Once again, science shows us moderation is the key to health and happiness
If you’ve been obsessing over losing those last 15 pounds, it’s time to find something else to worry about.
A large analysis by the National Center for Health Statistics—which used data from nearly 100 countries—will change the way you think about weight. It showed that moderate overweight is associated with lower disease and death rates.
And this isn’t one of those studies whose authors simply report a statistical anomaly without understanding science. It is difficult to discount this kind of analysis of straightforward vital statistics. I’ve seen this apparent paradox in my own practice. Plus, several other recent studies bear it out. An author of one of these studies, published in JAMA, is my colleague Barry Graubard— who has never been one to shy away from the science just because it went against the prevailing, politically correct “wisdom.” (Twenty years ago, he worked on our analysis with Nobel laureate Baruch Blumberg that showed excess iron is related to higher cancer rates.)
Disease by the numbers
So if a little extra weight is actually good for you, why are we always hearing the scary statistics? You already know: Two-thirds of adult Americans are overweight, and one- third are obese. And obesity is linked to increased blood pressure and higher risks of diabetes, heart disease, stroke, and kidney disease.
We don’t hear as much about studies that show people who are carrying some extra weight actually have better outcomes. Or the ones that show heavier people have lower mortality than “normal” weight people. Many of these findings apply to people with diabetes, stroke, and acute heart disease.
Part of the problem with prevailing weight research is that it’s built on a flawed measurement. The body mass index (BMI) was designed to measure weight independently of height. It does that using a simple formula: weight (in kilograms) divided by height (in meters) squared.
It makes sense that researchers and statisticians need a measure of weight that’s independent of height. In fact, when I first went to work at the National Cancer Institute this simple fact seemed to have become lost among all the fancy statistics. So I actually published a few papers in the American Journal of Clinical Nutrition reminding researchers how to use the BMI.
This led to a lively debate among medical researchers and scientists. We eventually titled our entry “expanding on the three limitations of body mass indices.” Ultimately, everyone agreed that there are important limitations for using the BMI.
But then they made the illogical decision to keep using BMI anyway as the index for overweight and obesity!
Why you shouldn’t pay so much attention to BMI
A BMI calculation that works for one population, gender, or individual may not work well for another. But to make it simple, medical research and practice use the same formula for everyone, and these numbers have become the standards for comparison.
So, there’s nothing magic, or even precisely accurate, about the way the BMI is now being used. It’s nothing more sophisticated than a measurement of weight and height.
As a medical research tool in larger studies, the fashion is now that scientists are using it to look for larger trends. And often, they regard BMI with “tunnel vision.” Instead of seeing it for what it is: a roughly measured estimate of overall health.
Here’s another problem with BMI. Even though it tells you if a person weighs more than other people of the same height, it doesn’t tell you why. Are those extra pounds fat or lean muscle? Did the extra weight come from a healthy diet containing nuts, low-fat dairy, whole grains, fruits, vegetables, and omega 3–rich foods? Or did it come from junk food and “empty” calories?
Unfortunately our healthcare system doesn’t allow doctors and nurses the time they need to accurately measure what matters: Fitness levels—not weight! All it takes is an inexpensive, non-invasive and easy-to-use caliper. If only our healthcare providers knew how to use them…
A little extra weight can be healthy
Staying healthy and staying thin are not the same thing. The Aerobics Center Longitudinal Study recently made this clear. The study was huge—it looked at 14,000 men (average age 44 years) and followed them for more than 11 years. Higher fitness levels had far greater impact on death rates from heart diseases and from all causes than did lower weight. In fact, men who maintained their fitness level had a nearly one-third lower death rate. And if you stay fit, you’ll maintain healthy muscle mass. Which means you’ll have a little “extra” body weight.
But that doesn’t tell the whole story of why extra weight has benefits.
Body fat may protect you by affecting your body’s beneficial biochemicals and hormones. It certainly provides extra padding to protect organs from traumatic injuries—which can mean the difference between life and death. Plus, in times of illness, some caloric reserve may give you the nutritional support you need as you heal.
Are the statistics telling the truth?
Discussion of the health risks of obesity is everywhere. Does that make doctors more aggressive when treating overweight people? Are they more concerned about patient health or medical liability when a person is overweight? If so, that could skew the numbers.
Another possible area of confusion is age. One study showed that three years after invasive treatment for coronary heart disease, overweight or obese men had a lower risk for death than normal-weight or underweight men. But the obese patients were often younger than the slimmer patients. More and more young people are obese—and since younger age is associated with lower death rates, the two risk factors may be getting crossed up.
In all things, moderation
Is it possible that the health benefits of a few extra pounds can be explained away by any or all of these factors?
Or maybe the simple moderation associated with moderate overweight has something to do with it. Not so long ago, and for thousands of years before, it was considered healthy and desirable to have some meat on your bones. It was just common sense that being underweight was “sickly.”
And decades ago science proved that being underweight is associated with higher death rates—compared to the happy middle.
The evolution of society’s thoughts about “body image” has drastically altered what is considered a “normal” body weight, statistics aside.
Time and time again, common sense tells us what we need in order to be healthy and happy. It’s not some arbitrary formula. And it’s certainly not deprivation. It’s moderation.
Moderation in all things is the key to health and happiness. And happiness itself may be a key. Who can be happy while frozen in front of a mirror, obsessing about body image and pants size? Who can be happy when counting every calorie, day in and day out? Eating should be one of the most normative and enjoyable human behaviors. But we make it a struggle. Living in constant calorie- cutting mode not only isn’t fun—it isn’t healthy.