It's saturday morning in Beverly Hills, just before class at Richard Simmons' Slimmons fitness studio. Several women in T-shirts and tights are on the dance floor, aerobic shoes tapping. This looks like a typical workout class, with one difference. Most participants weigh about 200 pounds.
This is the front line of weight-loss culture, where Richard Simmons, the curly-haired fitness dynamo, inspires his troops to sweat their way to a thinner, fitter body. "The disco's open all night!" he yells, cranking up the music. He leads the group in slow stretching warm-ups before heating things up with Saturday Night Fever moves.
In the back I'm shimmying and sweating along with the rest. At five-foot-six and 155 pounds, I'm one of the thinnest there. Yet it's surprising how well these women move, throwing their bodies into steps with grace and gusto. Many seem to be in such good shape that I wonder: Is it possible to be fat and also fit?
Simmons doesn't think so. "Fat kills," he says. "You go from being chubby to fat, to obese, to morbidly obese. And then there's death." Only losing weight can save people from that fate.
Most people would agree that fat kills. Why else would we have to step on the scale whenever we visit the doctor? Why else would medical and fitness experts write popular books with such titles as Fit or Fat and Weigh Less, Live Longer.
During the past two years, two highly publicized studies boiled everything down to a simple dictum: If you want to duck heart disease, stroke, high blood pressure, diabetes and even some cancers, you'd better not weigh too much. "Even mild to moderate overweight is associated with a substantial increase in risk of premature death," said Dr. JoAnn Manson, a Harvard epidemiologist and author of one of those studies.
Another study that tracks the relationship of weight to overall health recently came to a different conclusion, however. Epidemiologist Steven Blair and colleagues at the Cooper Institute for Aerobics Research in Dallas followed 25,389 men who had checkups at the clinic between 1970 and 1989. As a group, fat men were more likely than thinner ones to get sick and die early, he found. But then Blair added physical fitness to the equation.
He found that fit, fat men lived as long as fit, thin men. And thinner men who were out of shape were nearly three times more likely to die young than fat men who were fit. In other words, once Blair factored in the men's fitness levels, their weight had no bearing on how long they lived.
This was a surprise to Blair. It made him think that we are fretting and obsessing about something that may be totally irrelevant for some people: how much they weigh.
The author of numerous exercise articles published in prestigious medical journals, Blair has long been highly regarded by obesity researchers. But now he is at odds with some of them. After all, he's found that as long as they get in good shape, people who are overweight by 20 or 30 pounds have no increased risk for mortality. And to those of us who are not considered overweight, Blair issues a warning: If you don't regularly exercise--and a recent study shows almot two thirds of us don't--being slim is no guarantee against premature death.
To reach that conclusion, Blair looked at the checkup results of the men examined at the Cooper clinic. As part of that checkup, each subject climbed on the machine that's at the core of his research: the treadmill.
When I tried it, the pace was easy starting off; but after several minutes with the incline increasing, I felt like I was hiking up Mount Everest. The longer you can stay on the treadmill, the fitter you are, Blair says. Gasping for air, I kept it up for 21 minutes--just long enough to get a "superior" fitness rating for a woman my age, 36. And to Blair, it's that number on the treadmill, not the one on the scale, that matters most.
Up to now, most studies linking obesity to ill health did not factor in the subjects' fitness level. That leads to mistaken results, Blair says, because although excess weight is associated with high blood pressure, coronary heart disease, diabetes and colon cancer, those are exactly the problems regular exercise can help prevent.
"Overweight people suffer, although perhaps at a greater frequency, the same diseases as sedentary and unfit people of every weight," he says. Other researchers can sometimes find a correlation between weight and early death because fewer heavy people than slender people exercise, he adds. But that doesn't mean there are no fat exercisers (40 percent of the overweight people he's studied are reasonably fit) or that all thin people are physically active. "My challenge to obesity researchers is: How can you be so sure it's weight that kills?" Blair says "Maybe it's inactivity."
