Is Being Overweight Protective Against Disease?


  There is an overweight epidemic in North America and it is spreading to the rest of the world to the point where obesity is now the new normal. Being overweight and obese is clearly linked to all possible degenerative diseases, from diabetes to arthritis, from cancers to Alzheimer. Diabetes is now so common that it is considered quasi "normal", which is scary.

Strangely, a few studies have concluded that, while being overweight and obese was bad for your health, it seemed to have some protective effect over the age of 65.

How could that be? How could an accumulation of years of disease suddenly have protective effects? This really does not make any sense!

The best thing here is to look at the data. First, a few studies demonstrate a protective effect against osteoporosis fractures and mortality. Here is how fat can be protective in osteoporosis: fat tissue is not inert: it is an extremely active endocrine organ and produces estrogens, which have a protective effect on bony mass (this estrogen producing activity also explains why obese men have lower sperm counts, over and above the act that their testicles are kept at a higher temperature because of the insulating properties of fat). But other studies also suggest that mortality of all causes is decreased in overweight people. How could that be?

Data gives the answer: first, authors did not look into why people were underweight. They did refer to previous articles that demonstrated that "Unintentional weight loss and underweight (presumably due to underlying disease) is often reported to be strongly related to greater mortality risk". So it is not exactly earth-shattering to learn that people who lose weight because of some severe underlying disease like cancer will die early. It is also important to realize that the studies essentially looked at body mass index and actual fat content of the body. There was never any evaluation of the actual muscle mass nor of the actual fitness level of people. And this may be the missing piece of the puzzle.

What do nearly all people have in common? They do not train. Never. So starting in their thirties, they lose muscle mass and develop osteoporosis - over and above sunlight and vitamin D, strength training may actually increase bony mass (the body thinks it has to carry a bigger mass than in reality and bones get stronger). Being overweight puts some stress on the bones and the estrogen secreted by the fat also helps.

Being overweight is certainly somewhat protective for osteoporosis, but gives much less of a protection than resistance training.

People who never train (nearly everyone) also lose cardiovascular function to the point where any task becomes a terrible challenge. More: the average "thin" elderly loses constantly so much muscle mass that he gets to the point where he cannot get up from a bath or from a chair. So thin is actually frail. This does not have to happen! Elderly people who train regularly are as fit at 80 as an average 50 years old who do not train.

More: except for the sick and emaciated people suffering from severe chronic disease (chronic pulmonary lung function, cancer, severe cardiovascular disease, liver or renal disease, etc), "thin" elderly are what is commonly called "thin fat", They still have an increased cardiovascular risk because of the fact their fat is stored in their abdomen, where fat accumulation is associated with increased cardiovascular risk.

Finally, one has to take into account the fact that the survival of those overweight and obese people would not be that significant if it was not for modern medication. It is easy to close an eye on the significant morbidity associated with being overweight and simply look at crude comparative mortality ratios. The fact is, apart from osteoporosis, being overweight and obese is not protective against the very diseases these condition cause: it is simply less problematic than being a "thin fat" frail elderly.

The only significant protection is a real change in lifestyle with regular alternating resistance and cardiovascular training. Training has been demonstrated to improve survival, even in patients suffering from heart failure.

There is of course no obligation to train: but the consequences of not doing what our bodies are meant for is significant disease, frailty and an early death.

Ready to change your lifestyle? Or ready to help a frail parent improve his/her odds against disease? Please visit my blog at http://www.blog.fitnessmissionpossible.com, hit the contact page and tell me what you would like to do as far as exercise is concerned. I'll help you find an exercise program that will be fun to practice.

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