Fitness May Trump Weight for Good Health
 Question: Which is more important for health, how much you weigh or how fit you are?
If you picked fitness, you're in agreement with a study that compared how weight and fitness stacked up for men's overall health.
And that conclusion - that fitness matters more than how much you weigh - is counter to the prevailing assumption about weight and health.
"We all tend to assume that it's weight loss and obesity and seeing a change in pounds that is having the true effect on overall cardiovascular disease and, ultimately, mortality," says Tara Narula, M.D., at Lenox Hill Hospital in New York City and who was not involved in the study. "For these researchers to draw the conclusion that really it's fitness that may have more of an impact than seeing actual changes in pounds, that's big news."
Researchers at the University of South Carolina followed more than 14,000 well-off, middle-aged men for 11 years. Using a treadmill test to measure fitness, they found that men who maintained their fitness levels cut their risk of dying from cardiovascular disease - or any other causes - by about 30 percent, even if they failed to lose any excess weight.
Those who improved their fitness levels reduced their odds by about 40 percent.
But men whose fitness declined over the 11 years had a higher risk of dying.
"Being fit is more important," adds Perry Kubek, MD, a physician with East Petersburg Family Medicine. "Many of the studies documenting the benefits of 30 minutes of accumulated exercise have shown that intermittent bouts of activity (such as 10 minutes) whether they are occupational, recreational or the tasks of daily living have similar cardiovascular benefits."
Dr. Kubek said the idea is to accumulate 30 minutes of moderate activity daily. Many of his patients become less conditioned in retirement, because they are less active then they were when they worked.
"If you cannot or will not set aside a half hour of activity daily, then try to work more activities into the day by taking the stairs or walking rather than driving a short distance to the store," he says. "Try to work several shorter periods of activity, such as 10 minutes, into your schedule. The most important thing is to get started."
The researchers also found that body mass index (BMI), a measurement that takes weight and height into account - did not affect the men's mortality.
"People need to [think] more about their fitness, and not just their fitness, but trying to improve or maintain their fitness, rather than focusing too much on weight loss or worrying too much about weight gain," says study author Duck-chul Lee, Ph.D.
The study, published in the journal Circulation, had some limitations. Jonathan Whiteson, M.D., at NYU Langone Medical Center in New York City, says that BMI is not necessarily the best measure to use, because it doesn't take body composition into account.
But Dr. Lee adds that the researchers had similar results when they measured body fat in a subsample of men. In other words, fit men lived longer even if their body fat hadn't changed.
It's also not clear if the study results can be applied to minorities or to obese people. Nearly everyone in the study was of normal weight or overweight, not obese.
Still, Dr. Whiteson says, "the key fact here is that aerobic exercise reduces your risk factors for cardiovascular events. . . These were pretty impressive numbers."
Always talk with your health care provider to find out more information.
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