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If you’ve taken up running as a way to get healthy, you’re not alone – studies show that a desire to get or stay healthy is a primary motivation for many in the sport. But what does “getting healthy” actually mean? New research published in the British Journal of Sports Medicine says fitness, not weight, is the best predictor of long-term health.
The study, which looked at the relationship between cardiorespiratory fitness, body mass index, and mortality risk found that being out of shape increases the risk of premature death, regardless of how much one weighs.
Background
Since 1980, the prevalence of obesity has doubled in more than 70 countries around the world. Obesity is associated with numerous chronic diseases as well as cardiovascular mortality. For this reason, physicians have long counseled their overweight patients to lose weight to reduce those risks and potentially prolong their lives.
Despite these efforts, obesity rates have continued to rise. The World Health Organization reports that more than 43% of adults worldwide are overweight, and 16% are obese. Meanwhile, some studies have found that weight loss doesn’t consistently reduce mortality risk – but cardiorespiratory fitness does.
Many studies have shown how exercise is inversely correlated with cardiovascular morbidity and mortality – in other words, more exercise leads to less disease and death. Exercise is also known to be protective against various chronic illnesses and even certain types of cancer. Even moderate amounts of fitness can have major impacts.
Given this information, researchers wondered whether the protective effects of being fit might extend to those who were overweight.
Thin vs. fit study
Dr. Nathan Weeldreyer at the University of Virginia this systematic review in which 20 smaller studies were pooled to amass almost 400,000 subjects to evaluate the data and assess which was more important to good health outcomes: being fit or being “normal” weight.
Study subjects were stratified as being “fit” or “unfit,” then further sub-stratified by their body mass index (BMI) as being normal weight, overweight or obese.
The results were unequivocal. Compared with normal weight-fit individuals, overweight-fit and obese-fit had no significant increase in risk of all-cause mortality. However, compared with normal weight-fit individuals, an increased risk of all-cause mortality was observed in all individuals who were unfit regardless of their weight.
For cardiovascular disease mortality risk, being fit was protective across individuals of all weights with minimal differences in mortality observed between normal weight, overweight, and obese population. Being unfit had an approximately two-fold increase in the risk of all-cause mortality and a two to three-fold increase in the risk of cardiovascular mortality, regardless of weight.
Interestingly, in most of the studies, to be considered “fit” one only had to exceed the 20th percentile of fitness standards. This suggests that significant reductions in mortality risk may be attained with only moderate fitness levels, regardless of BMI status.
What it means
It is important to note that the authors of this study (and other studies like it) emphasize that these findings do not mean that people who are overweight or obese should not consider weight loss as a factor for improving health. Being overweight remains associated with a variety of important chronic ailments, and makes becoming fit more difficult than it is for those who are closer to normal weight.
What this study suggests is that rather than making weight loss a goal, people should instead focus on increasing their level of physical fitness. Weight loss may or may not follow, but even if it doesn’t, improved cardiorespiratory fitness will provide essential and long-lasting benefits to physical and mental health.
Putting it all together:
Make your focus on improving your fitness, and do not worry so much about your weight as a primary goal.
Calorie counting can be stressful and is often not helpful. Making modest changes in how and what you eat can start the process toward body composition and weight changes, but these should follow fitness.
If you own a scale, resist the urge to weigh yourself daily or to pay much attention to the number. Instead, follow your fitness watch’s calculated VO2 max as a better measure of your health.
Body fat percentage measurements from scales are notoriously unreliable and should not be relied upon as a health metric. Again, focus on fitness, and let the rest follow along.
