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But can there be good health without a high level of fitness? Or fitness without health? Does one cause the other? All of these issues are still open to debate, yet it appears that, to an extent, one can be fit without necessarily being healthy. For example, fitness is generally measured in the lab as maximum oxygen uptake, or V02max, as it's called. This is a measure of the body's ability to take in and use oxygen. If you have a higher V02max, this means you use more oxygen, so you can perform more work before fatigue sets in. As such, V02max also functions as a reasonable measure of the health of an individual's cardiovascular system, because a cardiovascular system that has been compromised by atherosclerosis (clogged arteries), for example, or lung disease from smoking won't be able to deliver oxygen to the working muscles as effectively. Beyond this point, though, fitness and health tend to part company.
An elite professional athlete, for example, will likely test as very fit in terms of V02max, but is he healthy? Very likely, but not necessarily; he might be exquisitely fit, but if he's under stress from trying to perform at his best in game after game, or from worrying about his contract or endorsement deals, as are so many elite athletes these days, or if he's taking steroids to build his strength or using illicit drugs or abusing alcohol, he may not be all that healthy. Elite athletes-the very fittest of the fittest-are often on the verge of physical breakdown from overuse injuries; professional football players, in particular, are typically walking textbooks of sport related injuries. Are they healthy?
Likewise, the average man or woman might be quite healthy in terms of mental, physical, and social well-being but without being particularly fit, or at least fit in terms of cardiopulmonary capacity as measured in the lab. In a recent Danish study, four researchers looked at highly fit subjects (as measured on a treadmill) who were either sedentary or active and at unfit subjects who were likewise either sedentary or active. Surprisingly, the study found that the active though unfit subjects had nearly the same low risk of heart disease as the active fit subjects. Likewise, it didn't matter if the sedentary subjects were fit or unfit; both groups had the same high risk of heart disease.
In other words, fitness doesn't seem to be as important a factor in one's risk of disease as one's current level of physical activity. But how can someone be active and healthy and still remain unfit? Or how can someone be inactive, unhealthy, and nonetheless fit? Genetics, apparently.
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