Fitness and fatness both matter. Excess weight from muscle, with a lean waist, is not a risk factor for premature death. Excess body fat distributed in the lower extremities, as often prevails in premenopausal women, is also not a marker of risk. Weight around the middle is, however, and its effect on mortality appears in this large analysis to be much the same as the risk of inactivity.
In last week's New York Times, Dr. Ezekiel Emanuel suggested that this year's resolution might be to abandon the ritual of your annual physical. The title of his column, perhaps chosen by an editor to maximize glibness and thus provocation was: "Skip your annual physical." But permit me to suggest you don't commit to that just yet. The annual physical exam warrants some more examination, a defense to follow its prosecution.
There are times when people work to prevent cancer and it doesn't work, but it's not unlike a seat belt in a car: The fact that it doesn't always help is not a reason to not wear a seat belt. Just because we might know one person who was killed while wearing a seat belt doesn't mean the rest of us should not wear them.
What really matters most to me today is not my mission, but my family. Because that's probably true for all of us every day, the mission matters all the more. The mission is to add years to life, and life to years. When the lives and years belong to someone we love, it's the most important thing in the world.
The bottom line is that anti-vaccine sentiment and associated conspiracy theories are a luxury accessible only to societies largely spared the historical toll of dreadful, vaccine-preventable diseases. If our children were still prone to polio, any anti-vaccine evangelists would be trampled by the mob rushing to the immunization clinic
If instead, we treated obesity more like drowning, we would tell the truth about food. We would not market multicolored marshmallows to children as part of a complete breakfast. We would not willfully mislead about the perilous currents in the modern food supply. We would not look on passively as an entire population of non-swimmers started wading in over their heads.
If you eat well and are active generally throughout the year, you will be healthier and leaner than those who are not. If that pattern persists over the holidays, or picks up again after, you will find in it pretty effective immunity against holiday-related health hazards. Build good health year round, and let the good times roll when the holidays roll around.