Since then, hundreds of scientific papers have confirmed that overweight or even obese people with certain health problems have better long-term outcomes than people of normal weight who suffer from the same diseases.
It's called the obesity paradox. Keep reading for the details. . .
Protects in Existing Heart Disease
As a board-certified cardiologist, author and co-author of 800 journal articles and two medical textbooks – and a member of editorial boards of major medical journals – Dr. Lavie is a very distinguished physician.Even so, he's bucking the orthodox view by saying excess fat should not be burned away at all costs. Sometimes it may be exactly what's needed to extend life.
While carrying extra poundage certainly confers a much greater risk for chronic disease, once you’ve got the medical problem, the story changes. Additional weight now offers protection.
His research team's first study on patients with heart failure found for every one per cent increase in body fat there was a 13 per cent increase in survival.
A prominent group of researchers from the Mayo Clinic looked at 40 studies covering 250,000 patients with coronary heart disease.
Those with a body mass index (BMI) regarded as normal (18.5 - 24.9), were most at risk of dying from any condition. Those considered overweight (25 - 29.9) had the lowest relative risk, while the obese (30 and above) had no increased mortality risk.
A study bringing together summaries of nine major heart failure studies involving 29,000 people corroborated these findings, as did another for 11,000 Canadians.
Extends Life in Other Conditions
Yet, as Dr. Lavie points out, "the most compelling findings giving indisputable credibility to the obesity paradox have nothing to do with heart disease..."Research shows:
- Overweight or obese diabetics are half as likely to die than their normal weight counterparts
- Each one unit increase in BMI above 27.5 lowers kidney dialysis patients’ risk of death by 30 per cent
- Rheumatoid arthritis sufferers with a BMI over 30 have a death rate two-thirds less than those with a BMI of 20 to 24.9
- Risk of dying from cancer and infections goes down as weight goes up
Why Fat Protects
While neither Dr. Lavie nor any other scientist has been able to explain the obesity paradox, fat is known to be protective in a number of ways.In conditions where there may be wasting, such as cancer or AIDS, the extra fat provides calories and reserves that lower the risk of death.
I’m not too surprised that in cancer, kidney failure and rheumatoid arthritis – diseases where patients often have rapid weight loss – a buffer of fat may provide some protection.
A lot hangs on the distinction between being fat and in good health, and being fat and having one of these conditions. Obesity is known to be a major cause of cancer and some authorities actually rate it the number one cause of cancer. If you are healthy now, you want to lose extra pounds and maintain a healthy weight.
The finding that fat can extend your life comes into play only AFTER you’ve got cancer. And I strongly suspect that this is because chemotherapy brings on rapid weight loss – the patients are too sick to eat – and the sudden plunge in pounds is not healthy for a person who is thin and sick already. It’s only under these unusual conditions that obesity might give you an edge.
Likewise, extra fat does NOT protect you from kidney disease. It merely provides a reserve to live on if your kidneys fail and you go on dialysis.
Padding Against Falls
If seniors fall, a more generous layer of fat can protect against fractures and provide energy reserves in stressful times. It can also supply a much-needed cushion against muscle and tissue loss that’s often seen in severe cases of arthritis.Thighs, bottom, hips, and upper arms suck up any energy overflow and store it there. This traps potentially harmful fats, preventing them from traveling through the bloodstream. This filtering effect, if we can call it that, protects the liver and lowers cardiovascular risk factors.
Fat cells also have key responsibilities in the body: bolstering immunity, storing glucose, generating and metabolizing many hormones, and producing key molecules such as nitric oxide - important for good blood flow.
So it's not all bad news when it comes to fat. As Dr. Lavie puts it, "Fat tissue is very active in our body and part of our essential tool kit for health and longevity."
Focus on Nutrition and Fitness
The benefits of fat mean those with the above health problems who are overweight or modestly obese might benefit most from improving nutrition and physical fitness rather than losing weight.Dr. Lavie points to the Mediterranean diet as one that reflects a healthy food lifestyle with documented health benefits. His review of the evidence also convinces him that fitness is highly protective regardless of weight.
His simple prescription? A 20 to 30 minute brisk daily walk, and working your big muscle groups twice weekly by using light weights.
- The Obesity Paradox by Carl J Lavie MD, Scribe Publications 2014
