More on "Fit & Fat"

Better to Be Fat and Fit Than Skinny and Unfit

By TARA PARKER-POPE

Published: August 18, 2008
The New York Times

Often, a visit to the doctor’s office starts with a weigh-in. But is a person’s weight really a reliable indicator of overall health?

Increasingly, medical research is showing that it isn’t. Despite concerns about an obesity epidemic, there is growing evidence that our obsession about weight as a primary measure of health may be misguided.

Last week a report in The Archives of Internal Medicine compared weight and cardiovascular risk factors among a representative sample of more than 5,400 adults. The data suggest that half of overweight people and one-third of obese people are “metabolically healthy.” That means that despite their excess pounds, many overweight and obese adults have healthy levels of “good” cholesterol, blood pressure, blood glucose and other risks for heart disease.

At the same time, about one out of four slim people — those who fall into the “healthy” weight range — actually have at least two cardiovascular risk factors typically associated with obesity, the study showed.

To be sure, being overweight or obese is linked with numerous health problems, and even in the most recent research, obese people were more likely to have two or more cardiovascular risk factors than slim people. But researchers say it is the proportion of overweight and obese people who are metabolically healthy that is so surprising.

“We use ‘overweight’ almost indiscriminately sometimes,” said MaryFran Sowers, a co-author of the study and professor of epidemiology at the University of Michigan. “But there is lots of individual variation within that, and we need to be cognizant of that as we think about what our health messages should be.”

The data follow a report last fall from researchers at the Centers for Disease Control and Prevention and the National Cancer Institute showing that overweight people appear to have longer life expectancies than so-called normal weight adults.

But many people resist the notion that people who are overweight or obese can be healthy. Several prominent health researchers have criticized the findings from the C.D.C. researchers as misleading, noting that mortality statistics don’t reflect the poor quality of life and suffering obesity can cause. And on the Internet, various blog posters, including readers of the Times’s Well blog, have argued that the data are deceptive, masking the fact that far more overweight and obese people are at higher cardiovascular risk than thin people.

Part of the problem may be our skewed perception of what it means to be overweight. Typically, a person is judged to be of normal weight based on body mass index, or B.M.I., which measures weight relative to height. A normal B.M.I. ranges from 18.5 to 25. Once B.M.I. reaches 25, a person is viewed as overweight. Thirty or higher is considered obese.

“People get confused by the words and the mental image they get,” said Katherine Flegal, senior research scientist at the C.D.C.’s National Center for Health Statistics. “People may think, ‘How could it be that a person who is so huge wouldn’t have health problems?’ But people with B.M.I.’s of 25 are pretty unremarkable.”

Several studies from researchers at the Cooper Institute in Dallas have shown that fitness — determined by how a person performs on a treadmill — is a far better indicator of health than body mass index. In several studies, the researchers have shown that people who are fat but can still keep up on treadmill tests have much lower heart risk than people who are slim and unfit.

In December, a study in The Journal of the American Medical Association looked at death rates among 2,600 adults 60 and older over 12 years. Notably, death rates among the overweight, those with a B.M.I. of 25 to 30, were slightly lower than in normal weight adults. Death rates were highest among those with a B.M.I. of 35 or more.

But the most striking finding was that fitness level, regardless of body mass index, was the strongest predictor of mortality risk. Those with the lowest level of fitness, as measured on treadmill tests, were four times as likely to die during the 12-year study than those with the highest level of fitness. Even those who had just a minimal level of fitness had half the risk of dying compared with those who were least fit.

During the test, the treadmill moved at a brisk walking pace as the grade increased each minute. In the study, it didn’t take much to qualify as fit. For men, it meant staying on the treadmill at least 8 minutes; for women, 5.5 minutes. The people who fell below those levels, whether fat or thin, were at highest risk.

The results were adjusted to control for age, smoking and underlying heart problems and still showed that fitness, not weight, was most important in predicting mortality risk.

Stephen Blair, a co-author of the study and a professor at the Arnold School of Public Health at the University of South Carolina, said the lesson he took from the study was that instead of focusing only on weight loss, doctors should be talking to all patients about the value of physical activity, regardless of body size.

“Why is it such a stretch of the imagination,” he said, “to consider that someone overweight or obese might actually be healthy and fit?”

See ya' in 2 weeks...

I Love My New Body...

By Julie Van Rosendaal

At age 7, I started a cupcake company. At 12, I won a chili competition. After college I launched a low-fat cookie business and wrote a bestselling cookbook, One Smart Cookie. But while I knew how to prepare healthy meals, I seldom followed my own advice.

At 330 lbs., I was making a ritual out of punishing myself with strict diets, my whole life, I would start a new diet every Jan. 1st,” she says. If that didn't work, "I would started a new diet every Monday morning, or after my birthday, or after Christmas.

At a New Year’s Eve party in 1997, I caught a glimpse of myself in a full-length bathroom mirror. Mortified, I locked myself in the bathroom for an hour. The next day, I vowed to lose weight. The difference this time: Was I’d do it on my own terms. I realized that instead of finding a new diet to try, I would have to figure out what worked for me.

