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Can You Be Fat And Fit? More Health Experts Say Yes

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Can You Be Fat And Fit? More Health Experts Say Yes

On Aging

Can You Be Fat And Fit? More Health Experts Say Yes

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Here's something else about pine nuts: Sprinkling them on food for a week could add up to 900 calories and gaining a little bit of weight. No need to feel guilty, though, if you are exercising. Experts say it's possible, as we age, to be a little overweight and still be fit. NPR's Patti Neighmond explains.

PATTI NEIGHMOND: The treadmills are in use, and so are the bikes. But this isn't your ordinary gym. This is a cardiac rehab gym at Cedars Sinai Heart Institute, where cardiologist Noel Bairey Merz directs preventive care.

Dr. NOEL BAIREY MERZ (Cardiologist, Cedars Sinai Heart Institute): I'm Dr. Merz. I'm the cardiologist (unintelligible). And here's the face to go with all the signatures.

NEIGHMOND: Bairey Merz watches a gray-haired man walking briskly on the treadmill.

Unidentified Man: I do this between 25 and 30 minutes. I go at 3.6 miles an hour; distance, over one and half miles.

NEIGHMOND: This patient isn't at all obese. But he says he is overweight, and he's working on it. Bairey Merz tells me he's doing exactly the right thing for his health.

Dr. BAIREY MERZ: So we just got a tremendously fine example of fitness at 82. Did I hear 82?

Unidentified Man: Eighty-three.

Dr. BAIREY MERZ: Eighty-three. We might agree that he's overweight, but he is very fit. So his overweightness, at this point, is not likely doing him any harm. And if anything, should he become ill and need a hospitalization, this modest overweight might actually be okay.

NEIGHMOND: That's because there's some evidence that being overweight is actually protective when people get sick.

Dr. BAIREY MERZ: Fat is our energy-storage device. It's, in a way, a little bit like having something in the bank.

NEIGHMOND: In one study, older people who had a few extra pounds were less likely to die than their more lean counterparts. And even in midlife, being moderately overweight may not be a bad thing, says Bairey Merz, as long as people are fit. And that means that heart, lungs, muscles are all working efficiently.

Dr. BAIREY MERZ: These would be people that, you know, could walk 30 to 60 minutes without having to stop. These are people that can climb two flights of stairs without becoming winded. These are people that could do some mild to moderate aerobic activity - brisk walk, jog, something like that.

NEIGHMOND: Bairey Merz is also doing a study of women's heart health. Recent findings show overweight women who were physically active had fewer heart problems than inactive women. In fact, being active was more important than being moderately overweight, when it comes to heart disease. Women who don't exercise lack what Bairey Merz calls cardiovascular reserve.

Dr. BAIREY MERZ: Everything is fine at rest. But then when they actually have to do something, they get winded. When they are faced with any kind of cardiovascular stressor - a car accident, a heart attack, pneumonia - they do not have a fitness level that is going to help them do well and survive.

NEIGHMOND: But is an extra 10 pounds always okay, as long as you're exercising? Health experts say not necessarily. When metabolism slows down at around age 50, men tend to gain weight in the abdomen, while women tend to gain weight in their hips and thighs. And it turns out, one is more dangerous than the other. Abdominal fat is worse than fat elsewhere in the body.

Geriatrician Arun Karlamangla, at UCLA, recently analyzed the health status of more than 4,000 men and women nationwide.

Professor ARUN KARLAMANGLA (Professor, Geriatrics, UCLA): In older people, more than just waist size alone, more than body mass index, the biggest projector of who's going to die first was waist-to-hips size, the ratio of waist size to hip size. People with higher waist-hip ratios died faster. And this was true in both men and women.

NEIGHMOND: Here's how Karlamangla says you can judge how you're doing: If you're a man and your waist is bigger than your hips, your risk of death has increased by 75 percent. For women, risk goes up gradually with every inch of increased waist size. Researchers don't know exactly why this is, but speculate abdominal or visceral fat interferes with the body's ability to process sugar.

Prof. KARLAMANGLA: Visceral fat increases insulin resistance, which increases the levels of insulin floating around in the body, which increases the amount of glucose in the body, which eventually leads to diabetes. And diabetes increases your risk for heart attacks and strokes.

NEIGHMOND: So to keep abdominal fat down and to maintain or build fitness, the federal government recommends 30 minutes of moderate exercise every day. If you want to lose weight, you have exercise at least 60 minutes a day.

Patti Neighmond, NPR News.

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