Thursday, April 22, 2010

Fit, Fabulous, and Obese?

In a word, yes.

When I look at the photo of my mother's family reunion I see mostly tall, mostly thin, and what most of people think of as fit and healthy looking people from ages two to 80. When you look at the photos of my father's family you're likely to see tall yet chubby folks of all ages. But it's not the size (or mass) that matters.
I'm thin so I must be healthy

Both sides can really pack it away when it comes down to it. The old world Eastern European appetite lives on in both, although my father's family seems to revel in eating a bit more than the maternal fam. It' just that one family seems to hold onto the fat much better than the other. Even when my sisters and I were (or are) training in sports or marching band daily, we never cut a svelte figure. Whereas, my mother seems to be perpetually slender, even in her mid-60's, and even back in the days when she didn't have a regular fitness regimen. My father was a chunky all-American center at a big Midwestern university, and I believe most of his brother's played football at least in high school. Fitness on my father's side leads to muscle with a healthy layer of fat, and even when I'm sedentary, my muscle mass is usually much greater than my more slender friends. Here's the deal: it's not safe to say that Dad's family lives a sedentary lifestyle and Mom's leads an active lifestyle. It's not not even safe to say one family is a family of overeaters. 

So, enough about my story and on to the research to back this up.

De Facts:    
The following data has been compiled in the book an Epidemic of Obesity Myths  

A remarkable finding is that heavy people who are fit have lower risk than thin people who are unfit." -Dr. Kelly Brownell, Director of the Yale Center for Eating and Weight Disorders, 2003

Fitness Vs. Fatness

"Consistently, physical inactivity was a better predictor of all-cause mortality than being overweight or obese." -Annals of Epidemiology, 2002

"There was a steep inverse gradient between fitness and mortality in this cohort of men with documented diabetes, and this association was independent of BMI … Obese men with fitness levels greater than the lowest quartile were at no increased risk for mortality when compared with men in the reference group."
-Diabetes Care, 2004

"[A] fit man carrying 50 pounds of body fat had a death rate less than one-half that of an unfit man with only 25 pounds of body fat."
-Harvard Health Policy Review, 2003

"We've studied this from many perspectives in women and in men and we get the same answer: It's not the obesity—it's the fitness."
-Steven Blair, P.E.D., Cooper Institute for Aerobics Research, 2004

"In Greek schoolchildren, primary CHD [coronary heart disease] risk factors are mainly associated with physical activity levels, independently of fitness, fatness, and/or fat intake… It is noteworthy that the present data contradict recent reports citing obesity as the single most important contributor in the pathogenesis of CHD during childhood … Confirming a previous report in Greek children, we found that the CHD risk factors studied were not substantially affected by qualitative aspects of diet."
Archives of Disease in Childhood, 2004

"Active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary … the health risks of obesity are largely controlled if a person is physically active and physically fit."
-The President's Council on Physical Fitness and Sports, 2000

"Compared with normal weight, overweight and obesity did not significantly increase all-cause mortality risk. Compared with low CRF [cardiorespiratory fitness], moderate and high CRF were associated significantly with lower mortality risk."
-Obesity Research, 2002

"Obese individuals with at least moderate CRF [cardiorespiratory fitness] have lower rates of cardiovascular disease (CVD) or all-cause mortality than their normal-weight but unfit peers. In fact, death rates in the former group are about one half those of the latter."
-Editorial, JAMA, 2004

"Unfit, lean men had twice the risk of all-cause mortality as did fit, lean men and also had higher risk of all-cause mortality when compared with fit, obese men. The all-cause mortality rate of fit, obese men was not significantly different from that of fit, lean men … In summary, we found that obesity did not appear to increase mortality risk in fit men. For long-term health benefits we should focus on improving fitness by increasing physical activity rather than relying only on diet for weight control."
-American Journal of Clinical Nutrition, 1999

"The report from the Aerobics Center Longitudinal Study presents convincing evidence that fitness is a more potent risk factor for mortality than is fatness … an effect of fitness that was statistically independent of the level of fatness was confirmed. The effect of fatness independent of fitness was less clear."
-American Journal of Epidemiology, 2002

"If the height/weight charts say you are 5 pounds too heavy, or even 50 pounds or more too heavy, it is of little or no consequence healthwise-as long as you are physically fit. On the other hand, if you are a couch potato, being thin provides absolutely no assurance of good health, and does nothing to increase your chances of living a long life."
-Steven Blair, P.E.D., Cooper Institute for Aerobics Research, 1997

"This prospective follow-up study among middle-aged and elderly men and women indicates that obesity (as assessed by increased BMI) is not related to an increased risk of all-cause and CVD mortality, but low-level LTPA [leisure time physical activity] and a low level of perceived physical fitness and functional capability are … In conclusion, in contrast with our initial hypothesis, obesity was not found to be an independent predictor of mortality among middle-aged and elderly men and women. However, low-level LTPA seemed to predict and a low level of perceived physical fitness and functional capability predicted an increased risk of all-cause and CVD mortality among both men and women."
-International Journal of Obesity Related Metabolic Disorders, 2000

"An interesting finding of this study is that overweight, but fit men were at low risk of all-cause mortality."
-International Journal of Obesity Related Metabolic Disorders, 1998

"Most studies of BMI and other measures of obesity have not adequately accounted for physical fitness, a known modifier of weight status and a potential mediator of the effects of obesity on CAD [Coronary Artery Disease] and adverse CV outcomes … Our data support previous studies showing that functional capacity appears to be more important than BMI for all-cause and CV mortality, especially in women."
-JAMA, 2004

And here is some research published in 2003 from an academic journals Nature and Obesityon obesity and fitness in Flemish (Belgium/Netherlands) youth:

"Results of this study show that obese subjects had poorer performances on weight-bearing tasks, but did not have lower scores on all fitness components. To encourage adherence to physical activity in obese youth, it is important that activities are tailored to their capabilities. Results suggest that weight-bearing activities should be limited at the start of an intervention with obese participants and alternative activities that rely more on static strength used."

This work is licensed under a Creative Commons Attribution-No Derivative Works 3.0 Unported License.

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