Harvard JoAnn Manson finds that hard to believe. "Physical activity is tremendously important," she says. "But you can't go to the extreme of saying it's 100 percent activity and weight means nothing." Manson doubts that fit heavy people are as common as Blair suggests. "Overweight and inactivity are intimately linked," she says. Also, recent studies have shown that weight loss has led to a decrease risk for mortality.
Like most obesity researchers, Manson argues that extra fatty tissue, especially in the abdominal area, contributes to heart disease. In her scenario, those fat cells release fatty acids that travel directly to the liver, where they interfere with the way insulin converts glucose into energy. A vicious cycle ensues known as insulin resistance. The body produces more insulin to compensate for the insulin's decreased effectiveness, she notes, and the extra glucose that is not converted remains in the blood-stream. Problems then arise, including high blood sugars, high blood pressure and lower HDL (good) cholesterol, thereby increasing risk for heart attack, diabetes and stroke.
Blair agrees that belly fat can be dangerous. But he says most anyone can fight off insulin resistance with regular exercise, which burns fat and helps control other metabolic risk factors such as high blood pressure and high blood lipids.
In his view, only people who are severely obese--those too fat to get out and walk--need to lose weight before starting an exercise program. Otherwise, according to Blair, those of us who are mildly or moderately obese may be commiting no crime against our health prospects if we exercise regularly and eat a healthful diet. We're just heavy.
"I'm concerned that millions of people get on the scale every morning and have their day determined by the numbers they read," Blair says. "We need to pay less attention to the scale and focus more on regular activity."
A few researchers agree with him. "We've been far too hung up on weight," says Dr. C. Wayne Calaway, A George Washington University endocrinologist. Calaway says that Blair's report drives home the idea that weight is the crudest measurement of health. "I'd much rather see a physically active heavy person than an out-of-shape skinny one," he says.
Calaway, like Blair, thinks fat can sometimes be a threat. If he sees a patient that exercises but still has a big belly and other risk factors for disease (high blood pressure, high cholesterol or high blood-sugar levels), he'll suggest the patient try to trim down by exercising even more and cutting calories. But blanket advice that heavy people need to lose weight through diet does not always make sense.
To the average person worried about the size of his or her thighs, all this squabbling among researchers may seem academic. After all, most scientists agree that to improve your health, you should exercise regularly and eat a diet low in fat and high in vegetables and grains.
But unless you have someone like Richard Simmons helping you, exercising solely to lose weight is often a negative experience. "Many people are gung ho in the beginning, but after three months, when they haven't lost a lot of weight, they stop coming," says Cinder Ernst, who teaches fitness classes for large women in San Francisco. "And then they've lost all the other benefits: flexibility, strength, mobility, stress reduction and self-confidence."
People who exercise without expecting to slim down stick with the regimen much longer, Ernst says. Pat Lyons, coauthor of Great Shape:The First Fitness Guide for Large Women, agrees. "If your goal is to fit into size 8 jeans, you set yourself up for failure," Lyons says. "But if you exercise to improve the quality of your life and get in shape, you'll feel satisfied with yourself."
One thing most health experts won't dispute: Thin or fat, everyone who exercises gets healthier.
by Laura Fraser from HEALTH (RD Oct/98)
HOW FIT ARE YOU?
This one-mile walk will test your fitness level. If you are taking prescription medications, consult your doctor first. If you experience pain during the test, stop immediately and call your doctor.
Start walking quickly, without straining, to get your heart rate up to at least 110 or 120 beats per minute. (Check pour pulse at your wrist; count the number of beats in ten seconds, and multiply by six). Measure your pulse again five minutes into your walk. If it goes above 120, that's okay. But if you are too winded to talk, slow down.
As you cross the one-mile mark, check your time and pulse.Then check this chart. find your age group and heart rate. If your time is greater than the times listed in column A, you are in the low-fitness category. If your time is between those in columns a and B, you are in the moderate-fitness category. if your time is less than B, you are very fit.