Moderation became my mantra. I’d have pizza for dinner, but only one piece. I didn’t eliminate any foods from my diet; I just started eating more fruits and vegetables, whole grains and lean meats.

And of course I exercised regularly.

My first month, I lost 10 lbs. A year and a half later, I had gone from a size 28 to a size 10. I didn’t know what it was like being thin, but now at 165 lbs stretched over a 5’11” frame, I get a thrill every time I board a plane because I no longer need a seat belt extender.

I love my new body and the way I feel, and I'm going to do everything I can to keep it that way.

Julie Van Rosendaal is the author of: One Smart Cookie, Starting Out: The Essential Guide to Cooking on Your Own, and Grazing: Portable Snacks and Finger Foods for Anytime, Anywhere.

The Overflowing American Dinner Plate

The New York Times is reporting, that according to the Department of Agriculture, the average Americans' weekly consumption of food has grown by almost two pounds in the last thirty years - WOW!

Concurrently, according to the Centers for Disease Control, the number of obese adults between the ages of 20 and 74 has more than doubled during the same period.

To read the article go to: The Overflowing American Dinner Plate

Vacation

Exercise is Key to Keeping Weight Off

Ramp Up Your Workouts to Shed Pounds, Keep Them Off, Study Shows

By Kelley Colihan

WebMD
Reviewed by Louise Chang, MD

July 28, 2008 -- How much do you have to work out in order to lose weight and keep it off? The answer is hotly debated among people who study weight loss.

A new study says that obese and overweight women need to cut calories and exercise 275 minutes a week more than their baseline physical activity -- or at least 55 minutes a day, five days a week to lose weight and keep it off.

The research was led by John M. Jakicic, PhD, of the University of Pittsburgh, and colleagues.

They tracked 201 overweight and obese women over a two-year period; 170 women completed the study.

At the start, all of the participants were sedentary. They were randomly assigned to one of four groups based on how much and how intensely they exercised and how many calories they burned.

The participants were told to eat or drink no more than 1,200 to 1,500 calories a day. Researchers tracked them by talking to them on the phone and having face-to-face talks.

Participants were encouraged to spread the exercise out over five days during a week, done in at least 10-minute chunks. The women were given treadmills to use at home and taught to monitor their own heart rates.

At the end of the two-year study, women who had lost 10% or more of their initial body weight reported that they had done more physical activity compared with those who did not lose as much weight.

After six months, women in all four groups had lost an average of 8% to 10% of their initial body weight. But the hard part was keeping that weight off. Most of them regained the weight.

Nearly 25% of the participants managed to keep 10% or more of their original body weight off over the two years.

But, those women who exercised about 275 minutes a week more over their baseline activity levels were the biggest losers.

They also got the most support, completing the most telephone calls from researchers, and said they participated in more eating behaviors recommended for weight control than those who gained the weight back.

Those who lost and kept off the weight also increased their leisure time physical activity, doing things like taking the stairs and moving about more at home and work.

A couple of limitations the study authors note are that diet alone was not included as one of the options and that the participants themselves reported what physical activity they did and how well they did it.

The study authors conclude that a relatively high level of physical activity is needed to lose weight and keep it off.

These results are likely to add fuel to the debate over how much is needed to lose pounds and keep them from creeping back.

General recommendations are for 30 minutes a day, or 150 minutes a week, of moderately intense activity most days of the week. But the debate rages on over a magic formula for sustaining weight loss.

Food Safety

Lately, it seems as if every time I turn on the television to listen to the news, or open a newspaper, there's yet another story warning us about contaminated food that has invaded our food supply:

"E. Coli found in frozen food..."

"Drinking water laced with drugs..."

"Tomatoes infected with Salmonella..."

"Tons of beef recalled because of Mad Cow Disease...."

It's as if no matter how many precautions I take, how careful I am in preparing my meals, picking my fruits and vegetables or handling meats and other perishables, I still have doubts about how "safe" our food supplies really are.

So, what am I to do - or someone else who might share my concerns?

Stay informed!

Here are some websites that I recommend for anyone who wants to stay informed:

• Centers for Disease Control and Prevention @ www.cdc.gov/foodsafety
• Center for Science in the Public Interest @ www.cspinet.org/foodsafety
• USDA Food Safety and Inspection Service @ www.fsis.usda.gov/food_Safety_Education/index.asp
  

Success... at Last!

Daily Weigh-Ins Helped Andrew Perry Lose 45 Pounds

Andrew Perry has lost 45 pounds, and with the support and the love of his wife, and his twin nine-year-old daughters, he has been able to keep it off for the past two years. After many failed attemps, Andrew is very proud of his accomplishment, and his family is very happy that Andrew has finally found a formula that works for him.

Andrew's Formula for Success Includes:


Adding Healthy Habits : Running and track. He started out being able to run 100 feet. He's completed two New York City marathons and regularly runs 800 meters in track meets.

Limiting Trigger Foods: Chocolate cherry cordials. His kids gave him two boxes, which are now safely tucked out of reach on top of his refrigerator for occasional treats. "Otherwise I'd eat the whole box at once."

