Most of us try to combat extra weight by dieting. But what if we were to worry a little less about our waistlines and instead focus on ways to offset the bad effects of the excess pounds? Several studies have suggested that exercise might be just the thing.

Extra weight — especially when it’s concentrated in a pot belly — stirs up inflammatory processes and disrupts blood sugar. Physical activity “cools off” inflammatory processes and helps our bodies keep insulin and blood sugar at healthy levels. So it makes sense that exercise might significantly blunt obesity’s ill effects even if it doesn’t cause weight loss. Some research supports this theory, but like all things metabolic, it isn't quite that simple.

One study found that men who were overweight but fit (as measured by a treadmill test) were less likely to die during the next 8 years than men who were lean but inactive. A 4-year study on women found that lack of physical activity, based on their answers to standard questionnaires, was a better predictor of a heart problem than weight.

However, data from a large, long-term study of nurses both confirms and contradicts these earlier studies. Researchers found that physical activity lowered the death rate across all weight categories. And nurses in the mid-range overweight category who were physically active (as little as one hour a week counted) had a lower risk of death than lean nurses who were inactive (exercising less than an hour per week). Being a little active and a little fat wasn’t such a bad combination.

But physical activity didn’t completely eliminate the risks that go along with being overweight or obese. In fact, when the nurses were grouped by how active they were, the heavier nurses were more likely to have died than the lighter ones at every activity level.

What do these results mean for you?

Despite the differences in these studies, they all suggest that physical activity will offset some of the effects of excess weight, if it’s just a few extra pounds. So, apart from any weight-loss goals you’ve set for yourself, it’s important to exercise regularly — even though exercise won't magically erase all the health risks of being heavy. If you are lean, it’s worth the effort to stay that way, and to make exercise part of your life. If you’re heavy, it’s a good idea to try to lose some of that weight, particularly around the waist. And, of course, exercise is an important component of any weight-loss plan.

This article is excerpted from the Harvard Health Letter. www.health.harvard.edu/health.

Q: I'm at my wit's end with terrible hay fever. I already use both a nasal steroid medication and an antihistamine. But every spring I still have what seems like the worst case of itchy eyes and nasal congestion. Is there anything else I can do?

A: Quite possibly. I start most patients with hay fever on a once-a-day nasal steroid spray. Understandably, some people are initially put off by the idea of using steroid medication, but when steroids are in the form of a nasal spray they affect only the tissues of your nose, not the rest of your body. For the small percentage of people who don’t get enough relief from sprays, taking an antihistamine pill once or twice per day may help. And in just a few patients, I end up recommending both the steroid spray and the pills.

But even that combination isn’t working for you, so I would probably refer you to an allergist for possible desensitization to allergens. Allergists can identify substances that are making your allergies worse, such as dust mites. They may do skin tests to try to pinpoint your specific allergies. Finally, they can give you injections to change your immune system so that you are not so allergic to the substances causing your problems; often their benefits last years. I certainly don’t send every hay fever sufferer to an allergist. Most do well on sprays and antihistamines. But in your case, it seems like seeing a specialist who can get to the root of your problem is the best way to go.

Thomas H. Lee, M.D.
Editor in Chief, Harvard Heart Letter
www.health.harvard.edu/heart