The Healthy Heart Walking Book (Macmillan)
MEN WOMEN
Age Heart
Rate A B A B
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30s 120 17:52 15:24 19:18 17:24
130 17:22 14:54 18:48 16:54
140 16:54 14:30 18:18 16:24
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40s 120 17:36 15:09 18:45 16:50
130 17:07 14:41 18:18 16:24
140 16:38 14:12 17:48 15:54
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50s 110 17:49 15:22 18:40 17:04
120 17:20 14:53 18:12 16:36
130 16:51 14:24 17:42 16:06
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60s 110 17:55 15:33 18:00 16:36
120 17:24 15:04 17:30 16:06
130 16:57 14:36 17:01 15:37
=================================================================
| HOW TO LOSE FIVE POUNDS FOREVER |
You have only five pounds to go - the same stubborn five pounds that tighten your waist band, add slight bulges to your thighs. No one, not even you, thinks you're fat. Maybe that's why it's so hard to say no to cheesecake or croissants.
When you set out to drop five pounds, the first thing you have to fight is ambivalence. Is it really important to be one size smaller? Important enough to find the grit to follow a weight-loss plan?
It's up to you to develop the commitment. But here's a plan for dropping five pounds -- and keeping them off for the rest of your life. The plan is based on the following principles:
Be Wary of Fad Diets. Quick-fix diets seem so simple. Meals, snacks and beverages are mapped out, and all you add is short-term (usually two weeks) discipline. And you do lose weight. So why are increasing numbers of doctors, nutritionists and fitness experts warning against them?
For one thing, their long-range results are dismal -- studies show that up to 95 percent of people who go on these fad diets regain weight. "As soon as you go off a diet," asserts Dr. Howard Shapiro, A New York City weight-loss expert, "you go back to old eating habits and the extra pounds return."
Worse, many crash diets aren't healthy. According to Sarah H. Short, professor of nutrition at Syracuse University, N.Y., "It's difficult to get all the nutrients you need on less than twelve hundred calories a day" -- the maximum count of most diet menus. Fad diets short-change themselves on iron and calcium by drastically cutting or eliminating consumption of red meats and dairy products.
If you must diet, search for a well-balanced plan, and beware of those centered around just a few foods or a single food group. "Dieting is an ideal opportunity to adopt healthy eating habits," stresses New York nutrition counselor Margery Libin.
Understand Water Weight. The facts of weight loss are the same, whether you're trying to lose 5 pounds or 50. To get rid of a pound of fat, your body must do something that's hardly possible in one or two days: burn 3500 calories more than it consumes. Yet most diets promise, and seem to deliver, a four-to-five-pound weight loss in the first week alone. How do they do it? The answer is water weight.
When you start a low-calorie diet, increased amounts of water are excreted due to changes in metabolism. Before long, however, water levels return to normal. According to your scale, you've gained weight; in reality, you never lost it.
Exercise Regularly. Because of the way exercise changes the body, physical activity could be the single most important factor in weight control. If you need to lose just five pounds, initiating a regular exercise program could mean hardly cutting back eating at all. Here's why:
Aerobic activities such as walking, running, swimming, and bicycling are the ones that burn calories most efficiently. Exercise experts agree that three half-hour workouts a week are minimum for fitness and weight loss or maintenance. You can compensate for a weekend splurge by beefing up your activity level for a few days.
Eat Three Meals a Day. When and how often you eat can be as important as what you eat. Digestion actually raises your metabolism temporarily, so that you burn more calories than usual for a few hours after a meal. If you divide you daily intake into three or more snacks (not snacks) you will have an extra edge in weight control.
You can maximize this "thermic" effect by coupling it with exercise. Take a 15 minute walk after each meal.
Change Bad Habits. By making even the slightest adjustment in your daily habits, you can chisel away weight that has accumulated gradually:
Read labels and nutrition books. Good nutritional content counts as much as calories. Buy a guide that lists nutrients in foods. Familiarize yourself with those that are rich in minerals and vitamins; note which ones have high levels of fat and salt. "Read labels and make comparisons," says Dr. Shapiro. "Different brands of the same foods have varying levels of calories, fat and sodium."
