Focus on Fitness, Not Fatness

The following information is from the book Big Fat Lies by Glenn Gaesser, Ph.D. which I highly recommend.  I present this information in an effort to help you take the focus  off of body weight, and focus instead on physical activity and a healthy diet.  The evidence is overwhelming (and the blog is longer than usual to make you aware of the amount of evidence, though this is only a small overview) that body weight does not deserve the blame we have assigned to it.  And the evidence keeps coming in--you may have heard the "new" evidence consistently reported in the news over the past 2-3 years that "surprises" the experts (and reporters), concluding that body weight is not to blame.  The bottom line--fitness matters more than fatness.  The caveat is that abdominal fat is strongly associated with cardiovascular disease and diabetes.  Note how large and long these studies are, and how well-respected the sources are.

·      Dr. Steven Blair and associates at the Cooper Institute of Aerobics Research in Dallas, Texas studied 10,244 men and 3,124 women between 1970-1981 and found that being heavy did NOT increase the risk of dying prematurely.  Furthermore, when considered in combination with fitness, being overweight seemed to be better than being underweight!

·       Dr. Blair and his colleagues reported that after 8 1/2 years’ follow-up on 25,389 men who had medical exams at the Cooper Clinic, the lowest death rates were observed in the fittest men, regardless of how much they weighed.

·       Dr. Reubin Andres, clinical director of the National Institute on Aging and a professor of medicine at Johns Hopkins, performed an independent statistical analysis on the data from the 1979 Build Study and found that the body weights associated with lowest mortality increased progressively with age.

·     Dr. Andres also reviewed 13 large studies, all lasting 12 years or more (in one large-scale study researchers followed 1.7 million Norwegian people for 16 years!).  The review has strengthened the case for modest weight gain with age (researchers estimate safe weight gain is 2-10 pounds per decade).

·   Dr. Ralph Paffenbarger at Stanford University has been tracking the health and mortality facts of nearly 17,000 Harvard alumni who entered the university between 1916 and 1950.  The men who had the best chance of living a long life were those who gained the most weight since college and who also expended at least 2,000 calories per week in physical activity.  (The amount of weight gained was not trivial--about 25 pounds or more for most of them!)

·     The famous Nurses’ Health Study (which has been scaring people with its alarming conclusions about the health risks of gaining weight ever since its news-making scientific reports were released in 1995) has its own unmentioned inconsistencies.  After reporting that a weight gain of 11-17 pounds since age 18 was associated with a 25% higher risk of heart disease, the researchers reported later that year that a weight gain of up to 20 pounds after the age of 18 did NOT increase the risk of dying from heart disease.  In fact, the risk associated with this degree of weight gain was 30% lower compared with women who remained fairly weight stable.

·      Furthermore, the Nurses’ Health Study found a consistently lower risk of breast cancer at higher body weights.  Similar results about breast cancer in women as a disease for which extra weight seems to be an advantage also come from 3 studies from Norway (one of which numbered 570,000 women) and half a dozen from the U.S. and Canada.

·   The famous, oft-quoted Framingham Heart Study originally concluded that being overweight, and gaining weight after age 25, dramatically increased the risk of heart disease.  Although the 1983 paper continues to be cited as definitive proof of the negative effect of obesity on health, two later reports undermine the conclusions of the 1983 report:

·        In 1989 a subsequent report from the Heart Study drew positive connections between higher levels of exercise and healthier levels of HDL cholesterol and triglycerides.  Most of the thin people exercised more and had better blood profiles than most of the fat people.  Therefore, it is entirely possible that the increased heart disease mortality rates of the “overweight” men and women of the 1983 Framingham report was due to physical inactivity, with weight simply being a harmless side effect of the inactivity.

·      A later report, issued in 1991, incorporated the biannual weight measurement data (which were taken but not analyzed in the original reports of the study).  Researchers found that weight gain was associated with significantly lower risk of dying from heart disease in both men and women.  Weight gain also decreased overall mortality rates from any and all causes in both men and women.

·   Another relatively unpublicized report from the Framingham study shows that heavier body weight is a distinct advantage in osteoporosis.  Two studies at the Mayo Clinic, one at Tufts, and one in France show similar results.

