Interesting column by Dr. David Lipschitz
 

This column is in todays newspaper (Jan. 29, 2013) and the heading is: Overweight people live the longest, not the best.

As I suggested in the thread heading it's interesting but I also think it's likely to be confusing to many people. Dr. Lipschitz has written some very good columns but I don't think this is one of them. It misses the mark.

The article compares overweight people to thin people but it seems that little, if any, attention was paid to nutrition. After all, he's a medical doctor and he bases the column on a study that was published in the "Journal of the American Medical Association". And since when are they all that concerned with nutrition? They're not. If this was about nutrition, the study would have been published in a nutrition journal.

So when they compare thin people to overweight people it's likely they are not taking nutrition into account. People can be thin because they eat a careful/healthy diet (no empty calories) or they can be thin because they are sickly as the result of eating a poor diet (not to mention smoking or heavy drinking etc.).

This seems like "reductionism" where they study one thing in isolation. It's based solely on weight and therefore it's a meaningless study.

Whoa Nellie. JAMA is the gold standard.

What was the consensus of the study?

Dr. Lipschitz began his article stating that the consensus was the exact opposite before and now it's best to be a little overweight. Like all things we read, it will switch the other way again soon I'm sure. Usually what's good for you in some ways is bad for you in others.

In that JAMA article, I believe an overweight person was anyone with a BMI over 25. If you look at a BMI calculation, most people, including myself, would consider 25-30 a 'normal' BMI. Certainly nutrition is paramount, but they are simply using numbers (a BMI over 25 or under 25 and longevity) and, in my opinion, come up with a poor conclusion...

The point I got after reading the article is that you can be a little overweight, not obese, and if you exercise a lot, you will live longer than a very thin person who exercises.

This was a reappraisal of 97 studies with 2.88 million people.

And that is what the computer said.

BMI is a measurement of weight to height. It is sometimes flawed because it does not take into account the composition of weight fat vis a vis muscle It is why doctors decided to rethink the BMI measurement
Muscle weighs more than fat

I read the column over quickly and couldn't find the comparison that you mentioned above. What I found was: (In my own words) Overweight exercisers are healthier than thin people who are sedentary. That's another reason I find fault with the column. He never states the ideal. He doesn't compare thin exercisers with overweight exercisers. And he doesn't compare good nutrition with poor nutrition. I believe thin pleople who eat a totally healthy diet (no processed foods and no empty calories) and exercise (to maintain good muscle tone and good percentage of body fat) represent the ideal.

If the study is meaningless, no amount of reappraised studies will change anything. And the computer is only as good as those who design the study; garbage in, garbage out.

I know two things. The Journal of the American Medical Association is extremely careful and ethical.

The other is...the computer could take just the facts about weight and activity and see who is living longer.

The other assumptions can be up to you.

My complaint was mainly about the column not about the American Medical Association. Their study may have been "careful and ethical" but still, in my opinion, not worth very much if it only took "weight" into account.

We know nothing about how the original studies were conducted and we can't look it up in the journal. So his readers are supposed to take him at his word that the study was a good study. This study was a study of many studies. How were the people selected for the studies? What age range did the studies cover? Did they eliminate smokers and heavy drinkers, etc.?

We shouldn't have to make assumptions.

Of what value is it to say that overweight people are healthier than thin people who are sedentary, when it's a known fact that being sedentary is very bad for health? It's like saying: "Overweight people have destructive eating habits but it's even more destructive to be sedentary." So we know what the worst of the worst is, but he sets no ideal for the average reader. All I see is that he muddied the waters and it's likely that most overweight people will go away thinking that being overweight is not so bad after all.

Studies, and columns from those studies, can be ethical but dumb and misleading at the same time.

I found it very interesting that a study based on over 2 million people showed that being overweight (not obese) could be healthy as long as you exercise. The study showed that exercise is more important than being thin in terms of longevity. That's what I took away from the article.

The problem I have noticed is that many people start their retirement years with the best of intentions. In my first Villages neighborhood, I made friends with a large group of people. Most of them started out doing a lot of walking, golfing etc.. Then one-by-one they they did less and less until they stopped exercising. So I believe counting on exercising alone to pull oneself through is shortsighted. Most of them were overweight and when they stopped exercising they didn't last long. They are all deceased. As he said in the article: Being overweight and sedentary is a prescription for disaster.

It's not that they didn't live long, it's that their last decade or so was miserable and they didn't fulfill their potential. They were all taking multiple drugs and having side effects, not to mention having to endure all kinds of medical proceedures. But many overweight people reading this column will only come away with one idea, that it's okay to be overweight.

Being thin is no guarantee of anything either. People can be thin by skipping breakfast or just having a cup of coffee and a slice of toast. And then they might have a ham sandwich for lunch etc.. On top of that, they may be sedentary.

He did get some things right but here's what I think he should have said but didn't: "Being overweight is generally bad for your health in the long run, but you can make the best of a bad situation by being fit." And, "just the fact of being thin is no guarantee of health and longevity, unless you also live a healthy lifestyle." (If the study is correct, there must be a lot of thin people who live very unhealthy lifestyles.)

Note: How much longer did overweight people live on average (being kept alive miserably by technology)? Perhaps he didn't think it was important enough to quantify.

Being Overweight Does Not Prolong Lives
 

Dr. Gabe Mirkin's response to the JAMA article:

Being Overweight Does Not Prolong Lives

A recent meta-analysis of a hundred large studies showed that being a little bit overweight offers slight protection (a six percent decrease) from premature death (Journal of the American Medical Association, January 2, 2013). This study has been widely reported in the media, with headlines such as "Our Imaginary Weight Problem".

Instead of being told that overweight is beneficial, people should continue to hear that excess weight shortens lives, particularly if their fat is stored in the belly.

WHY THE REPORT IS FLAWED: People with wasting diseases usually lose weight long before they die. All chronic diseases that shorten lives have a tendency to make people lose weight. Heart diseases, cancers, late stages of diabetes, kidney failure, arthritis, and even aging itself, usually cause weight loss before death (J Cachexia Sarcopenia Muscle, 2012;3(1):1-4). Weight loss that precedes death can last as long as 10 to 20 years, so it is impossible to correct epidemiological studies for this effect.

As people with wasting diseases approach death, their rate of weight loss increases dramatically. Sicker people, and those closer to death, lose weight faster than people with wasting diseases whose immunities are successfully holding their diseases at bay. It is true that people who have diseases that will eventually kill them may live longer as long as they do not lose weight.

EVEN A LITTLE BIT OF FAT IN YOUR BELLY CAN KILL YOU. Not all fat is harmful. Fat stored on your hips and upper legs protects you from disease. It does not turn on your immunity or cause inflammation; and it helps to prevent diabetes and heart attacks.

However, fat located inside your belly and around your organs:
• turns on your immunity to cause inflammation that leads to cancers, heart attacks, strokes, diabetes, inflammatory types of arthritis and so forth; and
• blocks insulin receptors to raise blood sugar levels, leading to diabetes that can damage every cell in your body.

This large study should not make you believe that being overweight is beneficial. You should maintain a healthful weight and try to lose any excess fat that you have in your belly. Belly fat is harmful and shortens lives.

Note: this article is from the Jan. 13 issue of Dr. Mirkin's eZine, a free newsletter on fitness, nutrition and health, available at Fitness & Health e-Zine

Thanks, bike42, excellent information.

bike42,

Thanks for the link, I just signed up for "Fitness & Health e-Zine". Heck, it's easy and free.....can't beat that!