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Walter M. Bortz II, M.D.

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Dare to Be 100, Fit and Fat

Posted: 08/22/2013 5:21 am

Mother was overweight her entire post-me life. She never recovered her trim 35-year-old figure. She was in the term of her day, "stout." She took absolutely no heed about this from her physician husband or son -- she took perverse pride in disregarding anything we urged. Ma lived to 95, the last survivor of 12 children. She died healthy, with no pills, no doctors, no tubes, no hospital. Just bump. Way to go, Ma!

Yet she was fat. This seeming paradox now comes clear. Forever, being overweight was considered to be a burden on health in one way or another. But now comes evidence that being overweight might even be good for you!

In a recent issue of the Journal of the American Medical Association, Katherine M. Flegal reviewed 4,142 articles in the literature about mortality and obesity (1). From this extensive list, 97 papers satisfied the group's rigid inclusion criteria. The group's major conclusion was that people who are little overweight live longer than do the lean ones.

Their study did not surprise me, because for years I have been following closely the work of Steve Blair, Prof. of Medicine at the University of South Carolina. I brag that I have been his friend for a long while. In my view, he is one of the most important scientists in the world. For 40 years he probed deeply into the preventive effects of exercise on the epidemic of heart disease, obesity, diabetes, cancer, etc. Nothing has escaped his antenna. His studies have probably involved 100,000 subjects with results that have huge implications for the other seven billion of us. He has done the most research on the fit/fat issue (2).

Summarizing Steve's important conclusions: first, unfit lean people have twice the mortality rate of fit, fat people. Fitness compensates for overweight. Second, the first step seems to be the important one. One need not be an elite athlete to realize the fitness advantage, just doing something rather than sitting is paramount.

Globally, there has been a huge increase in sitting, due to TV, driving and computers. Sitting is dangerous and excess sitting is probably the reason that inactivity prompts obesity.

As I wind back my personal tape further, I knew Dr. Jean Mayer, formerly of Tufts University. He was a good buddy of my Dad's, so I came under his influence. Some of his studies done 50 years ago are relevant. I recall one in which he took movies of lean and fat children playing tennis. While the lean kids were in motion most of the match, the overweight kids watched the ball sail by with little effort at interception. Mayer also reviewed occupational nutrition data and found that clerks and supervisors eat more than active workers and are therefore heavier (3). The relationship between occupation and calorie consumption was direct. He concluded that fat people move less, much as more recent research has confirmed. Most, but not all, fat people move less.

So mother, while overweight, remained fit. My conjecture is that her extra pounds served as a regular workout machine, without a gym. She walked a lot; she carried her groceries home; she climbed the stairs; she loved to dance. She rejected my Christmas gift of a pair of running shoes. She preferred her little heels that led her to several broken wrists. "Frailty, thy name is woman."

But Ma lived 95 healthy years. I think she lived this long not in spite of her weight, but because of it. She died nobly because she was fit.

Fit and fat becomes clear. Move.

References:
1) Flegal , K. et al JAMA, 2013 ; 303: 71-82.
2) Blair, S.N. et al Scand,Med.Sci. Sports 2012; Aug.22,e 24-28.
3) Mayer, J. Am. J.Clin. Nut.1956; 44:169-175.

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