Carvings     October 1, 2021

In the news

The myth of fit and fat: the last nails in the coffin

            When a team of researchers from the National Institutes of Health (NIH) stated that being overweight was not only unrelated to heart disease but that such persons had a longer lifespan, media journalists (most of whom happen to be just as overweight or obese as their fellow Americans) rejoiced. By the time the director of the NIH held a news conference to disavow the findings the damage had been done. For the next couple of decades the iconoclasts continued to claim that it was OK to be overweight as long as your blood pressure and blood sugar remained at normal values. Similar studies followed with the same misinformation.

            Studies from six countries have finally demolished that myth. It turns out that the spurious studies just didn’t last long enough – some only for five years. A decade or two later those fit and fat – the medical term is Metabolically Healthy Obese — were headed toward stroke centers and coronary care units.

            Research based on several million persons from six countries (U.S., U.K., Denmark, Canada, France and Scotland) verify what many of us have maintained: carrying extra fat puts one at higher risk of cardiovascular disease, stroke, type 2 diabetes and a shortened lifespan. The reports claiming the opposite suffered from several flaws, including that persons with congestive heart failure tend to lose weight as their illness progresses, and so do persons with type 2 diabetes. Some trials were done among selected groups and others relied on self-reporting, a notoriously error-prone method.

            The message is clear: overweight persons who are “metabolically healthy” do not remain so.

            Interestingly, only one of these studies acknowledged that BMI (Body Mass Index), the standard that has been used in scores of research protocols for decades, is an “inappropriate surrogate” for adiposity. The BMI was developed more than 150 years ago by a French demographer who used it to gather information about population groups. It was never intended to apply to individuals although it is typically used these days by physicians, nutritionists, fitness instructors and others in their research. The reason is simple and it should be obvious: it determines the ratio of weight to height and does not take into consideration the fact that two persons of equal weight and height, with the identical BMI, can have markedly different health profiles. As an example, a six-foot, 200-pound bodybuilder and a six-foot, 200-pound couch potato have the same BMI. But the former might have about 10 percent body fat, the latter perhaps 50 percent. Do you think that they will have the same health issues?

            Let’s hope that this myth will go to its grave early so that fewer of us will do likewise.

Lifestyle

            Beware of any diet program that claims that you will lose 5 or 10 pounds per week. That’s possible, but it isn’t safe or wise. Your target should be about two pounds per week. After all, that’s about 50 pounds in six months, 100 pounds in a year, and there is no reason to go beyond that. You will still amaze your friends and we’re months away from bikini season!

            If you push your body into starvation mode you will lose a great deal of lean body mass, which includes muscle as well as tissue from other organs. There is also a much greater risk of gallbladder disease when weight loss exceeds 2 pounds per week.

            Cravings are inevitable when you cut calories drastically but by substituting calorie-sparse foods like fruits and vegetables for calorie-dense refined carbohydrates like anything made with white flour or any form of sugar, those cravings will disappear. Plant foods take up a lot of space, so feel free to snack on them throughout the day. Even though fruit has some sugar, it’s almost never more than about 75 calories – about one-third as much as there are in a bagel – without the cream cheese!

            Fatigue and irritability also accompany marked weight loss. The former will jeopardize your job and the latter your relationships. It just isn’t worth it.

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