Better to be obese, but physically active, than slim, but avoid sports, say experts at the Cooper Institute in Dallas in a statement in the New York Times. They explain what the long-discussed so-called the obesity paradox.
A few years ago, Mercedes Carnethon, a diabetologist at the Feinberg School of Medicine Northwestern University, pointed out that not only obese people, but also thin people, suffer from type XNUMX diabetes. It was even more surprising when she noticed that healthy-weight diabetics were twice as likely to die than obese diabetics. How it’s possible?
This has been called the obesity paradox and specialists are at it. But the paradox is broader, and it applies to other chronic diseases as well. Overweight and moderately obese people (with a BMI of 31-35) often live longer and in better health than people with the recommended body weight, whose BMI does not exceed 25 points.
In 2002, such a relationship was first demonstrated by Dr. Carl Lavie, a cardiac rehabilitation specialist at the John Ochsner Heart and Vascular Institute in New Orleans. He showed it on the example of people suffering from heart failure. At that time, however, the reliability of his research was questioned. Only after a year of efforts did he find a medical journal to publish his observations.
Since then, several studies have been conducted to support Carl Lavie’s findings. It has been shown that people with coronary heart disease who are thin are more likely to die than those who are overweight and obese. Even slim people who need dialysis treatment for chronic kidney failure have a shorter life span.
The same relationship was noticed in patients with stroke, arterial hypertension and kidney disease. The crowning achievement of these studies were the observations of 11 thousand. Canadians, which was published in 2007 This time it has been shown that overweight people are less likely to die for any reason.
Experts tried to explain this paradox by the fact that the bodies of overweight and obese people have greater energy reserves, which helps them to cope better with chronic disease. It was also suspected that lean people have genes that make them more susceptible to these conditions and less able to cope with them. Dr. Lavie says that heart disease has a slightly different course than that of obese people.
It has also been speculated that thin people get worse treatment because doctors believe that they are less at risk of complications of a chronic disease and do not require such careful care.
More convincing, however, is Dr. Neil Ruderman, an endocrinologist at Boston University School of Medicine. In 1981, he pointed out that some people with normal body weight have metabolic disorders that favor diabetes and atherosclerosis. He called them “metabolically obese” people.
These disorders result from the fact that although such people have a slim figure, there is a lot of fat in their abdominal cavity, which is not visible outside. It is he who causes metabolic disorders manifested by elevated levels of cholesterol, triglycerides and high blood pressure. It also leads to the development of insulin resistance in the body, which is the starting point for, among others, diabetes.
On the other hand, physical activity protects against such changes, but it is usually not included in the research. However, observations of Steven Blair of the Cooper Institute in Dallas showed this. Well, regular aerobic exercise, even if it does not reduce the weight of an obese person, can reduce fatty liver, which in turn prevents metabolic disorders.
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“Exercise is a much more important risk factor of death than body weight,” said Glenn Gaesser, author of Big Fat Lies and head of Arizona State University’s Healthy Lifestyles Research Center, in a statement to NJT.
Epidemiologist Katherine Flegal believes that all extremes are the least beneficial to health, both being overweight (BMI over 35 points) and too low body weight (under 25 points).
He cites the data of the National Health and Nutrition Examination Survey, which shows that the lowest risk of premature death is in overweight people (from 25 to 30 points). People with moderate obesity (from 31 to 35 points) are at the same risk as people with normal body weight (up to 25 points).
Dr. Lavie emphasizes that weight should not be underestimated. It is best to be slim and physically active. However, if you do not manage to stay slim, you need to be physically active. (PAP)
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