[health] Focus shifts from obesity to exercise

One of these days I will likely fall over dead from a heart attack while running. I suppose the murmuring in the memorial service will be, "...and he was always running, little good that did him!"

"Notwithstanding all the studies, [Dr. Steven] Blair and other fitness proponents realize there are no guarantees. Heart attack rates inevitably climb with increasing age. Exercise is recommended, but it isn't a cure. There are no cures for heart disease. Blair knows he's just one errant heartbeat away from a newspaper headline: "Fitness expert dies on the run." The first sentence of the story almost always includes the word "ironically," as if Blair and friends believe running will help them live forever. They don't. They know the facts: Everyone dies, and some die while running." - Are Marathons Dangerous?

I often share news about fitness and health, more so after Forbes named the Federated States of Micronesia as the second most obese nation on the planet. While there are quibbles about the choice of metric and exact cut-offs for obesity among Pacific islanders, this nation is experiencing a health catastrophe as a result of non-communicable lifestyle diseases related to consuming more calories than are burned.

What caught my eye is a shift in thinking in the field of health and fitness.

"Reams of research have shown that excess body fat increases mortality rates, but Blair is banking on his morning runs to protect him. His own findings offer much hope. Evidence from the ACLS [Aerobics Center Longitudinal Study] indicates that the fit-but-fat are nearly as healthy as the fit-of-normal-weight. In other words, regular exercise offsets many of the dangers of being overweight. For that reason, Blair believes American public-health leaders should stop screeching from the rooftops about obesity and instead switch their message to the benefits of exercise. "When you look at me, you can tell I'm surprised and delighted by the fit-fat finding," says Blair. "But the point is, we're losing the obesity battle. So let's try something else. Let's focus on fitness." - Are Marathons Dangerous?

The "obesity battle" is also being lost here in the islands. As Dr. Blair suggests maybe the focus needs to change to fitness and exercise. In the JAMA article Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults the authors found that "fitness was a significant mortality predictor in older adults, independent of overall or abdominal adiposity." In other words, exercise always helps. Runners have long known that exercise alone will not necessarily lead to weight loss, the good news is that even without weight loss, exercise is beneficial. Fitness, not fatness, is a predictor of longer life.

That said, exercise is no guarantee of good health, or a magic preventative for heart disease. Runners have heart attacks. Given my own family history - the men die of heart attacks in their fifties and sixties, and my own poor dietary choices - I too will one day have a heart attack. Given my diet and family history, however, I should already have had a heart attack. So if you are at that memorial service, do not dismiss my running as having been in vain. I will have already lived longer with a higher quality of life than I would have without the running.