The Fat vs Fit Debate by Rachel Stockton

A study published earlier this week in JAMA Internal Medicine helps to clear up some of the debate on whether or not it’s possible to be overweight, yet metabolically healthy.

Study Details

Study participants consisted of 71,519 adults who were part of the Copenhagen General Population Study; they were categorized as baseline (normal weight), overweight and obese.  Additionally, they were categorized according to whether or not they had metabolic syndrome.

According to the National Institutes of Health, metabolic syndrome refers to the following cluster of risk factors:

  • large waisteline
  • high triglyceride levels
  • low HDL (or “good” cholesterol)
  • high blood pressure
  • high fasting blood sugar

Over the course of the study, there were 1,781 incidents resulting from heart disease. The researchers discovered that even overweight individuals without metabolic risk factors are at a higher risk for myocardial infarction (heart attack) and heart disease.

Prior Research

However, according to Steven Blair of the Cooper Institute,  there is other research that shows that people who are overweight but not obese have 1/2 the death risk than those who are relatively lean, but who aren’t fit. The key to this seemingly contradictory body of research is the definition of “fit”.  In order to be considered fit, there are certain variables that are factored in:

  • Smoking: A person who smokes regardless of whether or not they’re overweight is not considered fit
  • Exercise: Fit people are those who are physically active at least 30 minutes five days a week
  • Metabolic risk factors: Fit patients are those who have not been diagnosed with high blood pressure, high cholesterol or Type 2 diabetes
  • Family History: Patient has no family history of chronic illness

Waist size is another factor that determines fitness; according to WebMd, women who have a waist size of 35 inches or less might still be considered fit, even if she’s carrying a few extra pounds.



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