Maybe looks don’t count

Tuesday, August 12, 2008

The results of a study published in the Archives of Internal Medicine should not come as a shock to most people. Being overweight doesn’t necessarily make you unhealthy according to researchers in both the United States and Germany. Sports fans have known this forever; elite athletes can look like tiny Olympic gymnasts to massive NFL lineman. Both extremes and everybody in between are in shape and trained to perform at high levels.

The new research agreed. People who are overweight have a fifty-fifty chance of having high cholesterol, high blood pressure or high blood sugars. Pretty good odds, but not as good as those people who are within the normal range. They have a 75% chance of having normal blood tests. And for those who are obese, the chance of normal falls to a third.

Ideal body weight has been a thorn in the side of many people. How people appear, how clothes fit, how fat they are, has allowed whole industries to flourish. Weight loss clinics, gyms and fitness centers, liposuction and stomach stapling surgeries presume that being overweight equaled being at risk for heart disease and diabetes. These studies found that there may be more to health than meets the eye.

There aren’t many risk factors for heart disease and stroke, the big killers in this country. Smoking, high blood pressure, high cholesterol, diabetes and family history decide who will develop atherosclerosis or narrowing of the arteries. Aside from family history, the rest can be controlled and risk minimized.

The key to risk management is not what you look like, but what the numbers say and that requires a person to take preventive action. You can’t look in the mirror and see high blood pressure or high cholesterol; you need to visit a care provider and that means taking positive action.

This study reminds us that looking after the body is no different than car maintenance. You can look at the exterior of a car or truck and decide whether you like the shape and style but it gives you little information on how the engine is holding up. Routine maintenance with an oil, lube and filter, checking the fluid level and changing the belts will the let the car run almost forever. The same principles apply to the body. Routine maintenance allows the body to function well and hopefully run forever.

Deciding ideal weight using a scale or measuring body mass index (BMI) can be deceiving. Professional basketball players tend to have elevated BMI scores but they carry significant muscle and little fat on their frames. Football players tend to be big, but their physical activity and training decreases their heart and stroke risk factors.

The bottom line remains the same. What we look like on the outside doesn’t really matter; it’s what’s inside that really counts.

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