Thursday, May 23, 2013

Learning to love the middle aged spread

A feature report at Nature on the vexed issue of how much weight gain is actually bad for you:
But many researchers accept Flegal's results and see them as just the latest report illustrating what is known as the obesity paradox. Being overweight increases a person's risk of diabetes, heart disease, cancer and many other chronic illnesses. But these studies suggest that for some people — particularly those who are middle-aged or older, or already sick — a bit of extra weight is not particularly harmful, and may even be helpful. (Being so overweight as to be classed obese, however, is almost always associated with poor health outcomes.)

The paradox has prompted much discussion in the public-health community — including a string of letters in JAMA last month2 — in part because the epidemiology involved is complex, and eliminating confounding factors is difficult. But the most contentious part of the debate is not about the science per se, but how to talk about it. Public-health experts, including Willett, have spent decades emphasizing the risks of carrying excess weight. Studies such as Flegal's are dangerous, Willett says, because they could confuse the public and doctors, and undermine public policies to curb rising obesity rates. “There is going to be some percentage of physicians who will not counsel an overweight patient because of this,” he says. Worse, he says, these findings can be hijacked by powerful special-interest groups, such as the soft-drink and food lobbies, to influence policy-makers.

6 comments:

John said...

In 2005 I read "The Fats of Life" by Caroline Pond, a researcher who specialises in lipid metabolism. An excellent introduction to the subject. The book made two statements which caused me to put a huge question mark over current recommendations:

Obese people seem to be healthier than genetically bred lab animals.
Body Mass Index not that accurate.

Steve said...

Cute title, that book...

I can certainly see the point in losing weight to avoid diabetes, but given everyone's propensity to put on some weight in middle age, it always seemed to me that it would not be surprising if it was evolutionarily a desirable thing.

Steve said...

Is evolutionarily a word? :) My spell checkers says yes, but it sounds odd.

John said...

One issue Caroline points out is that fats are often stored near lymph nodes and fats are essential for proper immune cells. In fact we can experience some essential fatty acid depletion when a severe infection occurs because the immune cells, especially macrophages(front line troops) die. Puss is very much about dead macrophages. So with age having that fat reserve might be life saving.

The recent research also highlights it is not fat per se but where it is stored in the body and the fat composition types(monos, sats, omegas).

John said...

Steve,

This is worthy of serious consideration ...

http://chriskresser.com/vitamin-k2-the-missing-nutrient

In fact I consider it one of the great oversights in regard to cardiovascular health.

Steve said...

Well, seeing cheeses, butter and egg yolk all have vitamin K2, that's a recommendation I am happy to follow...