Dear Reader,

People make assumptions that the state of a person's body size or shape predicts whether or not s/he is physically fit. This is not always the case. Just as there are slender people who are in poor shape, there are overweight or obese people who are active and fit. So, is body size or shape a better determinant of good health than physical activity, or vice-versa? This continues to be a controversial topic among health experts.

Before addressing the two sides of the controversy, what is generally agreed upon is that regular physical activity, regardless of body size or shape, is important for attaining and maintaining good health. Physically fit individuals decrease their risk of disease, increase their metabolism, and have stronger bones. The Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine made recommendations about physical activity and public health based on a review of available research. According to these agencies:

• the more intense the physical activity (meaning longer duration and more calories burned), the less cardiovascular disease incidence and mortality
• regular exercise of moderate intensity offers significant health benefits
• at least eight to ten minutes of physical activity on most days can provide beneficial health and fitness effects

With this in mind, the Cooper Institute for Aerobics Research in Dallas, Texas studied 25,000 men to see how health is affected by both physical fitness and body shape or size. In terms of life expectancy, the researchers found that the fit, fat men lived as long as the fit, trimmer group. In addition, the out-of-shape, slimmer men were found to have a close to three times greater risk of dying early than the in-shape, fat group. These results appear to show fitness as a more significant factor than fatness.

On the other side, there are experts who would not discount obesity so easily. Even though one may eat a varied and well-balanced diet and exercise regularly, which are good things, they feel obesity is inconsistent with good health. Obesity is an established risk factor for heart disease, certain cancers, and stroke. Although you may be fat and fit, these experts believe that if you slim down, you will be healthier. Studies to support this argument have demonstrated further improvements in blood pressure, cholesterol, and blood sugar with weight loss among the obese.

A 1995 study done at the CDC examined whether weight loss in overweight white women, ages 40 - 64, improved their longevity. They found that in women who had a health condition related to obesity, weight loss did improve their lifespan. In those with no pre-existing illness, if they intentionally lost more than 20 pounds in the preceding year, there was a 25 percent reduction in death from cancer or heart disease. If the loss was fewer than 20 pounds, the benefits were marginal.

So where does this leave us? The following recommendations are good to keep in mind:

• blood pressure, blood sugar, and cholesterol check-ups: make sure they are within normal ranges by having periodic visits to your health care provider
• cancer screenings: pap smears and breast exams for women; prostate and testicular screenings for men. Consult with your provider for appropriate ages for these tests, as well as how often they need to be done.
• an annual, full-body skin cancer exam for adults at high risk (e.g., fair-skinned, blue eyes, history of severe sunburn in the past, moles) that can be performed by a dermatologist or other provider
• a fitness assessment by a qualified trainer or exercise physiologist. For those who don't have access to either, try these: if you can walk up a flight of stairs without getting winded, or can walk a mile in 20 minutes or less, you're probably in reasonably good cardiovascular shape. To test flexibility, sit on the floor with legs out-stretched, and keep them flat on the floor (no cheating by bending your knees!) — you should be able to touch your toes. These tests are a basic way of determining minimum levels of cardiovascular endurance and flexibility.

When figuring out your most appropriate weight range, consider all of the previously mentioned factors, in addition to heredity, family health history, and your own weight history. It's important to realize that we are not all meant to be thin.

As you can see, there's really more to it than just being fit or fat. Hopefully, by considering all aspects of your health, you'll be able to draw an informed conclusion that's right for you.

If you would like more opinions on this topic, check out the following resources:

• Shape Up America!
• Glenn A. Gaesser's book, Big Fat Lies: The Truth about Your Weight and Your Health

Alice

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