Is it worse to be skinny but out of shape or obese but fit?

A few weeks ago I began discussing a topic that is very pertinent to the fire service – heart health.

Aside from smoking, there are 5 major heart disease risk factors: obesity, high blood pressure, high blood glucose (development of type II diabetes), poor blood cholesterol(high LDL/total cholesterol and low HDL) and low aerobic fitness.Fitness

Last week I explained why being obese is very bad for your health but I also mentioned that your weight does not completely dictate your health status. What do I mean? Well, you may be surprised to know that if you’re overweight but still manage to maintain a high aerobic fitness you’re much healthier than someone who is lean but not aerobically fit.

In fact, being aerobically unfit increases your risk of developing heart disease to a greater degree than any other risk factor. I know it’s hard to believe – this is not common knowledge. But, trust me (I’m a doctor :)), this has been clearly illustrated by many large, long-running research studies. See the graph below in which 30,000 people were followed to see how much each of the risk factors independently contributed to the development of heart disease.

The take-home point here is to AVOID BEING SEDENTARY. People who do little to no movement have a much greater risk of developing heart disease, cancer, arthritis and other debilitating diseases and have a shorter lifespan and poorer quality of life than people who move.

You don’t have to become a distance athlete

The good news is, it doesn’t take a whole lot of hard core exercise to get out of the danger zone. In fact, research shows that the greatest health benefit occurs when going from sedentary/very low fitness, to just doing something/having average aerobic fitness.

I love telling people that because it means YOU DON’T HAVE TO TAKE UP MARATHONING TO IMPROVE YOUR HEALTH. Although I think it’s great that so many people do become motivated to move by having an event to train for, it’s important to understand that killing yourself doing long distance training or slogging through multiple hour workouts is not required to benefit from a greatly reduced risk of developing chronic disease.

Just move. “Sitting is the new smoking” because, as the data above shows, being sedentary is even worse for your health than being a smoker. The great news is that your movement can be anything that increases your heart rate and breathing. More on that here.

I challenge you to take the pledge to move more! Please leave your name below so we can cheer you on.

If you’re not on my list to get more health tips like these, enter your name and email below.

By | 2018-06-01T06:37:59+00:00 August 20th, 2014|Uncategorized|4 Comments

About the Author:

Dr. Karlie Moore has a PhD in Exercise Science and Nutrition and specializes in firefighter health. She has conducted fitness testing on hundreds of firefighters and has created the most comprehensive online wellness program for fire departments called the FitCulture program. Dr. Moore is also married to a firefighter and so understands their lifestyle and the health challenges associated with it.


  1. Greg Friese August 21, 2014 at 5:32 pm

    Even as a marathon runner I have to put in effort to get 10,000 steps on my non-running days.

  2. Chris Riddell August 27, 2014 at 2:52 pm


    This data conflicts with information that my cholesterol specialist told me. She said that, given all other factors, people who weigh less tend to live longer. Obviously I will try to remain both active and fit, while also watching my overall weight. Is this a new development to a long term study? Thanks Karli. Although I don’t post often, I read your blog each week and often share it with my crew after roll call in the morning.

    • Karlie August 29, 2014 at 8:11 pm

      Hey Chris, thanks for commenting, I love to hear that you share these with your crews! Ultimately you have to consider all of the heart disease risk factors when you’re considering your longevity. I wouldn’t say that there is really a conflict between this info and what your doctor told you because both high fitness and a healthy weight will result in a longer life. This post was really getting at the importance of being fit even if you struggle with keeping your weight down. (and perhaps when your doctor stated “all other factors” he/she wasn’t including aerobic fitness).

  3. Chuck December 26, 2018 at 1:38 pm

    I am currently recovering from major knee surgery and therefore can not get up and move. So in the meantime I am using therabands to keep my muscles working

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