We are a nation of heavyweights.
Nearly half of Canadian adults are overweight or obese. Inch by inch, right across this country, our waistlines continue to expand. We demonize fat. Thin is in. Fat is fatal. Here is what the latest research has to say about that: poppycock.
Carl Lavie, a cardiologist at the John Ochsner Heart and Vascular Institute in New Orleans and a leading researcher in his field, is the author of a new book, The Obesity Paradox. In his own practice he found that his patients who were overweight or moderately obese and had heart disease tended to do better than those who were thin. The same was true of those with arthritis, kidney disease, diabetes, cancer and HIV.
The research is also on Lavie's side. A 2013 mega analysis of 97 studies covering 2.9 million people found that people with a body mass index of 25 to 30, which is considered overweight, have the lowest mortality rate. BMI is a measure of body fat based on weight and height. Twenty-five or greater qualifies as overweight while 30 or greater is obese. The mildly obese, a BMI of 30-35, had a five per cent lower mortality rate than the normal weight BMI.
Before you reach for that box of chocolates, be aware that after that, the numbers don't work in your favour. The obese and the morbidly obese have a higher mortality rate that is directly correlated to their weight. Still, for the overweight and mildly obese there is very little data to prove that weight loss improves health outcomes. In fact, the research suggests that in some cases, overweight people might be the longest living of all. That's the obesity paradox.
Now, as you might imagine, the suggestion that carrying a few extra pounds might actually confer some health benefits hasn't been exactly welcomed by the health commissars. The people who dole out advice to the weight-challenged masses tend to be thin themselves.
If Lavie's ideas about the "healthy obese" doesn't have many of them reaching for the Alka-Seltzer, his assertion that a thin person has the worst prognosis of all probably will. Thin people with metabolic challenges (high blood pressure, unhealthy levels of cholesterol and blood sugar levels) who are inactive do worse than almost anyone else. Lavie's view that there may be a "protective benefit" to being slightly overweight, that exercise is not always good and that BMI is a flawed measurement for the senior population is far from mainstream.
Let's be clear here. Lavie is not saying it's OK to be obese. What he is saying is that it's much more important to be fit and to have good metabolic health than it is to be thin. If your weight isn't perfect, it's not the end of the world. So the age old advice about keeping healthy as we age continues to apply: eat well, exercise and stay active. If you do that, feel free occasionally to reach for a second helping of dessert.
