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Fat but aerobically fit worse than slim and lazy

A news item was picked-up by almost every major news outlet in the western world recently - just before our traditional New Years' Eve "pledge to change our lives" time. The story had several titles, most ranging from "Fat but fit worse than slim and lazy" to "No truth to fat but fit." Some even added the tag line "Study demolishes myth that exercise makes up for obesity, scientists say."

This all stemmed from a massive study by Gabriel Hogstrom, Anna Nordstrom, and Peter Nordstrom - they studied 1.3-million Swedish men over a 29-year period. See The International Journal of Epidemiology article "Aerobic fitness in late adolescence and the risk of early death: a prospective cohort study of 1.3 million Swedish men" or copy and paste this link http://ije.oxfordjournals.org/content/early/2015/12/20/ije.dyv321.abstract?sid=4ef10963-0688-42d2-bdf4-de89dfca59e2

The mass media grabbed onto the secondary outcome of the study which was "the risk of early death was higher in fit obese individuals than in unfit normal-weight individuals."

Here is an example story from the December 20th, 2015 National Post by Laura Donnelly. The image is from the story:

LONDON — Scientists say they have destroyed the myth that you can be "fat but fit," with research showing that obese regular exercisers are likely to die before slim unfit people.

Obese people with high levels of aerobic fitness were 30 per cent more likely to die prematurely, compared with those were slim but did little exercise, a study of 1.3 million men found.

The researchers tracked men for 30 years, before coming to the conclusion that being the right weight is the most important factor for long-term health.

Scientists said the findings demolished the myth that being fit could compensate for obesity.

Unfit normal-weight individuals had a 30-per-cent lower risk of death from any cause than did fit obese individuals

A number of studies have suggested that obese people who were regular exercisers were at no greater risk of a potentially fatal illness than people of normal weight.

The new research, the largest study of its kind, was based on 18-year-old Swedish military conscripts whose aerobic fitness was tested by asking them to cycle until they had to stop due to fatigue. They were then followed by the health researchers into middle age, for an average of 29 years.

Prof. Peter Nordstrom, of Umea University in Sweden, said: "Unfit normal-weight individuals had a 30-per-cent lower risk of death from any cause than did fit obese individuals." He said the findings challenged the idea that obese people could compensate for their mortality risk by doing plenty of exercise.

Nordstrom said: "These results suggest low BMI (body mass index) early in life is more important than high physical fitness, with regard to reducing the risk of early death."

Overall, men in the highest fifth of aerobic fitness had a 48-per-cent lower risk of death from any cause compared with those in the lowest fifth, the study, published in the International Journal of Epidemiology, found.

Such men had an 80-per-cent lower chance of death associated with alcohol or drug abuse and a 59-per-cent lower chance of suicide, and showed a 45-per-cent drop in heart disease deaths. But when such men were obese, they were still much more likely to die early compared with slim men.

StatsCan figures released in June found that 61.7 per cent of Canadian men were obese or overweight in 2014, compared with 46.2 per cent of women.

Earlier this month, England's chief medical officer suggested that obesity poses such a threat to the country it should be treated as a "national risk" alongside terrorism.