WOMEN'S HEALTH Fit vs. fat: Study shows activity level may determine future heart risks

A high weight was not independently associated with heart risks.
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SAN JOSE, Calif. -- It is better for women to be fat and fit than lean and lazy if they want to prevent heart problems, a new study shows.
But the surprising findings aren't carte blanche for Americans to load up on burgers and fries after a trip to the gym.
For when it comes to preventing diabetes, how much you weigh is more important than how much you work out, a different team of scientists reported.
The dueling studies, which appear today in the Journal of the American Medical Association, are reigniting the decades-old "fit vs. fat" debate over the health merits of different body shapes.
Though it has long been thought that thinness is the healthy ideal, a growing body of evidence suggests that a person's size may not be as important as how she got that way.
Activity level
Researchers at the University of Florida reported that a woman's activity level -- or lack thereof -- appears to be the greatest predictor of whether she suffers heart attacks or other heart problems in the future.
Not exercising, or doing so only sporadically, left the more than 900 women studied at greatest risk for cardiovascular troubles, the scientists found. A large waist circumference or high weight, on the other hand, were not independently associated with heart risks.
"Exercise is at least as important -- if not more important -- than just your weight level," said Dr. Timothy R. Wessel, lead author of the heart report.
"The reason this study is so timely and interesting to people is there is such a focus in this country on weight loss through what I would call fad diets such as the Atkins diet. People should not lose sight of the fact that a cornerstone to any weight-loss plan should be increasing your physical fitness level."
Increase in risk
But researchers in Boston, who looked at a decade of data on more than 37,000 women, have less heartening news for those who have been struggling with their weight.
Women who were overweight in their study had a roughly threefold higher risk of developing diabetes compared with women of healthy weight levels, they found. Women who were obese had a ninefold increase in risk.
Physical activity, while helpful for all-around health, did not play the beneficial role it had for women in the Florida heart study.
"You really can't get away with being fit and fat in terms of diabetes prevention. You need to get your weight down," said Howard Sesso, an assistant professor of medicine at Harvard Medical School and one of the study's authors.