Is it healthier to be lean or to be fit?
Studies published Wednesday suggest the answer is yes.
The first, by researchers at Brigham and Women's Hospital in Boston, finds that no matter how much exercise a woman gets, if she's overweight, she's at risk of developing diabetes.
The other study, by University of Florida researchers, finds that regardless of a woman's weight, if she's not physically fit, she's at risk of developing heart disease.
The health message sounds murky, but authors of both reports, published in Wednesday's Journal of the American Medical Association, say the best way to avoid health problems is to be both fit and slim.
"Exercise is important in diabetes prevention," says epidemiologist Howard Sesso, a co-author of the diabetes report. "It's just that being overweight or obese is that much more important."
Sesso and colleagues examined data from the ongoing Women's Health Study, which involves nearly 38,000 women 45 and older. Weight, height and physical activity were recorded for an average of seven years.
The researchers found that women who were overweight, with a body mass index (a ratio of weight to height) of 25 to less than 30, had more than three times the risk of diabetes compared with normal-weight women. Those who were obese (a BMI of 30 or higher) have nine times the risk. Walking four or more hours a week cut the risk for obese women only slightly.
In the heart study, researchers examined 906 women who had been tested because of suspected heart problems. Researchers found that obesity alone didn't increase the risk of heart disease. "An obese woman who was physically fit had a low risk," says co-author Carl Pepine, chief of cardiovascular medicine at the University of Florida College of Medicine, while "a lean woman who was not physically fit had a relatively high risk."
An overweight woman who can play a round of golf, swim and do yard work has a lower risk of heart disease than a thin woman who can't do those activities, the researchers found.