Posted by: isaaph | October 29, 2007

Fat and fit, lean but unfit?

Finally! A Filipino doctor acknowledges that a fat person can be healthy.

Fat and fit, lean but unfit?

By Rafael Castillo, MD

BOSTON, Massachusetts―We keep on saying that being fat is a risk factor for heart disease and stroke, but it may be better to be fat and fit, than lean but unfit.

So says Dr. Frank Hu, associate professor of Nutrition and Epidemiology at the Harvard School of Public Health here in Boston. Dr. Hu however stresses: “It’s best to be lean and fit.”

Dr. Hu was part of an impressive faculty of world experts which discussed insulin resistance, which is now believed to be the common denominator of many medical conditions, from obesity to diabetes to cancer, liver disease, HIV infections and a long list of diseases of the modern world.

Now back to overweight and obesity. Many may confuse body weight and body fat. Most people don’t distinguish between the two, but they are actually two different things and knowing the difference is essential to determine whether or not one needs to lose weight to remain healthy.

Body weight

What we refer to as our body weight is the number we see on the weighing scale, either in pounds or kilograms. Technically, our body weight is actually a function of our body mass multiplied by the acceleration of gravity. But to simplify matters, let’s just concentrate on the reading on the weighing scale. That’s our weight.

To assess whether one is overweight or not, a standard formula has been used by many clinicians to determine what one’s ideal body weight is based on one’s height. Roughly, one’s ideal body weight in kilograms is one’s height in centimeters minus 100. One inch is 2.54 centimeters, and one kilogram is 2.2 pounds.

“Overweight” therefore connotes excessive weight for one’s height, based on the formula or some predetermined “average” standards outlined in height-weight charts. An important fact however is missed in the computation. The weight is only an indication of heaviness, but inadequately factors in the body composition, consisting of bones, muscles and fat. Muscles and bones are called lean body mass and weigh more than fat.

Body fat

Fat comes in two types: essential fat and storage fat. Essential fat is needed by the body to remain alive and function well. We can’t survive long if we’re completely devoid of fats. In fact, every cell of the body has some amount of fats. So essential fats are stored in practically all tissues and organs of the body.

Storage fat is that we find beneath the skin (subcutaneous) which serves as a reservoir for energy during times of fasting or famine.

Over the last few years, research has shown that storage fat in the abdomen―also called visceral fat―is the vicious type of fat associated with all sorts of cardiovascular complications. Although it protects internal organs from trauma, it also secretes hormones which can constrict the arteries and make the blood clot easily.


Health experts are now saying it’s okay to have fats anywhere else except in the abdomen. Belly fat is risky. Pear-shaped type of obesity (more fats on the hips) is not so bad; but an apple type of obesity (abdominal or visceral fatness) can lead one to the emergency room, or the morgue.

Women, because of their hormones and child-bearing, have three to four times more essential fat than men. The amount of storage fat is similar in both men and women.

Total body fat (essential and storage) is approximately 10 to 18 percent in men, and 16 to 25 percent in women. True obesity is defined as excessive fats, or greater than 25 percent body fat for men and 30 percent for women.

An old way of measuring body fat is through skinfold measurements, where the thickness of fat tissue just under the skin at various sites on the body is measured. Another old way, admittedly tedious, is by underwater weighing, which uses special equipment to calculate body fat. Nowadays, special scales are available that determine body fat just by standing on them.

Waist circumference

A practical and very easy way to determine if one has a little too much of the bad type of fat (visceral or abdominal fat) is by simply measuring the waist circumference at the level of the navel or umbilicus. In Asians, more than 90 centimeters (35.5 inches) in women or more than 80 centimeters (31.5 inches) in men strongly suggest a visceral type of obesity.

In the presence of other risk factors such as diabetes, hypertension and cholesterol problems, increased waist circumference indicates that the individual has the “Metabolic Syndrome” which increases the risk of heart attack and stroke four to five-fold.

Where the fat is

So where the fat is, is more important than how much of it the body has.

So one may be overweight according to a weight chart but have a healthy body fat composition consisting more of muscles and very little of visceral fat. Athletes belong to this category. They have dense muscle tissue, hence, their weight is heavier, but with a healthy body composition.

On the other hand, a person can have a normal weight, or may even be underweight according to the height/weight charts, yet still have an unhealthy level of body fat especially abdominal fat. He is medically obese.

Many sedentary people belong to this category. They may look lean but unfit, and are at high risk for cardiovascular complications without them realizing it. Excuse me please while I measure my waist circumference.

Source: Philippine Daily Inquirer



  1. […] isaaph placed an observative post today on Fat and fit, lean but unfit?.Here’s a quick excerpt:Hu was part of an impressive faculty of world experts which discussed insulin resistance, which is now believed to be the common denominator of many medical conditions, from obesity to diabetes to cancer, liver disease, HIV infections … […]

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