An article in the Journal of the American Medical Association reports the fat-but-fit people over 60 have greater longevity than thin-but-unfit individuals. Researchers studied a collective of over 2,000 men and women over 60. The subjects' fitness was assessed at baseline exams using a maximal exercise test, and 'fatness' was determined from their body mass index (BMI), waist circumference, and percent body fat. Low fitness was defined as having a maximum treadmill test result falling in the lowest 20% of their sex.

All-cause mortality was recorded during the follow-up period, which averaged 12 years. Among the 450 deaths recorded during the study, those who died were older, had lower fitness levels and more cardiac risk factors than the survivors. After adjusting for age, gender, and time in the study, it was found that fit participants had lower death rates within each level of adiposity - overweight, waist circumference, and percent body fat. In most cases, the death rates for the highest fitness groups were less than half those of the unfit. The findings suggest that fitness levels in older persons influence the usual association of obesity with mortality.

The authors of the study conclude: "It may be possible to reduce all-cause death rates among older adults, including those who are obese, by promoting regular physical activity, such as brisk walking for 30 minutes or more on most days of the week." Good advice, indeed.