Our Fitness Paradigm

It is important to define terms if you want to research a topic or have a meaningful conversation; everyone needs to be on the same page and know what they are talking about. The terms "Health" and "Fitness" have been used in many ways over the years, but not in a manner we felt was clear or optimal. Below we address these terms and in doing so argue that comprehensive human well-being is best defined as Fitness.

Above are several definitions for the term “Health.” You can see that freedom from disease/illness and injury are common themes in these definitions. Anyone who has experience with healthcare systems around the world knows these are indeed important factors. However, several of the definitions above point to something more. The World Health Organization (WHO) definition is the most widely accepted definition among doctors and researchers. Ironically, it is also the broadest and most vague. The WHO definition suggests that there are levels of “Health.” We think they are onto something, but terms need to be broken down a bit more.

Let’s begin with the most obvious threat to health or well-being: death. Certainly death is inevitable, but for many it comes sooner than they expect and in ways they do not expect. Thus, the top causes of death should be a major focus as we care for our well-being. The top 10 causes of death in the USA are shown above and an important takeaway is that most of these deaths are attributable to chronic diseases. These are persistent, generally lasting a year or more and require ongoing medical attention. They also tend to significantly limit the activities of daily living. Considering these observations, we should all be paying special attention to these diseases.

As mentioned previously, 8 of the 10 top causes of death in the USA are a result of chronic disease. However, the burden of these diseases goes beyond death. There is a tremendous economic cost to these diseases, a cost that increases with each passing year. These costs place a burden on all aspects of society, but the individuals suffering from these diseases will be the hardest hit given the nature of health insurance systems. More specifically, the money required to treat chronic diseases can be financially crippling. For people who have these diseases, a common question they ask is, “How did this happen?” Indeed, they likely did not have any of these diseases when they were young. For those that currently do not have any of these diseases, they will often think to themselves, “Ok, I am healthy.” We propose that both statements stem from a failure to realize that health is not a constant.

 Health is not a state you can achieve and then ignore. There are numerous factors which can cause a decline in health. For example, an otherwise healthy person will likely start seeing a decline in their skeletal health (bone mass) starting at 30 years of age and this will compound over time to place them at very high risk of fractures later in life.

Another example to consider is individuals who may have a health condition they are managing (i.e., that is stable), but are then exposed to an outside factor such as a virus and their risk of death increases significantly. For example, individuals with preexisting conditions were at a significantly greater risk of dying from COVID-19. So, if health is something that may vary during our life, are we using that term correctly? Is it really all we are striving for?

If health is not a constant, and there is a level of well-being that goes beyond the absence of disease and injury (see WHO definition of Health above), it seems something is missing. Indeed, just because individuals may appear healthy does not mean they have the well-being indicated in the WHO definition of health. They could be at risk for serious problems later in life. Three such examples are given above. All three of these groups would be considered healthy in a medical assessment but are likely predisposed to medical issues down the road. What we propose is that while they are healthy in their current state, they lack “Resilience.”

Above are several examples of how an alteration of lifestyle factors can make individuals less susceptible to chronic disease (i.e., more Resilient). With these in mind we are now able to more specifically define the terms Fitness, Health, and Resilience.

Based on the arguments presented above, “Fitness” is a better term to describe the state of overall well-being referenced in the WHO’s definition of Health. Health & Resilience are therefore components of Fitness. Individuals can have different levels of health and resilience which determine their overall level of fitness. Each human being should strive to optimize their Fitness by investing in both their Health and Resilience.