfit participants and overweight and fit participants (β=0.04, p=0.35). Compared to normal weight unfit adults, overweight fit (HR=0.28; 95% CI: 0.11-0.70; p=0.008) adults had a lower hazard rate for all-cause mortality. CONCLUSIONS: These finding suggest that increased lower body strength, independent of physical activity, may reduce premature all-cause mortality and attenuate systemic inflammation among overweight adults.
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