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So, you can’t be fit and fat…..Are you really sure about that?

Recently there was an attention grabbing headline that stated you could not be fat and fit (1)(2). Interestingly enough the research didn’t quite say that but that doesn’t make for a good story, now does it?

What the research actually stated was that unfit healthy-weight males had a 30% reduced risk for any cause of death than fit, obese males. Let’s contextualise this though – if the healthy-weight, unfit men had a risk for any cause of death of 0.05%* then the obese, fit males only had a risk of 1.5%. The risk must be contexualised otherwise we cannot determine it’s significance. 30% sounds impressive but that is simply the relative risk and it’s the absolute risk that’s important. Also keep in in mind that this was the result of this particular piece of research and by no means stated that obese individuals cannot be fit (or healthy for that matter). Interestingly, the research only looked at men of which who died quite prematurely and who were in the armed forces. Does this negate their findings? No, but it means there is a specificity to these results that does not necessarily translate to general population.

What’s also worth pointing out is that it’s not clear what the diet was for the obese individuals. No-one has ever stated that it’s ok to eat whatever you like, be obese but exercise to offset that risk. Only when a number of healthy behaviours are employed does obesity lose its risk. This means that if you eat a healthy diet, get regular exercise, are fit (measured in VO2 or METs), are reasonably unstressed, get enough sleep and drink enough water – your BMI has much less significance.

It’s also worth mentioning that this particular piece of research conflicts with many other published journal articles that have found a low cardiovascular fitness is the greatest risk factor for all-cause mortality (not BMI) (4) (5) . This certainly highlights the importance of cardiovascular fitness which is not surprising considering the number 1 global killer is cardiovascular disease. Cardiovascular fitness offers many many health benefits and cardiovascular protection and it’s potency should not be underestimated. In fact a study published in 2014 found that the number 1 risk factor for any cause of death was a low cardiovascular fitness (see graphic). Why is this so? Well getting fit means that you:

  1. Reduce your resting heart rate (and reduce the workload of your heart)
  2. Increase your oxygen carrying potential of the blood via increasing haemoglobin levels (thereby reducing the workload on the heart and reducing your risk for ischaemic** diseases)
  3. Increase your oxygen delivery capability via increased capillary density (thereby reducing the workload on the heart and reducing your risk for ischaemic diseases)
  4. Increase your myoglobin concentration which increases the stored oxygen capabilities of muscle tissue; of particular importance is the heart muscle and reducing risk for ischaemic cardiac events
  5. Increase your HDL levels which increases antioxidant and anti-clotting properties of the blood (reducing your risk of atherosclerosis, a heart attack or a stroke)
  6. Reduce blood triglycerides
  7. Improve hormone sensitivity (insulin, leptin, growth hormone etc.)
  8. Reduce stress hormones and increase feel good hormones
  9. Reduce your stress and anxiety
  10. Increase your ability to utilise fat as an energy source (even more so if you’re keto or fat adapted)
  11. Utilise your lung capacity more efficiently  (improving pulmonary function)
  12. Strengthen your pulmonary muscles (improving pulmonary function)
  13. Improve the efficiency and functioning of every system in the body
  14. Strengthen the body systems against biological stress making it more equipped to fight illness

In fact, it has been said that if we could put the benefits of exercise into a pill, we’d have an epidemic of health. There is truly no reason not to be exercising!

So for anyone struggling with your weight, the research does show that you can be completely healthy and overweight. Part of the key is in getting fit. Also remember that research may only be specific to the group that was studied and there can somewhat limited application to the wider public. Every person is individual and we are all unique due to varying genetic and environment factors so don’t give up. Focus on your health, not the scales. The take home message from all the research is that we control the risk factors we can and we don’t worry about the ones we can’t.

The most important things we can do for our health include eat well, drink lots of water, get enough sleep, get fit, reduce our stress, form healthy relationships, get connected with our community and interestingly, forgive.

(1)  http://www.dailymail.co.uk/health/article-3368186/No-T-fat-fit-say-experts-Doing-lots-exercise-overweight-does-not-prevent-early-death.html

(2) http://ije.oxfordjournals.org/content/early/2015/12/20/ije.dyv321 

(3) https://www.ncbi.nlm.nih.gov/pubmed/24438729

(4) http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2009.00653.x/full

(5) http://jamanetwork.com/journals/jama/fullarticle/209641

 

*Note – I could not get full access to the research to find the absolute risk for the unfit healthy-weight males. If someone can send this to me it would be appreciated.

** ischaemic – lack of oxygen supply (ischaemic heart disease and ischaemic strokes are significant causes of deaths in developed and developing countries)

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