A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study

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Sloan, Robert
Haaland, Benjamin
Sawada, Susumu
Lee, I-Min
Sui, Xuemei
Lee, Duck-Chul
Ridouane, Yassine
Riemenschneider, Falk Muller-
Blair, Steven
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Lee, Duck-Chul
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The Department of Kinesiology seeks to provide an ample knowledge of physical activity and active living to students both within and outside of the program; by providing knowledge of the role of movement and physical activity throughout the lifespan, it seeks to improve the lives of all members of the community. Its options for students enrolled in the department include: Athletic Training; Community and Public Health; Exercise Sciences; Pre-Health Professions; and Physical Education Teacher Licensure. The Department of Physical Education was founded in 1974 from the merger of the Department of Physical Education for Men and the Department of Physical Education for Women. In 1981 its name changed to the Department of Physical Education and Leisure Studies. In 1993 its name changed to the Department of Health and Human Performance. In 2007 its name changed to the Department of Kinesiology. Dates of Existence: 1974-present. Historical Names: Department of Physical Education (1974-1981), Department of Physical Education and Leisure Studies (1981-1993), Department of Health and Human Performance (1993-2007). Related Units: College of Human Sciences (parent college), College of Education (parent college, 1974 - 2005), Department of Physical Education for Women (predecessor) Department of Physical Education for Men
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The purpose of this study was to examine the impact of combined cardiorespiratory fitness and waist-to-height ratio in the form of a fit-fat index on incident diabetes risk. Additionally, the independent predictive performance of cardiorespiratory fitness, waist-to-height ratio, and body mass index also were estimated and compared.


This was a prospective cohort study of 10,381 men who had a normal electrocardiogram and no history of major chronic disease at baseline from 1979 to 2005. Random survival forest models and traditional Cox proportional hazards models were used to predict diabetes at 5-, 10-, and 15-year incidence horizons.


Overall, 4.8% of the participants developed diabetes. Receiver operating characteristic curve analyses for incidence risk demonstrated good discrimination using random survival forest models across fitness and fatness measures; Cox models were poor to fair. The differences between fitness and fatness measures across horizons were clinically negligible. Smoothed random survival forest estimates demonstrated the impact of each fitness and fatness measure on incident diabetes was intuitive and graded.


Although fitness and fatness measures showed a similar discriminative ability in predicting incident diabetes, unique to the study was the ability of the fit-fat index to demonstrate a better indication of incident risk when compared to fitness or fatness alone. A single index combining cardiorespiratory fitness and waist-to-height ratio may be more useful because it can indicate improvements in either or both of the measures.


This article is published as sloan RA, Haaland BA, Sawada SS, Lee I-Min, Sui X, Lee DC, Ridouane Y, MüllerRiemenschneider F, Blair SN. A fit-fat index for predicting incident diabetes in apparently health men: A prospective cohort study. PLOS ONE. 2016;11(6):e0157703. 10.1371/journal.pone.0157703. Posted with permission.

Fri Jan 01 00:00:00 UTC 2016