Fit and Fat Beats Lean and Lazy in Survival

Fitness may actually be a more important factor than your weight when it comes to living a long, healthy life, a new study suggests.

Researchers report that older people who are fit -- even if they are also fat -- are likely to live longer compared with those who are out of shape. The study is the latest research to suggest that being a bit overweight may not be as dangerous to your health as other factors.

A November Centers for Disease Control and Prevention study suggested that being up to 25 pounds overweight doesn't appear to raise the risk of dying from cancer or heart disease. And a Duke University study in July posed a puzzling -- and controversial -- paradox in which obese people who'd endured a heart attack appeared to have a better chance of surviving it than their skinnier counterparts.

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However, medical experts warn that you shouldn't ignore your body mass index completely; instead, they recommend using fitness as a means for maintaining a healthy body weight.

"Our results showed pretty clearly that fitness provides substantial protection against dying," says study author Steven Blair of the University of South Carolina at Columbia, who is also the director of research at the Cooper Institute for Aerobics Research in Dallas. "Even people who are obese, with a body mass index of 35 or higher, if they are fit, they have a much lower chance of dying than those who are unfit."

Blair and colleagues looked at 2,603 adults over age 60 and evaluated their fitness levels using treadmill tests. Their findings, to be published in the Journal of the American Medical Association, suggest that weight isn't everything.

Other medical experts not affiliated with the research agree with this conclusion.

"Performance measures are always better than appearance measures in anything," says Dr. Paul Thompson, director of cardiology at the Hartford Hospital and a professor of medicine at the University of Connecticut. "What something looks like does not tell you how it runs."

Blair concurs. "There is a great benefit to being fit," he says, "even if you are in fact obese."

Obesity Still a Big, Fat Problem

However, doctors warn that body fat cannot be ignored completely in the quest to get in shape.

"This study is one of several that weigh in on the relative importance of obesity and fitness," says Dr. Robert Vogel, a professor of medicine at the University of Maryland. "Some studies have found weight to be more important; others, such as this one, have found fitness to be more important. The true answer is that both are important."

Dr. Salim Yusuf, a professor of medicine at McMaster University in Ontario, Canada, agrees.

"People should do both -- keep a healthy body weight and enhance fitness," he says. "The most important message is that individuals should maintain a healthy weight and also exercise regularly to enhance fitness."

Being in shape not only makes you feel good but also provides substantial health benefits that can protect you from a number of chronic diseases, such as heart disease, diabetes and some types of cancer.

In addition, exercise prevents high blood pressure and boosts levels of high-density lipoprotein, or "good," cholesterol, which prevents plaques from building up in your arteries.

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