To Be Fit—or to Lose Fat? That Is the Question

Jean Cacciabaudo, MD

The great debate in wellness focuses on fitness vs. fatness. Most healthcare professionals encourage overweight patients to get down to a healthy weight. However, recent research suggests that getting to a healthy weight and maintaining it may be daunting, since patients often yo-yo between weight loss and gain. 

So where should we focus our efforts? A large study recently published in Circulation comes down on the side of physical fitness. Small studies had suggested this previously, but the new research followed 14,358 middle aged men over 11.4 years--90 percent of whom were overweight or obese. The study used BMI (body mass index) as the marker of weight and aerobic activity in METs (metabolic equivalents).
                              
The participants who were most fit, shown by their aerobic activity measured on a treadmill using METs, had a lower overall risk of death or dying from cardiovascular disease during the follow-up period. Men who maintained their fitness levels from the start of the study lowered their risk of death by 30 percent compared to those who became less fit. If the men improved their fitness levels over the study period, they could lower their risk of death up to 44 percent.
 
Furthermore, BMI changes did not significantly affect overall mortality. Becoming a normal weight did not reduce mortality while adding excess pounds did not increase mortality rates when adjusted for the level of fitness. In the end, it was clear that physical activity is the most important factor men can modify to reduce their overall mortality rates.
 
Since this study neither included women nor men with a healthy BMI, researchers need to see if similar outcomes occur in these groups. Bottom line: Nearly two thirds in the US are currently overweight or obese and struggle with their weight daily. They may be more successful achieving better health if we encourage them to improve their fitness levels while making smarter and healthier food choices.
 
Like Hamlet, the best advice may be to stop sulking and get moving!
 
See Dr. Cacciabaudo and other North Shore-LIJ experts in our new heart health video in the North Shore-LIJ Health System video portal.
 
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Author

Jean Cacciabaudo, MD,

Chief of Cardiology,
Southside Hospital
 

*Disclaimer: The medical content on the North Shore-LIJ Health Blog is for informational purposes only and should not be considered a substitute for consultation with your physician regarding diagnosis, treatment or any other form of specific medical advice. More...
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