The Fat But Fit Paradox: Should we re-assess our thinking?
The research proving the link between obesity and chronic lifestyle diseases, such as Type 2 Diabetes (T2D) and cardiovascular disease (CVD) is irrefutable. However, being fit, even if overweight, may attenuate some of the adverse effects of obesity. Research in the late 1990s identified, what is now known as the ‘Fat but Fit’ paradox and demonstrated that being so called normal weight might not be enough, as being fit also play a major role in good health.
There is a general misconception that being normal weight is synonymous with being healthy, however this concept may be wrong. Research has shown that in general, normal-weight but unfit individuals have significantly higher risk of all-cause CVD mortality than normal-weight fit individuals. However, several studies have shown that normal weight, but unfit individuals could be at a higher risk than obese but fit individuals of a cardiac event.
Many of our physical and biochemical traits such as the storage of body fat and cardiorespiratory fitness are determined by both our genes and environment. Research has shown that heritability of both obesity and cardiorespiratory fitness might be up to 50%. Therefore, as we learn more about how our environment, i.e., nutrition, exercise and lifestyle choices interact with our genes, we are realising why some of the traditional ‘one size fits all approach’ to improving health outcomes are not working.
It may be time to to re-assess our thinking regarding the ‘fit versus fat paradox as there is emerging evidence suggesting that a moderate to high cardiorespiratory fitness might counteract the adverse effects of obesity on many other health outcomes.
There is no doubt that obesity, and especially severe/morbid obesity (BMI >35 kg/m2), is a major public health problem, and that nutrition, exercise and lifestyle intervention programs are important goals. However, the latest research suggests that our focus should also be on increasing cardiorespiratory fitness, and not exclusively on losing weight/fat, since a medium–high cardiorespiratory fitness level may reduce the adverse effects of obesity on health and wellbeing.
Bottom Line:
This research paper highlights why knowing your Cardiaction PWA parameter SEVR, which is both a measure of both your aerobic VO2max capacity and cardiac efficacy of your heart, is as important as knowing your BMI with regard to your cardiovascular health and general wellbeing.
REFERENCE
Ortega FB, Ruiz JR, Labayen I, Lavie CJ, Blair SN. The Fat but Fit paradox: What we know and don’t know about it. British Journal of Sports Medicine. 2018 Feb 1;52(3):151-3.