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When It Comes to Health, Fitness Beats BMI and Body Composition, Research Suggests

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Although using body mass index (BMI) is no longer the end all, be all as an indicator of your health, we still tend to look at general body composition as a visual way to measure our overall fitness.

In other words, we assume being overweight means we are probably less healthy and have a greater chance of developing Type 2 diabetes, heart disease, and other illnesses.

However, new research published in the British Journal of Sports Medicine suggests there might be a better way to measure a person’s overall health and susceptibility to disease than either BMI or body composition: Your VO2 max.

Fun fact: According to his BMI in 2023, Mat Fraser, the five-time Fittest Man on Earth, was considered obese.

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What Is VO2 Max?

A VO2 max test measures how much oxygen a person can utilize during intense or maximal exercise. It is considered an effective way to measure a person’s aerobic endurance and overall cardiovascular fitness.

A traditional VO2 max test is done on a treadmill, but it can also be done on a rowing machine or stationary bike. The test begins at a comfortable pace, and the intensity increases incrementally until you can no longer hold on.

The Details

The research looked at data from 20 studies that included close to 400,000 people where cardiovascular fitness was compared to BMI. It analyzed both a person’s risk of cardiovascular disease and overall risk of mortality.

The result: Those who are overweight or obese but performed well on their VO2 max fitness test did not have a statistically significant higher risk of heart disease or death. However, those who did not perform well on a VO2 max test had a two to three times greater risk of heart disease or death, regardless of whether they were overweight or obese.

The researchers, led by Siddhartha Angadi, an associate professor in the Department of Kinesiology at the University of Virginia, surmised that, from a health perspective, being unfit is then a much greater health risk than carrying extra weight.

Worth Noting: Two months ago, we wrote about another piece of research with a similar result.

The study, published in the journal Nature Metabolism in September 2024, suggests that the belly fat in those who exercise regularly is healthier than those who don’t, making them less susceptible to developing illnesses like heart disease and Type 2 diabetes despite having that excess belly fat.

The Big Picture

While the link between exercise and health has long been established, we still tend to use markers like BMI and body composition rather than fitness tests to measure health.

But if this study — and the Nature Metabolism study from September 2024 — hold merit, then it’s about time we start considering a person’s fitness level in the bigger picture health equation.

Because even though they say you can’t outrun a bad diet, if you continue to exercise and stay fit, you actually…maybe…sort of…can.