Fit and fat?

Staying fit, by Anya Petersen-Frey

Is fit and fat an oxymoron? According to Dr. John Foreyt, director of the Nutrition Research Clinic at the Baylor College of Medicine in Waco, Texas, it is. "Someone who exercises on a regular basis and eats right is not going to stay obese," he states. Stephen Blair of the Cooper Clinic in Dallas, Texas, disagrees. "The notion that all fat people are sedentary and unfit and at high risk for disease is not true." Blair notes that fitness is an important predictor of mortality, yet overweight and obese people who are fit do not have elevated mortality rates. So, which is it? The answer may not be clear but one thing most medical professionals agree on is that it is better to be fit and slightly overweight then very thin and unfit. Jody Wilkinson, a researcher at the Cooper Institute for Aerobic Research in Dallas, Texas, echoes a common sentiment. "You can be fit and a little heavier, and it's still better than being skinny and sedentary."

A 1995 study published in the International Journal of Obesity tracked 25,000 men over a 23-year period. The finding showed that fitness level was a better indicator of heart disease then weight. Similarly, a 1999 study in The Journal of the American Medical Association found that overweight men who exercised regularly had death rates only slightly higher than those of unfit men of normal weight.

These studies don't convince everyone. The National Heart, Lung and Blood Institute issued guidelines in 1998 that changed the definition of healthy weight in such a way that it classified an additional 29 million Americans as both overweight and unhealthy. No one argues that obesity and a sedentary lifestyle are huge problems in the United States, however, until there is a way to differentiate overweight people who are fit and exercise regularly from those who do not, the numbers can be misleading.

Gerald Fletcher, MD, a cardiologist at the Mayo Clinic in Florida, doesn't argue that some people are fit and fat. "But," he stresses, "most people are not." Regardless of inherited tendencies, size or shape, doctors agree that maintaining a healthy lifestyle remains the single most important advice that they give patients. Some factors that are indicators of good health include:

Total cholesterol levels below 200 mg/dL

Blood pressure below 140/85

Blood sugar between 80 and 120 mg/dL before meals

The majority of body fat occurring below the waist

The ability to walk briskly (4 mph) or jog at a light pace for 20 minutes while holding a conversation

Glenn Gaesser, PhD, associate professor of Exercise Physiology at the University of Virginia, says that we need a new approach to health and fitness -- one that places less emphasis on body weight and more on long-term lifestyle changes. It is intuitive that exercising more and eating better will naturally result in weight loss and this is generally true. But how much weight a person may lose varies greatly. Evidence is abundantly clear -- it is more important to be fit than it is to be thin. So perhaps the path to a fitter and healthier body is not so narrow after all.

Anya Petersen-Frey is a local fitness instructor.