His Secret Weapons: Weighing himself daily and monitoring body fat; reading food labels and watching portion control. He still measures out cereal, nuts and any other food with concentrated calories and a small portion size. He always has something slightly sweet, such as a cup of tea with a little honey, before leaving the office so that he's not ravenous when he gets home.

What He Can't Live Without: Physical activity, especially running. and... brownies.

His Favorite Snack: Trail mix.

His Biggest Struggle: "Controlling myself, especially with stress eating." Also, "It's hard to stop thinking of yourself as a fat person. I am a formerly fat person."

Previous Weight Loss Attempts:"I've read practically every diet book available. And I've tried them all, with no long-term success. Any diet plan that's moderately organized just doesn't work for me."

What Worked This Time: Slowly changing his habits. "I decided not to eat anything from a box and nothing frozen. I lost 10 pounds, then plateaued there and had to take it up a notch. I tend to lose weight in clumps."

What Motivated Him to Succeed: A photo of him celebrating after the Yankees won the 1996 World Series. " I was huge!"

Rewards Along the "Weigh": New running shoes, a jacket and starting blocks for meeting running goals.

And Benefits of Weight Loss: "I now eat more fruits and vegetables, and I've been able to stop taking my cholesterol lowering medications."

thewashingtonpost.com

TODAY

Not a Moment Too Soon, I Thought of Tim Russert

By MICHAEL BICKS

Published: July 8, 2008
The New York Times

This is a follow-up post to my previous post on the death of Tim Russert

Most Saturday mornings, I bicycle with a group of men, mostly in their 50s, whom I affectionately call the Cheat Death group. We are all in pretty good shape, competitive but supportive, and convinced that hard-core exercise is our ticket to postponing the inevitable.


The ride a few Saturdays back was a tough one. At 6:30 a.m., the pack took off fast and immediately headed for the hills near Durham, N.H. The first few climbs felt pretty good, but by the third hill I started to feel nauseated.

Figuring that was probably a result of the four beers and large Chinese dinner the night before, I kept going. Twenty-five miles into the ride, I had fallen to the back of the pack. I was short of breath and wondering how I was going to make it much farther.

I am someone who hates to quit. But after the third time the group had to stop and wait for me, I decided I had no choice. I watched them pedal away, then lay down in the grass.

I was angry and scared. For the first time my body had given out on me, and I had no clue what was going on. Besides the nausea, my only symptoms were a persistent cough and an overwhelming feeling that something was not right.

I called my wife and got a ride home.

After showering, I lay down in bed and started thinking. Though I am a 50-year-old guy with a stressful job and a little too much around the middle, I had a clean bill of health. I had good cholesterol numbers and a great doctor, and recently I had passed a cardiac stress test.

That’s when Tim Russert popped into my head. In the last couple of weeks, like almost every middle-age man, I had taken a very personal interest in every detail of his story. Yes, he was overweight. But hadn’t he just passed a stress test?

That’s when the light went on. I bolted out of bed, went to the computer and Googled “How do you know you are having a heart attack?” The first Web site that popped up was a list of warning signs from the American Heart Association. As I read on, I started to sweat.

“Nausea.” Check.

“Shortness of breath.” Check.

“Chest discomfort.” Perhaps, though it really didn’t feel like much.

Ignoring the Web site’s advice to call 911 (I was too vain to have an ambulance pull up to my house), I drove to the hospital.

When I stepped up to admissions desk the nurse asked why I was there. “Mild chest pains,” I said. “How old?” she asked. “Fifty,” I replied.

She nonchalantly turned to the orderly and said, “Hey, Lenny, we got another one.” I guess many men, stunned by Mr. Russert’s sudden death, were doing just the same thing I was.

A doctor attached some wires to my body and conducted a quick EKG. “Mr. Bicks,” he said minutes later, “you are suffering a heart attack.”

“Are you sure?”

“Yes,” he answered, then produced those squiggly lines on the graph paper. I swore. Then I called my wife and I started to cry.

This is one of those times that defines your life, like the death of a parent or the birth of a child. In a split-second, you cross the invisible “before and after” line and realize that nothing is ever going to be the same. For that moment my life had been removed from my hands. But I kept thinking, I’m supposed to be invulnerable. I’d passed a stress test, drank red wine, used a lot of olive oil, exercised like an insane person. This could not possibly be happening to me.

The doctor took out a large needle full of a sedative. The rest is a blur: a trip in an ambulance to a larger hospital, sirens blaring, an hour on the table in a cath lab, a stent implanted to open the blocked artery, my wife crawling tearfully into my bed to give me a hug, a doctor showing me before-and-after pictures of my artery, and losing his temper when I asked when I might return to work.

As in Tim Russert’s case, there were no warning signs. No sign I was suffering from coronary artery disease. A piece of plaque in one of my arteries just broke off and created a massive blood clot. When it did, I suffered a severe heart attack. If I had not gone to the hospital, I might very well have died.

Because at the right moment I thought of Tim Russert, I am one of the lucky ones. I get to hug my wife and my kids, understand how wonderful my friends are and realize exactly how much I love my life. It is a debt I can never repay.

Michael Bicks produces documentaries for ABC News.