Eating Healthy Won't Make Up for Not Exercising

“Diet and exercise,” goes the old mantra—it’s hard to find a better shorthand for the fundamentals of good health. Of course, the picture can be more complicated. But a new study reminds us of the importance of both elements, finding that otherwise healthy, smart-eating people who didn’t exercise can still have a high risk of cardiovascular disease—in fact, they had the same risk as people who were overweight.

The study used data from the National Health and Nutrition Examination Survey and focused on people ages 4o to 79. Researchers divided the data into two categories, comparing people with healthy body mass index (BMI) to those with overweight BMI. They then assessed the two groups for cardiovascular risk.

Specifically, they focused on people who had healthy BMI, but who had characteristics that might make them more likely to have cardiovascular risk: an unhealthy sagittal abdominal diameter (a fancy way of saying “a gut”), shortness of breath after exertion, and less than recommended levels of exercise. They also adjusted for other factors, age, race, and gender.

After crunching the numbers, they found that even people with a healthy BMI, but who led sedentary lifestyles, showed roughly the same risk for cardiovascular disease as those with an overweight BMI. In an interesting wrinkle, they also found that people who sit for long periods of time—which has recently been associated with unhealthy outcomes—had lowered cardiovascular risk if they also were physically active.

In other words, exercise correlated with lower risk of cardiovascular disease even among people who otherwise sat a lot. And generally, lack of exercise is associated with higher risk of cardiovascular disease even among otherwise healthy people.

There are a few caveats, the authors note. There’s some debate over whether the standard method for calculating cardiovascular disease risk actually overestimates the threat in some populations. And some of the data on physical fitness was self-reported, meaning it may not be a precise measure. Overall, though, this data should be generalizable to most adults in the United States.

The findings, the authors argue, suggest that focusing on BMI as a healthy target may not be enough. People may reach what’s considered the appropriate weight for their size, but if they’re not exercising, the study shows, they may have the same risk as overweight people when it comes to cardiovascular disease. The lesson? When it comes to your heart health, exercise matters.

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