Study Challenges The Notion
That You Can Be Fat and Fit
New research challenges the notion that you can be fat and fit,
finding that being active can lower but not eliminate heart
risks faced by heavy women. "It doesn't take away the risk
entirely. Weight still matters," said Dr. Martha Gulati, a heart
specialist at Northwestern
Memorial Hospital.
Previous research has gone back and forth on whether exercise
or weight has a greater influence on heart disease risks.
The new study involving nearly 39,000 women helps sort out the
combined effects of physical activity and body mass on women's
chances of developing heart disease, said Gulati, who wasn't involved
in the research.
The study by Harvard-affiliated
researchers appears in Monday's Archives
of Internal Medicine.
Participants were women aged 54 on average who filled out a questionnaire
at the study's start detailing their height, weight and amount
of weekly physical activity in the past year, including walking,
jogging, bicycling and swimming. They were then tracked for about
11 years. Overall 948 women developed heart
disease.
Women were considered active if they followed government-recommended
guidelines and got at least 30 minutes of moderate activity most
days of the week, including brisk walking or jogging. Women who
got less exercise than that were considered inactive.
Weight was evaluated by body mass index: A BMI between 25 and
29 is considered overweight, while obese is 30 and higher.
Compared with normal-weight active women, the risk for developing
heart disease was 54 percent higher in overweight active women
and 87 percent higher in obese active women. By contrast, it was
88 percent higher in overweight inactive women; and 2 1/2 times
greater in obese inactive women.
About two in five U.S. women at age 50 will eventually develop
heart attacks or other cardiovascular problems. Excess weight
can raise those odds in many ways, including by increasing blood
pressure and risks for diabetes, and by worsening cholesterol.
Exercise counteracts all three.
"It is reassuring to see that physical activity really does make
an impact," said lead author Dr. Amy Weinstein of Boston's
Beth Israel Deaconess
Medical Center. However, she added, "If you're overweight
or obese, you can't really get back to that lower risk entirely
with just physical activity alone."
University of South
Carolina obesity expert Steven Blair, a leading proponent
of the "fit and fat" theory, said the study is limited by relying
on women's self-reporting their activity levels. That method is
not as reliable as a more objective fitness evaluation including
exercise treadmill
tests, Blair said. These tests include heart-rate measures
to see how the heart responds to and tolerates exercise.
In Blair's research, overweight people deemed 'fit' by treadmill
tests did not face increased risks of dying from heart disease.
Dr. Laura Concannon, who specializes in treating overweight patients
at Chicago's
Advocate Illinois
Masonic Medical Center, said the study's message that exercise
can help reduce health risks isn't new, but it's important.
"Anything that can motivate the public is useful because heart
disease is becoming a bigger and bigger problem as levels of obesity
increase," Concannon said.
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