Glucose Homeostasis Remains Normal in a Physically Active Military Population
Adam W Potter1, Juliette I Jacques1,2, Christopher L Chapman1,2
1US Army Research Institute of Environmental Medicine, Natick, MA 01760, United States.
Military Medicine
|November 13, 2025
Summary
Physically active individuals with higher body fat may maintain healthy glucose levels, supporting the "fit-fat" concept. Regular physical activity appears to offset the metabolic risks associated with adiposity in this population.
Area of Science:
- Exercise Physiology
- Metabolic Health
- Obesity Research
Background:
- Glucose dysregulation is a common comorbidity of obesity, impacting performance.
- Elevated glycated hemoglobin (HbA1c) indicates prediabetes or type 2 diabetes.
- The 'fit-fat' concept posits physical activity can counteract obesity's metabolic detriments.
Purpose of the Study:
- To investigate the interplay between body fat percentage, HbA1c, and cardiorespiratory fitness.
- To assess if physical activity mitigates adverse glucose regulation in relation to body fat.
- To examine these relationships within a cohort of physically active military personnel.
Main Methods:
- Cross-sectional study of 216 physically active military personnel.
- Measured relative body fat (%BF) and HbA1c.
- Assessed maximal oxygen uptake (V.O2max) as a proxy for physical activity.
Main Results:
- A weak inverse association was found between fat mass and HbA1c in men.
- Maximal oxygen uptake did not show a significant association with HbA1c in either sex.
- Cluster analysis revealed no significant differences in HbA1c across varying adiposity and fitness profiles.
Conclusions:
- Normal HbA1c levels in this active military group suggest physical activity may preserve glucose homeostasis despite adiposity.
- Findings support the 'fit-fat' hypothesis, indicating current fitness standards may suffice for metabolic health.
- Routine HbA1c testing may not be necessary for young, active service members meeting fitness standards.
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