Being fit is not an excuse to skip a health checkup. Here's why

Mint

21-04-2025

Nine years ago, when I met him in his office for
a column in this very publication, Darshan Mehta,
then 55 and managing director of Reliance Brands, effortlessly jumped on to his desk and posed cross-legged for a picture. India Inc was well aware of his love of running and would regularly cite his example whenever they had to name someone who had built a successful career but also always made time for exercise, health and wellbeing. Very recently, the sexagenarian suffered a fatal heart attack while running on the treadmill. Jog the memory back four years and the dramatic heart attack that Danish footballer Christian Eriksen suffered on-field while playing a UEFA Euro Cup game comes to mind. Just 29 at the time, Eriksen was revived by doctors on the field, and was then moved to a hospital, as billions watched the whole thing unfold live on television.
Eriksen, among one of the fittest men in the world, and Mehta aren't the first healthy people to suffer heart attacks. It's just that thanks to social media, the internet and instant messaging, the word spreads faster today. While those who don't want to exercise may use this as a valid warning to avoid anything 'strenuous", thereby, putting themselves at a greater risk of developing health problems, fit and active people need to pay heed to these incidents and make health screenings a regular part of their lives.
Even people who appear extremely fit and active may have underlying health issues that are silent in the early stages, explains Dr Sandeep Doshi, consultant for internal medicine and executive health checkup, Kokilaben Dhirubhai Ambani Hospital, Mumbai. 'Conditions like high blood pressure, diabetes, kidney diseases, liver issues, or even certain cancers may show no symptoms initially but can still progress quietly," says Doshi.
In medical terms, a 'fit" person is someone who meets a set of baseline physical and clinical health indicators such as Body Mass Index (BMI) between 20-24, has normal results on electrocardiogram (ECG) and Stress Test (an indicator of heart function), shows normal range on basic laboratory tests, including parameters like blood sugar, cholesterol, kidney and liver function. Additionally, they should be able to walk at least 5km in an hour, which is the minimum threshold of cardiovascular and musculoskeletal fitness, say doctors and fitness experts. 'However, being fit does not always equate to being free of underlying health risks, which is why a deeper understanding of individual health status is important," warns Dr Narander Singla, lead consultant for internal medicine at the CK Birla Hospital, New Delhi.
Regular medical check-ups help detect underlying and dormant health issues when they are still treatable or manageable. 'Specifically, these check-ups should include blood pressure monitoring, blood sugar testing (fasting and post-meal), kidney function tests (serum creatinine, urea), liver function tests, cholesterol and lipid profile, ECG and/or Stress Test (Treadmill Test), ultrasound abdomen (to detect organ changes), screening for breast and cervical cancer for women, and screening for colon cancer as per age guidelines for both men and women. These tests form the foundation of preventive health and are key to identifying silent conditions early," says Doshi.
While Doshi says routine health check-ups should start at 40 years of age, Singla recommends starting earlier, between 20 and 30 years, and continuing for the rest of your life. Dr Udgeath Dhir, director and head of cardiothoracic and vascular surgery, Fortis Memorial Research Institute, Gurugram, suggests people should start even earlier. 'Hypertension and diabetes are silent killers. These illnesses start at a young age, so school and college students should also get their blood pressure checked regularly," says Dhir. However, all three unanimously agree that if someone has a family history of disease or heart condition these check-ups need to begin at a much earlier age.
'Individuals with a family history of chronic conditions such as diabetes, hypertension, heart disease, stroke, or cancer should be more vigilant. For them, starting check-ups earlier and more frequently (every three or six months) may be necessary to detect early warning signs and manage risks proactively," advises Singla. Doshi adds that people who smoke and who work in high-stress professions should also start check-ups earlier and more frequently. 'The frequency of the check-ups depends on the risk profile and previous findings, but annual evaluations are a common and effective benchmark for middle-aged and high-risk individuals," suggests Doshi.
As an elite footballer playing for a top tier European football club, Eriksen underwent extensive 'medicals" and testing regularly. Mehta had access to the best healthcare and testing facilities in India. While regular medical check-ups are comprehensive and can help detect most illnesses and risk factors early, some health issues, especially certain cardiovascular conditions, may not be evident even in routine tests. This is why we sometimes see professional athletes (like Eriksen) and fit individuals, who undergo extensive evaluations and have access to top-tier healthcare, still suffer sudden and severe health events like heart attacks, explains Singla.
'Contributing factors could include genetic predisposition, undiagnosed structural heart anomalies, stress, or even random and unpredictable biological events. This underscores the fact that health screenings reduce risk but cannot eliminate it entirely," adds Singla. Doshi flags another dilemma that doctors face: there is always a clinical challenge in determining how far to investigate someone with no symptoms or complaints. 'A coronary angiography is an excellent test to detect blockages in the heart arteries. But would you conduct this invasive test on a person who feels completely fine and has no symptoms? While testing is powerful, routine use of high-end diagnostic tools in healthy individuals is not always justified, unless specific risk factors are present. Moreover, some events cannot be predicted, even with the best tests and technology," argues Doshi.
For those who want to use untimely deaths of a few as a reason to not exercise, there is no greater disservice you can do to yourselves.
Exercise is the cornerstone of long-term health and disease prevention. Without regular physical activity all major body systems deteriorate over time, muscles weaken, blood vessels stiffen, metabolism slows, and immune responses decline, says Doshi. Exercise prepares the body for emergencies be it fighting infections, managing stress, or recovering from illness. It helps maintain proper levels of electrolytes, hormones, prostaglandins, interferons, and other important biochemical compounds that keep the body running smoothly. It also preserves the tone and strength of skeletal and cardiac muscles, and ensures healthy blood circulation through the effective functioning of venous valves.
Simply put, an active lifestyle reduces the risk of chronic diseases, improves quality of life, and increases longevity. At the same time, those who are already active and can finish a gruelling marathon with a smile, should avoid assuming invincibility and undergo medical check-ups as advised by their doctors. 'No matter how active one may be, it's important to be realistic about your body's changing capabilities with age. Just because someone could complete a marathon at 35, it doesn't mean they can or should attempt the same at 55 without proper reassessment and conditioning," notes Doshi.
Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.