Fat and fit? Sorry, that’s a myth

It’s a tempting idea, one that physicians and health practitioners have been grappling with for decades -is it possible to be fat and fit? Not really, says new research which finds that overweight people with apparently healthy metabolic indicators have up to a 28 per cent greater risk of coronary heart disease.

Earlier this year, Carleton University in Ottawa made the news when it revealed that something was missing from its campus fitness centre: scales. University health administrators said the decision was “in keeping with current fitness and social trends,” which proclaim that a person’s weight is, on its own, at least, not a good indicator of overall health.

“Our health and fitness is multi-faceted,” said Bruce Marshall, manager of wellness programs, to Postmedia. “The best indicator is how well you feel in your body.”

The fat but fit trend started picking up steam in the early 2000s, as criticism grew of the use of the body-mass index or BMI —calculated by dividing a person’s weight by the square of their height— as the primary tool for determining a healthy weight range and overall fitness.

And the idea seemed to be backed up by health research, too, which found that about 30 per cent of people who fall within the category of clinically obese (having a BMI of 30.0 or higher) were also found to have healthy metabolic indicators for blood pressure, blood sugar and cholesterol levels.

Is it possible to be healthy and obese? Unfortunately, no, says a growing body of research, including a recent study from Imperial College London and the University of Cambridge in the UK. Researchers tracked data on more than half a million people across ten countries in Europe for a period of 12 years and found that overweight people with healthy metabolic profiles had a 26 per cent greater risk of developing chronic heart disease than people within the healthy weight range. Obese people with healthy profiles had a 28 per cent greater risk.

“Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors,” said lead author Dr Camille Lassale, from Imperial’s School of Public Health and now based at University College London, in a press release, “Even if their blood pressure, blood sugar and cholesterol appear within the normal range, excess weight is still a risk factor.”

The problem with the “fat but fit” theory appears to lie in the difference between fitness and health. Fitness is loosely used to indicate a person’s ability to perform daily activities without undue fatigue — for example, being able to walk up stairs or carry groceries and being alert and energetic throughout the day. By that definition, overweight people can be fit, yet they may still be unhealthy, since on its own and over the long term, excess weight comes with well-observed health risks.

One study last year from the Karolinska Institutet in Sweden found that white fat tissue samples from people classified as obese have abnormal changes in gene expression which affected how the body responds to producing insulin. The researchers found that these changes were present in both healthy obese and unhealthy obese people.

Health Canada reports that 20 per cent of Canadians aged 18 or older, roughly 5.3 million adults, are classified as obese, with a 21.8 per cent rate for men as of 2014 and 18.7 per cent rate for women. A further 40.0 per cent of men and 27.5 per cent of women fit into the category of overweight.