Fitness versus Fatness

The issue of fitness versus fatness and the effect that each has on health and longevity has been debated for decades. Many people think that as long as you're fit, it doesn't matter if you're carrying around excess fat. Still others think that if you're naturally thin, you don't need to exercise. But is this really true?

A study published last year in the American Journal of Epidemiology (Am J Epidemiol 2002; 156:832-841) addressed this very issue and provided some unique insight. The authors of the study concluded that both fitness and fatness are risk factors for mortality, and that being fit does not completely reverse the increased risk associated with excess body fat.

In other words, regular exercise does not cancel out all the health risks of being overweight. Exercise certainly reduces the health risks, but does not appear to eliminate them completely. It's the normal-weight people who are in shape who can expect to live the longest, healthiest lives.

Not long after the study was published, Reuters Health interviewed the author of the study, Dr. June Stevens, a professor of nutrition and epidemiology at the University of North Carolina. In the interview, published in the Nov 4th issue of Reuters Health, Dr. Stevens summarized her findings by stating, "It is important not to be overweight, but it also important to be fit. Just being slender is not enough. Just being fit is not enough. In order to enjoy the best life expectancy, you need to be both."

The new findings are based on data from 2,506 women and 2,860 men in eight U.S. cities who participated in a study that began in 1972, when their average age was about 45. The subjects were grouped into the following categories: fit, not fit, fat and not fat. They were followed until 1998.

In both women and men, the unfit-fat group faced the greatest risk of death. But while exercise helped boost longevity in the overweight group, it did not erase all the negative effects of the excess weight. Likewise, people who were thin but unfit also faced a shortened life span.

The findings of this study emphasize the importance of both maintaining a healthy weight and getting regular exercise. But for people who exercise regularly yet still can't seem to shed those extra pounds, don't give up. Dr. Steven's says, "Keep exercising, and if you can't lose weight, work hard not to gain [more] weight."






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