Obesity continues to balloon around the world, placing huge pressure on our health care systems and budgets as well as compromising the lifestyle options of those afflicted.
All is not lost, however: people who build and maintain cardiorespiratory fitness when overweight do not have the risk of cardiovascular disease that unfit and overweight people face.
In fact, they have a lower risk than thin people who do not exercise.
The findings that cardiorespiratory fitness is a strong predictor of cardiovascular disease and all-cause mortality, and attenuates risks associated with overweight and obesity, is from a new systematic review by a research team from universities in Virgina and Arizona, in the US, and Bristol in the UK. https://bjsm.bmj.com/content/59/5/339
The researchers reviewed 20 studies that examined the joint relationship between Body Mass Index (BMI) and cardiovascular disease.
The analysis found that those classified as fit, regardless of BMI status, showed no statistically significant increase in cardiovascular disease or all-cause mortality risk compared with normal weight and fit individuals.
In contrast, all people who were unfit showed twofold to threefold increases in risk of cardiovascular disease and all-cause mortality compared with normal weight and fit individuals.
“Fitness, it turns out, is far more important than fatness when it comes to mortality risk,” said Siddhartha Angadi, associate professor of exercise physiology at the University of Virginia School of Education and Human Development and an author of the study.
“Our study found that obese, fit individuals had a risk of death that was similar to that of normal-weight, fit individuals and close to one-half that of normal-weight, unfit individuals.”
“Exercise is more than just a way to expend calories. It is excellent ‘medicine’ to optimise overall health and can largely reduce the risk of cardiovascular disease and all-cause death for people of all sizes,” Angadi said.
The researchers said that while increased risks of morbidity and mortality are associated with increased BMI, weight-centric interventions (interventions primarily concerned with weight loss, typically via calorie restriction) are largely unsuccessful at maintaining long-term weight reduction and thus improved health outcomes.
“Most people who lose weight regain it,” said Glenn Gaesser, a professor at Arizona State University, and co-author of the study.
“Repetitive cycles of losing and gaining weight – yo-yo dieting – is associated with numerous health risks comparable to those of obesity itself.
"Improving cardiorespiratory, aka aerobic, fitness may help avoid the adverse health effects associated with chronic yo-yo dieting.”
Only 20% of adults meet the physical activity guidelines set by the US Department of Health and Human Services. Current guidelines for adults recommend 150 minutes of moderate-intensity physical activity each week or 75 minutes of vigorous-intensity physical activity, along with muscle strengthening two days a week.
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