Being physically fit is very much better for long term health than being unfit. But in this era of cheap and attractive calories, it is quite possible to be both physically fit and overweight to some degree. Many people are. Unfortunately, being fit doesn’t meaningfully protect against the detrimental effects of excess fat tissue on health and disease risk. If you are carrying more visceral fat tissue, then you have a higher risk of all of the common age-related diseases, when compared with someone of the same level of fitness with less visceral fat tissue.
Not so many years ago, metrics based on the ratio of height to waist circumference – such as the simple waist-stature ratio – began to appear in epidemiological studies as a replacement for the time-worn use of body mass index. The waist-stature ratio correlates more closely than body mass index with risk of disease, mortality, and other unfortunate aspects of aging. This points to the importance of visceral fat in disease processes. Even so it will take some time to percolate through the research community. Epidemiology doesn’t move rapidly, and older data sets often lack the necessary information for use of waist-stature ratio,
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