You may be consistent with your workouts, whether practising flexible yoga asanas or engaging in intense strength training, building endurance and showing all the signs of being fit. But being fit does not mean you are lean; you can be overweight and still have the stamina to run marathons or perform agile Pilates exercises. Body shapes and metabolism differ, so not all fit people will be lean.
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But even when all the parameters, from normal blood pressure to not getting winded during exercises, are in check and everything seems fine, the bigger question still remains whether fitness can offset the risks associated with excess body fat. One of the primary risks is related to cardiovascular health.
HT Lifestyle spoke to Dr P Ashok Kumar, senior consultant in interventional cardiology at KIMS Hospitals, Bengaluru, to understand how heart health is impacted in the ‘fit but fat’ debate. This current narrative focuses on building stamina, endurance, and improving metabolic rate, rather than fixating on the weighing scale. The senior cardiologist believed that the issue is much more nuanced.
“The answer to the question from my perspective cannot be a simple ‘yes’ or ‘no’,” he said, emphasising that both fitness levels and body composition must be evaluated together when assessing long-term cardiovascular risk.
Can a fat but fit person have good heart health?
The cardiologist revealed that a person who exercises daily, from aerobics to weight training, may improve their heart health even if they are overweight or obese.
He elaborated on some of the key health markers: “It is true that a person who is ‘fat’ rather than ‘fit’ might possess good cardiovascular fitness, normal blood pressure, good cholesterol levels, and no symptoms of diabetes.”
But why is fitness not enough
Despite being fit and having good health markers, the benefits may only be short-term. Excess body fat continues to place stress on the body, which can eventually lead to heart problems over time. In fact, the cardiologist warned, “Fitness does not completely neutralise the cardiovascular risks associated with excess body fat.”
Obesity is the precursor for a range of metabolic and cardiovascular complications that develop over time. It is not only about excess weight, but the excess weight can change how the body functions, affecting major physiological systems.
“Obesity is particularly associated with inflammation, insulin resistance, raised triglyceride levels, atherosclerosis, and a range of other risk factors that culminate in heart disease, heart failure, or stroke over time,” he noted.
Other than obesity triggering several health red flags, another issue the cardiologist pointed out that determines heart health is where body fat is stored. He identified visceral fat, which surrounds the internal organs, as a much bigger risk to heart health than subcutaneous fat.
He elaborated, “Two people can have the same BMI, yet their risk of heart disease is quite different depending on the location of their body fat reserves. For this reason, waist circumference or hip-waist ratio is being considered as a determinant of cardiovascular risk in addition to BMI.”
So, for a short time, even when every health parameter, from blood pressure to lipid profile, may appear normal, the risk does not disappear entirely. Over time, excess weight can over time increase the strain on the heart and raise the chances of cardiovascular diseases. So the best approach is both staying fit and managing weight.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
