In our weight-obsessed culture,  we can lose sight of the fact that health is not all about being thin. In fact, healthy eating and physcial activity alone - and separate from weight -  are critical contributors to wellness and disease prevention.  A new study reaffirmed this understanding with respect to fitness. The study reports that maintaining or improving fitness counteracts much, but not all, of the increased risk associated with weight gain.

The study was published in the Feb. 14 issue of the Journal of the American College of Cardiology.

The study took place between 1970 and 2006.  3,148 healthy adults enrolled in the Aerobics Center Longitudinal Study. All received at least three extensive medical exams at the Cooper Clinic, in Dallas.

Three risk factors were assessed: high blood pressure, high cholesterol or metabolic syndrome.

Metabolic syndrome raises the risk of diabetes and heart disease. To be diagnosed, someone must have at least three of the five signs: large waist (abdominal obesity), high triglycerides, low "good" cholesterol, elevated blood pressure (but not necessarily high enough to be classified hypertensive) and high fasting blood sugar (although not yet high enough to be classified as diabetic).

Fitness was assessed on a treadmill test.

At the end of the study, 752 participants had high blood pressure, 426 had metabolic syndrome and 597 had high cholesterol.

Those who maintained or improved fitness over time had a lower risk of developing any of the three risk factors.

Those who maintained fitness had a 24 percent lower risk of high blood pressure, 38 percent lower risk of metabolic syndrome and 25 percent lower risk of high cholesterol. Those who gained fitness reduced their risk of each about the same or slightly more.

Being fit and not being fat work independently to reduce risk factors, said the studies lead author, Duck-chul Lee, a research fellow at the University of South Carolina, in Columbia. If you can't improve both fitness and fatness, try to at least maintain one, he said.

 "If you are going to be overweight, you have to be fit." says Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital, in New York City . She is also a spokesperson for the American Heart Association's "Go Red for Women" campaign. 

Duck-chul Le, Ph.D., research fellow, University of South Carolina, Columbia; Feb. 14, 2012, Journal of the American College of Cardiology