By Fergus Joseph Dignan, Civilian Medical Practitioner, MOD

I very much enjoyed reading the ‘warm up’ article by Steven N Blair in the January edition of BJSM. The first study that he quoted on attributable fractions for all cause deaths was a real eye popper!

I was very surprised to see that low cardiorespiratory fitness was a greater attributable risk factor (in both sexes) than obesity, smoking, high cholesterol, and diabetes, as well as hypertension in women.

The second study was almost equally as fascinating. This illustrated that the risk of cardiovascular mortality in Type 2 diabetes in the obese category who took moderate to high levels of exercise, was half that of diabetics in the normal weight category who took no exercise. There was one thing that puzzled me and that was the histograms illustrated that for the type 2 diabetics who took low levels of exercise the cardiovascular risk was the same for those in the obese category as in the normal weight group.

This article will certainly alter the way that I communicate health promotion to my patients, and I would like to congratulate Steven Blair for such a stimulating article.