With research just published in the European Heart Journal showing so-called obese but fit people to be as healthy as slim ones and not having the medical complications usually associated with being overweight, such as diabetes, high cholesterol or high blood pressure, is it time to question the use of the term and redefine our preconceptions about what is healthy? Should we accept that fitness and obesity are not mutually exclusive and stop banging on about obesity, despite it being linked to a range of chronic diseases and being estimated to cause 30,000 deaths a year in the UK?
The study involved more than 40,000, mainly white, professional people in the US, and followed them from 1979 to 2003. It found those who were fit but obese had a 38 per cent lower risk of dying than those who were unfit and obese. It also concluded that obese people who were otherwise physically fit had no greater risk of dying prematurely than those whose weight was normal, suggesting there’s a large subset of obese people who can be metabolically healthy.
Dr Francisco Ortega, the chief author of the study and now working at Spain’s University of Granada, says, “We should stop worrying about fatness and worry more about fitness.”
But before we all sit back with a family bag of Doritos and relax, congratulating ourselves that we hit the gym three times a week, obesity expert Zoe Harcombe, author of The Obesity Epidemic, sounds several notes of caution. “We are in the middle of an obesity epidemic and it doesn’t matter how fit you are, if you’re filling your body with junk you’re going to run into health problems no matter how many marathons you run,” she says.
“It’s still valid to call people obese, and a third of the population meet that definition. According to World Health Organisation data, 2.7 per cent of men and women were obese in the UK in 1972. By 1999 this had risen to 22.6 per cent of men and 25.8 per cent of women,” she says.
Harcombe has a number of problems with the study itself too. “It was done on a particular group of people – 98 per cent Caucasian, well educated, and working in executive or professional positions. It didn’t look at fitness but ill-health, and one treadmill test between 1979 and 2003 does not define ‘fat’ and ‘fit’.”
She also points out that the numbers of people in the study are “tiny”. She says, “It means that 2.8 people in 1,000 died in any one year in the fat and fit group and three to four people in 1,000 died in the fat and not fit group. It’s misleading, and it’s unhelpful to send a message that obesity doesn’t matter.
“The reality is most obese people are unhealthy and need to do something about it. It makes headlines, and academics are as egotistical as pop stars. Is it better to be fit and fat rather than just fat? Absolutely. Do I think that this study has proven this? No.”
Harcombe is also keen to point out that the research was partially funded by Coca-Cola, the world’s biggest soft-drinks-maker, and wants to burst the myth she says was promoted during the Olympics – that you can eat burgers and drink cola, as long as you exercise. “The message from food companies is: you’re fat because you’re lazy. They want us to put it in the mouth and burn it off, but the damage sugar does to the arteries’ lining is much worse than fat. Eat more raw food and you will tend towards your natural weight and minimise the risk of modern illnesses. And you shouldn’t have to exercise madly at the gym; just walk, talk, cook, clean. Running marathons is so not natural,” she says.
For Dr Simon Williams, principal lecturer in health and exercise science at Glamorgan University, fitness is key, and if you’re carrying lean muscle rather than fat you can be healthy. However, he stresses that most of the rising number of obese people in the UK are not fit. “The study highlights the importance of physical activity and that it’s possible to be obese and physically fit, but the reality is people who are obese are not extremely fit,” he says.
“In the 25-35 BMI range, there appears to be some protection from disease if you are very fit, but not for the severely obese, with a BMI above 35. And nowadays there are a lot of them. This study is interesting but, if you are obese, your chance of developing the diseases mentioned is still higher. The most important thing is to become physically active and your health will improve.”
Ultimately, it seems that you can be overweight and metabolically fit and healthy, and you can carry a bit of extra weight and not be at an increased risk of disease, but let’s be honest: is that extra roll of bulk hanging over your joggers lean ripped muscle or good old-fashioned flab? You decide. n
The Obesity Epidemic, Columbus Publishing, £20
Tomato sauce is good for you
Tests by Finnish scientists suggest eating ketchup every day is good for your heart.
The sauce attacks ‘bad’ cholesterol, or low-density lipoprotein, and a dollop on breakfast, lunch and dinner saw LDL levels drop significantly in the space of just three weeks. Tomatoes have long been considered a health super-food as the pigment that gives them their red colour, lycopene, can protect against prostate cancer. A tomato salad might be better for you, but where’s the fun in that?
Alcohol is healthy
Apparently moderate beer intake can improve cardiovascular function, although a beer gut is never a good look, while red wine has long been known to have potent anti-cancer and artery-protecting benefits.
Chocolate cake for breakfast can help you lose weight
Morning is when the body’s metabolism is most active, so the best time to consume sweets is at breakfast, as we have the rest of the day to work off the calories. The chocolate cake diet recommends eating it along with proteins and carbohydrates to help stem a craving for sweets later. That’s because breakfast is the meal that most successfully regulates ghrelin, the hormone that is responsible for hunger and cravings.
Fat is good news
It’s essential for every cell in the body and, according to surveys, we are deficient in the fat-soluble vitamins A, D and E. These are responsible for healthy eyesight, bone strength, mental health, protection aganst cancer and blood vessel disease and heart health, and we need to eat fat so these can be absorbed into the body.
Too much fruit is bad for you
Fruit is packed with vitamins, fibre and antioxidants but it also contains calories due to its high fructose content. Grapes and bananas are the worst offenders. Fructose doesn’t trigger insulin production so the body doesn’t know it’s full. It can also increase levels of triglycerides, a type of blood fat linked to heart disease, and rot the teeth.