Women…Fit and Fat?

Dear Reader,

I find myself battling a common misconception with some of my patients. It’s the thinking that if you are capable of a hard workout routine you can be “fat but fit”. So, there’s no need to worry about heart health.

Take one of my new patients, who I’ll call Alice. She’s middle-aged. And when she came to me she was “a little on the heavy side,” as she put it. When I told her she really had to drop the extra pounds to avoid heart disease and other serious health problems, she dismissed it, insisting she was in great shape. “Dr. Sears, I run 25 miles a week and lead an active lifestyle, so I’m not worried. The last time I went to see a doctor, he said the same thing.”

This mistaken belief is understandable. There’ve been a lot of reports in the press about how “people come in all shapes and sizes” and that women aren’t at risk for heart disease just because they’re heavy, so long as they exercise regularly. There’ve even been a few research reports supporting this idea. So a lot of doctors believe it—and pass it on to their female patients.

The problem is they’re dead wrong. Heart disease is still the number one killer of women today. In fact, since 1984 more women have died of heart attack than men —and exercise alone isn’t enough to prevent it if you’re above a normal weight.

A groundbreaking new study busts the myth. Researchers in Boston ran one of the

largest studies ever on women, obesity, and fitness. They tracked the overall health profiles of 39,000 women, with an average age of 54, over a ten-year period. Thirty-four percent exercised regularly, 31 percent were overweight, and 18 percent were obese. None showed signs of heart disease, diabetes, or cancer at the beginning.

By the end of the study they found that with regular exercise heart disease rates were still a lot higher even for women with “a little extra padding.” The risk was 54 percent higher for this group and 87 percent higher for active but obese women.

The bottom line is that size matters. You need to stay slim and lean if you want to ward off heart attack.

The first thing to do is adjust your diet. You can easily switch on your body’s natural “fat-burning engine” with a diet rich in lean meats, seeds, nuts, and above-ground vegetables (preferably organic, grass-fed, and wild-caught). Avoid all starchy, high-carb foods, including bread, pasta, and cereal—anything grain-based.

Second, you need the right kind of exercise program to burn fat. Short bursts of intense exercise with periods of rest in between are the best way to turn on your fat burning switch. This is what my PACE program is all about.

You’ll also need a reliable way to find out if you’re lean or not. Don’t be fooled by the “Body Mass Index,” the tool a lot of fitness experts use. It only compares height against weight, without distinguishing between fat and muscle mass. You can see the problem with this: since muscle is denser than fat, you can technically weigh more and have a high BMI but still be relatively lean.

Body composition will give you a much more accurate measurement of how slim you actually are. Skin calipers are one of the best ways to measure it. You can get them at exercise equipment stores or you can also order them on my website. They come with simple instruction manuals that will show you how to get a good read on how much fat you’re carrying.

Another simple method: measure your waist and hip girths. Wrap a tape measure around your waist at your navel and record the number in inches. Next measure the circumference around your hips at their widest point.

Waist girth should be less than your hip girth in both men and women. As a woman, your waist should be 3 or more inches less than their hips in girth for optimum fitness.

Finally, you can grab your skin between your finger and thumb just to the side of your navel and measure the thickness of the skin fold. It should measure less than 1 inch.

To Your Good Health,

Al Sears, MD

1 For example, see Jane E. Brody. “Fat But Fit: A Myth About Obesity is Slowly Being Debunked.” New York Times. October 24, 2000; and Charmaine Camilleri. “Fit, Fat and Healthy: Researchers are challenging the idea that you need to be a size 10 to be in shape. Heavy people can be fit too.” theage.com.au. October 6, 2003.

2 For example, see Sui et al. “Cardiorespiratory fitness and adiposity as mortality predictors in older adults.” Journal of the American Medical Association. 2007. 298:2507-2516.

3 “Go Red For Women Day Is Feb. 15.” http://chfs.ky.gov/news/chfs021405b.htm, February 15, 2005.

4 Weinstein et al. “The joint effects of physical activity and body mass index on coronary heart disease risk in women.” Archives of Internal Medicine. 168:884-890.