One Cannot be "Fat But Healthy"
Extensive human evidence strongly supports the conjecture that excess fat tissue is simply harmful. That harm cannot be evaded by exercise: one cannot be "fat but healthy". Visceral fat packed around the abdominal organs generates chronic inflammation, a raised burden of senescent cells, and all sorts of other issues. It pushes fat into the organs themselves; in the case of the pancreas that excess fat is the primary cause of type 2 diabetes. In the liver, it leads to fatty liver disease. Even modest amounts of excess fat tissue raise mortality rates and shorten life expectancy.
A large study finds that physical activity does not undo the negative effects of excess body weight on heart health. "One cannot be 'fat but healthy'. This was the first nationwide analysis to show that being regularly active is not likely to eliminate the detrimental health effects of excess body fat. Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity."
The study used data from 527,662 working adults insured by a large occupational risk prevention company in Spain. The average age of participants was 42 years and 32% were women. Participants were categorised as normal weight, overweight, or obese. Additionally, they were grouped by activity level: 1) regularly active, defined as doing the minimum recommended for adults by the World Health Organization (WHO); 2) insufficiently active, some moderate to vigorous physical activity every week but less than the WHO minimum; 3) inactive. Cardiovascular health was determined according to three major risk factors for heart attack and stroke, namely diabetes, high cholesterol, and high blood pressure.
Approximately 42% of participants were normal weight, 41% were overweight, and 18% were obese. The majority were inactive (63.5%), while 12.3% were insufficiently active, and 24.2% were regularly active. Some 30% had high cholesterol, 15% had high blood pressure, and 3% had diabetes. The researchers investigated the associations between each weight category and activity group and the three risk factors. At all weight levels, any activity (whether it met the WHO minimum or not) was linked with a lower likelihood of diabetes, high blood pressure, or high cholesterol compared to no exercise at all. At all weights, the odds of diabetes and hypertension decreased as physical activity rose.
However, overweight and obese participants were at greater cardiovascular risk than their peers with normal weight, irrespective of activity levels. As an example, compared to inactive normal weight individuals, active obese people were approximately twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. "Exercise does not seem to compensate for the negative effects of excess weight. This finding was also observed overall in both men and women when they were analysed separately."
The problem us that after age 50 or so, no amount of dieting or eating healthy can eliminate all the visceral fat. Excercise helps but the gym is full of "skinny fat" people that still carry extra weight in the abdominal region.
Perhaps fasting will help, based on this study
https://pubmed.ncbi.nlm.nih.gov/27240637/
Fasting might be the only option. For example, there's a reason many famous ancient greeks and Romans love to very old age since it was normal neck then to. Skip food for many days in a row
https://www.lifespan.io/news/niacin-increases-nad-significantly-in-human-trial/
'Niacin supplementation also appears to improve body composition. Participants saw a decrease in whole-body fat percentage in controls and increased muscle mass in both the control and study group. After 10 months of niacin supplementation, the patients demonstrated improved muscle strength.
The researchers also observed that hepatic fat was halved and visceral fat was reduced by a quarter. These types of fat deposits are both linked to an increased risk of metabolic syndrome. So while the niacin had no effect on the surface fat around the body, it did impact significantly on the unhealthy fat surrounding the organs.'
This study has a major flaw - to consider the participants who met "minimum recommended (activity levels) for adults by the World Health Organization (WHO)" as "regularly acitive" is absurd. Those recommendations are so low that such people can at best be considered as the least inactive. The reallly "active group" should be at leat five time as active as is recommended by WHO.
The study would be more helpful if the terms 'normal weight', 'overweight', 'obese' and 'fat' were defined in some quantitative way, e.g. by BMI. I can think of several friends who could benefit by seeing these results. However, as written, they would probably agree completely with the conclusion but not see themselves as 'fat', in spite a BMIs of around 30.
@ks,
Bmi brackets are universally recognized as...
https://www.ncbi.nlm.nih.gov/books/NBK535456/figure/article-18425.image.f1/
With bni over 30 they are not fat but rather obese. There might be some discretion for v bodybuilders and athletes, though. Arnold schwarzenegger was close to BMI of 30 , for example, but that was hardly fat. Probably, at some point even muscle mass in excess is bad but not as bad as proinflamatory fat
To add some balance to the conversation, I've lost count of the number of longevity enthusiasts I've known who lost significant weight, and then proclaim they have reversed aging. No they haven't. They are just thinner. In some cases they get so catabolic it is obviously harmful to their health.