The surprising combo that may save you from dying of heart disease

Up until not too long ago, being “pleasingly plump” was a sign of good health. Especially as you got older. And now, we have the science to back up that sensible, conventional wisdom  

In fact, a recent study found that having a higher body mass index (BMI)—along with one other key factor—seems to protect older men and women with cardiovascular disease from suffering an early death.  

But before we get into that study, let’s back up to discuss why it’s taken so long to acknowledge the protective benefits of carrying a little extra weight… 

The science behind the so-called obesity paradox 

Around 12 years ago, observant researchers noted that overweight—or even mildly obese—patients with chronic diseases, such as heart disease, fared better than their slimmer, or underweight, peers. 

Unfortunately, those observations were brushed aside—and researchers began referring to it as some kind of unexplainable anomaly, calling it the “obesity paradox.” 

(As you may recall, similar evidence shows that chronic disease rates among French men and women are about half of what they are in America. Even though, on average, the French drink more wine and alcohol, smoke more, and eat more fatty foods. For many years—instead of adjusting their theories to reality—mainstream researchers called that observation the “French Paradox.”) 

But in reality, BMI was never a good tool to use in gauging health 

In fact, when I first started as a researcher at the National Institutes of Health (NIH), I saw all these multi-milliondollar research studies rely on BMI as an indicator of health. 

Yet, over time, we learned that: 

  • More than half of people considered overweight according to BMI have a healthy cardiometabolic profile, including normal blood pressure, cholesterol, and blood sugar levels. 
  • About a quarter of people with a so-called normal BMI have an unhealthy cardiometabolic profile. 

At the end of the day, BMI is just an empty statistical manipulation (weight divided by height, raised to an exponential power). And it really doesn’t mean all that much. 

Plus, there are much better and more accurate ways of predicting a person’s mortality risk (not to mention assessing body composition). And that point brings me back to the study I mentioned at the beginning of this Dispatch

Men and women with a higher BMI have consistently better outcomes

The recent study published in the American Journal of Medicine involved more than 2,000 people, 60 years or older, with heart disease, who were admitted to the hospital between 2006 and 2018. 

Before heading home from the hospital, the men and women had their BMI and gait speed (how fast they walk) measured. Based upon those measurements, the researchers categorized the patients into groups and followed them over the next two years.

It turns out, fast walkers with a higher BMI had a lower death rate and a “consistently favorable prognosis” compared to slow walkers with a higher BMI. And remember, mortality rate is the one outcome to which we should pay the most attention, as statisticians can’t manipulate it. (Either a person dies, or they don’t.) 

Of course, it’s important to recognize that these outcomes again suggest your gait is the single, strongest predictor of mortality. NOT how much you weigh…or your BMI…especially as you get older.

And, on the contrarysome extra body weight actually seems to protectolder men and women with heart disease from an early death—as long as they continue to preserve normal gait.

That’s great news! And it confirms my long-standing, common-sense approach to healthy aging, which includes:

1.) Staying active. Aim to get just 140 to 150 minutes of light-to-moderate exercise weekly. Science shows this weekly total is the optimal amount for warding off chronic disease and improving longevity. 

Specifically, suggest focusing on activities that improve your core and balance, such as casual walks in Nature, gardening, hiking, swimmingand yoga. (Remember, exercising on natural terrain challenges your core muscles and your balance—helping you maintain a strong, steady gait as you age.) 

2.) Supplementing daily with 250 mcg (10,000 IU) of vitamin D. If there were just one nutritional supplement you could take, vitamin D would be the one I would recommend, as science shows it protects you against just about every chronic disease in the book. It can even help protect you against respiratory infections, such as the coronavirus. (I’ll tell you more about that impressive benefit on Thursday.)

3.) Following a Mediterranean-type diet. A wealth of science shows that following a Mediterranean-type diet helps support your overall health and longevity. Plus, when you follow this balanced, wholesome diet, you take in loads of protein and essential fatty acids, which your body needs to maintain muscle mass and support heart health—especially as you get older.  

Here’s a quick reminder of what you can enjoy in this traditional diet: 

  • Full-fat, whole-milk dairy, including butter, eggs, cheeses, and yogurt. (Remember, in the Mediterranean, they eat cheese or yogurt at each and every meal. But health experts typically overlook that point because it doesn’t fit their “anti–fat” narrative.)  
  • Wild-caught fish and grass-fed and -finished, free-range meat, especially lamb, which has the best nutritional profile of all meats. 
  • Nuts and seeds.  
  • Five servings of fruits and vegetables each day.  
  • Alcohol in moderation.  

Of course, there are many more safe, effective, and natural approaches to protecting your heart and improving your lifespan as you age, which you can find in my Heart Attack Prevention and Repair Protocol. To learn more about this comprehensive online learning tool, or to enroll today, click here now! 

In the end, there is no “obesity paradox.” If you’re older and being hectored about some extra body weight—but you still have normal gait—just walk away…and keep walking. 


“Impact of Gait Speed on the Obesity Paradox in Older Patients With Cardiovascular Disease.” Am J Med, 2019 Dec;132(12):1458-1465.e1. 

“How useful is the body mass index (BMI)?” Harvard Health Blog, 3/30/16. (