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Moderate exercise extends survival in overweight diabetes patients

SAN FRANCISCO — Modest exercise can help men live longer, even if they carry the dual health risks of excess weight and diabetes, a new study finds.

Researchers tapped into a health database to assess the survival rates of 2,690 men who had, over the past two decades, undergone a stress test at Veterans Affairs medical facilities. None had any heart problems when tested at the outset, but all had type 2 diabetes.

The score on the stress test indicates how often each man exercises. For example, a poor exercise score suggested a sedentary individual, whereas a man with a moderate score probably completed the equivalent of a brisk walk five times a week. A high score implied regular strenuous exercise such as swimming or jogging, says physician Roshney Jacob-Issac of GeorgeWashingtonUniversityHospital and the VeteransAffairsMedicalCenter in Washington, D.C.

Medical records showed that 762 of the men died during the follow-up period, which averaged seven years. Men who were normal-weight or overweight and who had a moderate exercise score were 40 percent less likely to die during the follow-up period as were similar-weight sedentary men. Obese men with a lifestyle that includes moderate exercise were half as likely to die as similar guys who didn’t exercise much.

Normal-weight and overweight men who exercised frequently slashed their death risk by about two-thirds, compared with sedentary men of similar weights. But a strenuous exercise routine extended survival in obese men only slightly.

Jacob-Issac presented the findings June 15 in San Francisco during an annual meeting of the Endocrine Society.

“We often focus on weight loss as a way to improve mortality,” she says. “That may not be the key issue here, although it’s important.”

While other research has found a link between exercise and survival, “this study is unique in its size and the duration of follow-up” in a population of diabetic men, says Glenn Cunningham, a physician at Baylor College of Medicine in Houston, who wasn’t affiliated with the research.

“Getting a lot of these people to lose weight is really difficult. If we get them to exercise at least moderately, they can partially offset the lack of weight loss,” he says. “Clinicians think in these terms.” But often, doctors’ persistence in encouraging patients to exercise wears thin, he adds.

Study coauthor Eric Nylen, an endocrinologist also at the V.A.MedicalCenter in Washington, D.C., cautions that the finding doesn’t mean diabetes patients shouldn’t worry about being overweight. But the effect of exercise is clear, he says, and the rating scores of the men’s exercise regimens stem from actual stress tests, not reported activities listed on a self-reported questionnaire.

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