Cut portion sizes; make canny substitutions. You shouldn't have to give up your favorite foods or resign yourself to being hungry. But consider this: Wouldn't a two-egg omelet sprinkled with herbs be almost as satisfying as the three-egg cheddar-and-ham-filled special? Think trim -- if you substitute a cup of skim milk for whole milk on your morning cereal, for example, you'll cut over 70 calories a day -- more than 25,000 (or a total of seven pounds) in a year. Such sacrifices add up. You may lose weight the way you gained -- slowly-- but lose you will.
Find substitutes for your high-calorie favorites. This technique may prove psychologically easier than dieting. "Everyone has a personal weakness," says Dr. Shapiro, "a food you know causes problems. Maybe it's peanuts or chocolate or doughnuts."
He recommends that you list your six highest-calorie weaknesses and try to avoid them for a while. At the same time, add six healthy, low-calorie items to your diet. "Choose foods you truly like," he advises. "don't list cottage cheese if you hate it."
You may be unaware of the blockbuster calorie counts of some foods you often eat. Margarine and butter each pack about 100 calories into a tablespoon. Oils have about 120, so try going light on the oil-and-vinegar dressings.
Even salads can turn on you if they are topped with high-ticket items such as chunks of hard cheese (100 calories per 30 grams), chickpeas (135 per 130 grams), raisins (85 per 30 grams) and bacon bits (140 per 30 grams). Dressing can run as high as 100 calories a tablespoon. Stick to low-calorie dressings, a squirt of lemon juice or vinegar.
Alcohol is also high in calories. a 125-millilitre glass of wine contains around 90 calories; a mixed drink around 200; a bottle of beer, 150. Turn to white-wine spritzers and light beers and wines.
Remember, this is a lifetime plan. Don't despair over occasional lapses. Just vow to follow it as carefully as possible for a month or so. Soon your eating habits will have changed for good, and the pounds that disappear will stay away with a little effort. YOU MAY NEVER NEED TO DIET AGAIN.
| TEN POUND-LOSING TIPS |
| SHED THOSE EXCESS POUNDS SAFELY AND FOREVER |
If you wish to lose from 10 to 50 pounds, begin as follows: First reduce your calorie intake by 400 to 1000 calories per day, depending on your body size and the amount of weight to be lost. A man eating 2,500 calories normally and slowly gaining weight, with 30 pounds to lose, might reduce his intake to 2000 calories. This entails no major sacrifices and will not make him weak and hungry. In no instance should total calorie intake go below 1200 per day, because of the dangers of nutrient deficiency and pronounced lowering of basal metabolic rate.
While you are rearranging your eating, you may as well move toward a more healthful diet. This means you will eat fewer fatty meats, whole eggs, full-fat dairy products and soft drinks, and more fresh fruits and vegetables, grains, fish and poultry, egg whites and low-fat milk. Plan to stay on this new food plan for at least a few months, but don't look upon the reduced calories as a permanent feature of your life. Healthy foods are a permanent feature, but dieting is a temporary therapeutic measure to help achieve phase one - weight loss.
While you are starting your new diet, begin your exercise program slowly but progressively. Select one or more exercises that you can do regularly with pleasure. Don't neglect less familiar sports -- perhaps roller skating, brisk walking or bouncing on a trampoline is for you. But it must be an endurance-type exercise, in which you will breathe hard, work up a sweat and will do it continuously for 30 to 45 minutes, three to five sessions a week. Once you have decided on the sports you like, forget "exercise" and think of the sessions as your "play periods." Don't let anyone cheat you out of them. It is this mental transition that will allow you to achieve phase two - lifetime maintenance of a suitable weight.
It is important that you proceed gradually with your play program. Your tendons, ligaments and muscles need time to adjust. It took years to get out of shape, so allow yourself a couple of months to get back into shape. Walk a mile a day the first month, two miles the second month and so on. You may need as long as a year to fully establish your play program and become fit. But check first with your physician if you have been sedentary for a long time and are over 40, or if you have a chronic health problem.
When you are down to your desired weight retain a steady level of exercise. This allows calorie intake to rise to balance energy expenditure and keep body weight stable. Regular physical activity is an effective and enjoyable pathway to life-long weight-control. It brings you many health benefits and permits reasonable, and frequently robust, food intake.
