Exercise is important to maintaining health

LITTLE ROCK — Being moderately overweight is associated with the longest life expectancy.

For most of the 20th century, actuaries had shown that life expectancy followed a bell-shaped curve. People who were at their ideal weight or thin or those who were obese had a shorter life expectancy than those who were overweight. In other words, actuaries said, if you had a body mass index (BMI) between 24 and 30 you lived the longest.

A few years ago, this concept was debunked when a series of research articles in prestigious journals showed that even a few extra pounds shortened life expectancy.

Now comes a new article in the Journal of the American Medical Association that analyzed the results of 97 studies involving 2.88 million people in whom weight was correlated with life expectancy. In this report, individuals who were overweight having a BMI between 24 and 30 were 6 percent less likely to die from all causes than those who were at their ideal weight and 16 percent less likely to die than those who had a BMI above 35.

While the evidence is compelling that overweight people live longer, they may well not live better. After the age of 60, the combined effect of less muscle and more fat puts overweight individuals at a much greater risk of experiencing weakness, frailty and difficulty walking. This in turn contributes to falls,fractures and loss of physical independence.

Mixing being overweight with being sedentary is a prescription for disaster, almost always leading to a poor quality of life.

But combine being plump with exercise, and your future can be bright.

In fact, if you are fat, you’d better be fit. All it takes is regular exercise, and a chubby person can remain as physically strong or stronger than any sedentary person, thin or not. Research done at The Cooper Clinic has clearly shown that overweight individuals who exercise are far healthier than sedentary individuals who are thin.

Furthermore, overweight individuals who still exercise have a significantly lower risk of heart disease and stroke than someone who looks to be “in good shape” but doesn’t exercise.

I am not suggesting that obesity isn’t a problem. The “obesity epidemic” is real. An analysis from the National Health and Nutrition Examination Survey (2009-2010) showed that 35.7 percent of adults were obese with a BMI of 30 or higher.

A quick review: To accurately assess a person’s weight you have to correct the value for their height. This is done using the body mass index, which is calculated by dividing weight in pounds by height in inches squared then multiplying by 703. Ideal weight is defined as a BMI between 18 and 24, “overweight” is a BMI between 24 and 30, “obesity” is above 30 and “extreme obesity” is a BMI above 40.

The most recent information indicates that 40 percent of adult men and 30 percent of adult women are “overweight.”

But the trends over the last 20 years suggest that it’s the lack of exercise, as much as diet, that’s responsible for the dramatic rise of obesity. In the years 1980 to 1991, a time when the prevalence of obesity was surging, the average American’s calorie intake actually declined from 1,854 calories to 1,785 per day. At the same time, total fat intake decreased by 11 percent.

So the reason we’re getting fat is not because we’re eating more, but because we’re not exercising.

And yet for the overweight and unfit among us, the first thing everyone says is “lose weight.”

Unfortunately, the recommendation to diet comes with a much lower emphasis on exercising. The most important message must be to stay fit.

For every pound of fat lost by dieting, a pound of muscle is lost as well. Dieting leads to a higher risk of illness and death. If the diet fails and the weight returns, it is all in the form of fat with virtually no return of the lost muscle. This leads to even more weakness, a greater risk of falling and an even higher risk of further disability.

If you want to live long and live well and if you are overweight, the message is simple: Don’t worry about your weight and your shape.

First, you must exercise.

Second, work on being happy.

Third, never diet but eat sensibly.

Fourth, see your doctor frequently and work assiduously to stay healthy.

Remember, it is not how good you look but how good you feel that is important.

Dr. David Lipschitz is co-director of the Healthy Aging Center at Saline Memorial Hospital. More information is available at: drdavidhealth.com