·     Glenn Gaesser, author of Big Fat Lies and previously the associate director of the Adult Fitness Program at the University of Virginia, has observed firsthand in counseling hundreds of men and women that the majority of individuals with high blood pressure are NOT obese, and the majority of obese people do NOT have high blood pressure.  Countless research studies confirm this observation.  Furthermore, the standard advice to the obese hypertensive to “lose weight” may have serious consequences.  The evidence shows that hypertension more than doubles the risk for early death in thin and non-obese people, whereas it only marginally increases the risk of early death in obese people.  The weight-reduced hypertensive may be more likely to die from cardiovascular disease!

·       75% of all the body weight-mortality studies published since the 1950’s find weight to be irrelevant to health and mortality, or suggest that heavy people live longer!  There are many long-range studies of men representing a variety of populations, including: . . .

      Seven Countries Study (nearly 13,000 men in 7 countries)

      Civil service employees in Great Britain, Denmark, and Paris

      Maoris in New Zealand

      Pima Indians in Arizona

      Middle-aged men in Finland

      San Francisco longshoremen

      Employees of the Chicago Peoples Gas Company

      Residents of Western Scotland

    Californians in the Western Collaborative Group Study

      State employees of New York in the Albany Study

      African Americans in the Charleston Heart Study

      Evans County Heart Study

      Kaiser-Permanente Study in the San Francisco Bay area

      and also in women:

     1,464 middle-aged women in University of Amsterdam (25-year study)                       

    741 white and 454 African American women in Charleston Heart Study (30-year study)

     2,731 women in Kaiser-Permanente Medical Care Program in Oakland (15-year study) 

     17,159 Finnish women (12-year study)

·      Because obese people have more fat on their bodies it had been assumed that they must also have more fat in their arteries.  But the fact is that both autopsy studies and coronary angiography studies have not been able to connect weight or body fat to the existence of atherosclerosis or to progression of the disease!  Well over half of the angiographic studies done between 1976-1994 show that obesity has NO relationship to either the presence or progression of atherosclerosis.  Numerous studies confirm that weight has nothing to do with cholesterol levels.    

·     The largest and most comprehensive study by Applegate at University of Tennessee of over 4500 men and women showed that the fattest people, not the thinnest, had the cleanest arteries!

·        In the Cleveland Clinic Foundation study of 262 men and women, a slightly greater percentage of non-obese men and women showed evidence of progression of cardiovascular disease.

One final observation--Type II diabetes, hypertension, high blood cholesterol and triglycerides can all be remedied without losing any weight (even in those who remain obese!).  Weight reduction often does not cause these problems to go away and they may, in fact, significantly worsen.  An exciting fact in diabetes care which has been well-recognized in the last 2 decades is the surprising observation that just a minimal weight-loss (only a few pounds) in diabetics often results in major improvements, supporting the idea that it is likely not the weight-loss per-se that is responsible for metabolic improvements, but rather the change in diet and exercise.

The conclusion? 

“Thinner is healthier” is NOT a fact but an unsubstantiated hypothesis.  Just because obesity is often associated with disease which results from a lack of activity and a high animal fat diet does not mean that obesity causes the diseases for which it has been blamed.  In fact this long list of well-done studies indicates that there may very well be no relationship between body fat and mortality.  Therefore, if we lose weight without focusing on the real cause of disease, namely a too high animal (saturated) and processed (trans) fat diet, too little plant food, and too little physical activity, it is unlikely we will achieve desired result—prevention of lifestyle disease.  In fact, we very likely make things worse by just “losing weight”.

Few if any studies to date have been designed carefully enough to focus on weight while simultaneously excluding other likely influences on health.  Failure to consider the location of fat may help explain why the research on the health impact of obesity is riddled with inconsistencies.  In recent years it has been well-established that abdominal fat is one of the strongest risk factors for cardiovascular disease and diabetes.  A waist circumference of 35” in women, and 40” in men puts you at considerably higher risk for these diseases.

The bottom line—fitness matters more than fatness.  The caveat is that abdominal fat is highly associated with cardiovascular disease and diabetes. 

So your watch and your belt are 2 of your best pieces of equipment in your quest for better health.  Use your watch to aim for 30-60 minutes of physical activity, even “piecemeal”, on most or all days of the week.  Use your belt size to make sure you keep your waist size less than 35” in women and 40” in men.

Fitness is cheaper than any health insurance and feels better than any diet.  Enjoy a healthy lifestyle and the freedom that comes with taking the obsessive focus off of weight,

Diane Preves, M.S., R.D.

Thank you for sharing this post with others who might benefit from the information shared herein.  Please contact me if you are interested in hosting a 10-week  N.E.W. LIFE program on Long Island.

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