New research has just plunged a dagger through the core of the mentality that you can be “fat but fit.”
Physical activity does nothing to cancel the harmful effects of excess body weight on cardiovascular health, according to a bombshell study published Thursday in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology.
The findings contradict previous studies concluding that maintaining physical activity could lessen the effects of extra body weight on heart health.
“One cannot be ‘fat but healthy,’ ” said the study’s author, Alejandro Lucia, a professor of exercise physiology at the European University of Madrid. “This was the first nationwide analysis to show that being regularly active is not likely to eliminate the detrimental health effects of excess body fat. Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity.”
Lucia cites previous research that suggested, in adults and children, a “fat-but-fit” lifestyle could be in similar cardiovascular heath to those who are “thin but unfit” — and adds that’s led people astray from the true priority.
“This has led to controversial proposals for health policies to [prioritize] physical activity and fitness above weight loss,” he said. “Our study sought to clarify the links between activity, body weight, and heart health.”
This study surveyed data from 527,662 working Spanish adults, all insured by a large occupational risk prevention company. Thirty-two percent of the participants were women; The average age was 42.
They were categorized by activity level and body weight — with some 42 percent classified as normal weight with a body mass index (BMI) of 20 to 24.9. Approximately 41 percent were overweight, with a BMI of 25 to 29.9, while 18 percent were considered obese, with a BMI of 30 or above. The majority of the study’s pool, more than 63 percent, were physically inactive. About 24 percent were regularly active and just more than 12 percent were considered insufficiently active.
The research team then examined the associations between BMI, level of physical activity, and high cholesterol, high blood pressure and diabetes — the three of which carry big risks for heart attack and stroke.
They found that across all BMI measurements, any physical activity was linked to a lower likelihood of diabetes, high cholesterol and high blood pressure when compared to no exercise at all.
“This tells us that everyone, irrespective of their body weight, should be physically active to safeguard their health,” said Lucia.
So yes, being active is important. But size still matters.
Regardless of activity levels, the overweight and obese participants faced higher cardiovascular risks than those with normal body weight. When compared to inactive normal-weight adults, physically active obese people were still about twice as likely to have high cholesterol, four times more likely to have diabetes and five times more likely to have high blood pressure.
“Exercise does not seem to compensate for the negative effects of excess weight,” he added. “This finding was also observed overall in both men and women when they were [analyzed] separately.”
Lucia concluded that obesity and inactivity must both be combatted.
“It should be a joint battle,” he said. “Weight loss should remain a primary target for health policies together with promoting active lifestyles.”
However, the study makes no mention or recommendations for diet — and when it comes to an example of physical activity, Lucia said “walking 30 minutes per day is better than walking 15 minutes a day.”
Sean Heffron, MD, a cardiologist at the Center for the Prevention of Cardiovascular Diseases at NYU Langone Health, underscored that obesity is a risk factor for cardiovascular disease — as is insufficient physical activity — but weight loss requires a two-part formula.
“Exercise in and of itself isn’t the kind of way to lose weight,” he said. “It’s complementary to having an ideal body weight,” but improving your diet is the other piece of the puzzle.
“Certainly the ideal would be to have both.”