More evidence that it's healther to be "overweight"

Buried in the NY Times , because they don’t want to give people bad ideas by putting it on the front page, is the news than in a study of Canadians, people who were overweight, that’s BMI between 25 and 30, lived longer. There’s a 17% lower risk of dying compared to “normal” people:

“Overweight may not be the problem we thought it was,” said Dr. David H. Feeny, a senior investigator at Kaiser Permanente Center for Health Research in Portland, Ore., and one of the authors of the study. “Overweight was protective.”

…

The study took into account smoking status, physical activity, age, gender and alcohol consumption. It included a separate analysis excluding those who died early in the 12-year period, in order to weed out participants who might have been thin because they were smokers or had an underlying disease, like cancer.

Meanwhile, on the other side of the Pacific ocean, a study in Japan finds the exact same thing:

Health experts have long warned of the risk of obesity, but a new Japanese study warns that being very skinny is even more dangerous, and that slightly chubby people live longer.

People who are a little overweight at age 40 live six to seven years longer than very thin people, whose average life expectancy was shorter by some five years than that of obese people, the study found.

"We found skinny people run the highest risk," said Shinichi Kuriyama, an associate professor at Tohoku University's Graduate School of Medicine who worked on the long-term study of middle-aged and elderly people.

I previously blogged about an American study which showed the same thing, that being “overweight” leads to longer life expectancy.

The evidence in favor of “overweight” being healthier is compelling. Not only is this consistent across three separate countries, I would expect the confounding factors to pull in the opposite direction. This is because higher social class people live longer, and higher social class people, because of their higher future time orientation, will do whatever the consensus opinion considers to be healthy, and the consensus opinion considers thin to be healthy. Paul Fussell in the book Class noted that proles are heavier than the middle class and the upper middle class.

It’s too bad that men and women are lumped together, because men, on average, have higher BMI than women, so a man with a BMI of 30 isn’t exactly comparable to a women with a BMI of 30.

The studies also don’t say if muscle weight is healthier or unhealthier than fat weight. Before you people jump up and down and say “Ooh! Ooh! Muscle weight is healthier!” let me point out that Asians have the longest life expectancy and blacks the shortest life expectancy, but blacks have the most muscle and Asians have the least muscle. Bulked up professional football players have a notoriously low life expectancy. Humans didn’t evolve to be super-muscular for a reason.

When will doctors start recommending that their thin patients go to McDonalds and eat some Big Macs? If they don't, it will be because these studies violate the belief that Puritanism has to be good for you.

Comments

[sabril]

"If they don't, it will be because these studies violate the belief that Puritanism has to be good for you. "

It's also possible that it's another cause and effect issue. e.g. there's something about people who naturally gain weight which also serves to help their health in other ways. Or there's something about naturally thin people which damages their health.

Anecdotally, it seems to me that of the naturally thin men I know, a large percentage are balding. So perhaps testosterone is helping to keep them thin but harming them in other ways. For such a guy, I doubt it will help him to go out and chow down in hopes of gaining weight.

[dearieme]

I'd be interested to know on what evidence the classification into "underweight", "normal", "overweight and "obese" was originally made. Call me a cynic, but I'd guess that it was made on bugger all evidence.

[HS: It was obviously based on multiples of 5, 25 and 30. I'm not sure why underweight was set at 18.5 rather than 20.]

[mnjohn]

Yea but being thin is more attractive which matters more than health silly. Take a look at a Alessandra Ambrosio versus your run of the mill prole girl.

http://www.hollywoodrag.com/images/celebrity/alessandra_01.jpg

http://www.flickr.com/photos/shaxxon/201916890/

aesthetics definitely matter more.

[Niklas Blanchard]

Here is an interesting article about muscularity and life expectancy, in an evolutionary biology context:

http://www.newscientist.com/article/dn17244-hunks-get-more-sex-but-theres-a-price-to-pay.html

[Gannon]

Being excessively thin is not probably not a cause, but rather a sympton of not having a perfect health. I like my girls with a 22 BMI.
On the other hand, what classifies as an overweight range, the 26-30 BMI is probably in reality normal, specialy for men. BMI definitively does overstate the weight of tall men, but is probably pretty accurate for women for small and medium height. This is just like cholesterol: don't worry too much if it's around 250 if you are a white guy, but start worrying if it's above 280. For cholesterol just like BMI the normal ranges are too strict.

[C_Q]

I have not read the articles referenced in the post, however, I will comment that BMI is a somewhat flawed means of assessing body composition, especially for athletic people.

BMI is calculated from a person's weight and height. I just used an online BMI calculator and it informed me, based on these measurements, that I fall into the "overweight" category.

However, I know from a recent test at my gym that my body fat stands at less than 15%. This number would place me in the "fitness" category (overweight starting at 26% body fat).

All this is to say, that if these studies are using BMI as the only criterion for determining whether or not a person is overweight, than it would seem they are including both pudgy people and athletic people in the same group.

With that in mind here's my wild guess:

I suspect that people with a mesomorphic body type (above-avg. muscle, low body fat)would be healthiest, and live longer than ectomorphs(low body fat, low muscle) and endomorphs (high body fat, low muscle). Mesomorphic is also the body type that is likely to be misidentified as "overweight" by a BMI calculation.

Also, I'd guess massive bodybuilders probably have shortened lifespans due to steroid use and other extreme stresses they regularly place on their bodies. It will be interesting to see how much longer Arnold will be around--he's in his 60s now.

[DaveinHackensack]

"Yea but being thin is more attractive which matters more than health silly. Take a look at a Alessandra Ambrosio versus your run of the mill prole girl."

Different strokes for different folks. I happen to think it's not attractive when a girl's ribs are showing, but you and I may differ on that. It's also worth remembering that artists, at various points in time, have elevated different female looks. During the Renaissance, who would wanted to paint this Ambrosio woman? In the modern era, different female looks have been promoted as well. Check out the female leads in silent films from the early 20th Century, for example.

BTW, not to be picayune, but it's spelled "yeah".

[Gil]

You might as well be arguing that life expectancy is 50% genetic. Plenty of people seem to make it to the average whilst engaging in all the 'wrong' activities. However, when it comes to muscles and life expentancy it's hard to tell how much steroids are involved as few would admit to it. But since most can't get ripped without steroids or similar substances maybe muscles aren't that bad at all (if done naturally).

[CC01]

"It’s too bad that men and women are lumped together, because men, on average, have higher BMI than women" (HS)

Are you sure about this? I'm pretty sure its the other way around: Women tend to have higher BMIs.

[Joshua Holmes]

More classic mile-wide-inch-deep "analysis" from Siggy.

***Before you people jump up and down and say “Ooh! Ooh! Muscle weight is healthier!” let me point out that Asians have the longest life expectancy and blacks the shortest life expectancy, but blacks have the most muscle and Asians have the least muscle.***

The likelihood of dying violently in your youth is much higher for blacks than for East Asians. Being murdered in your teens by a drug gang or rebel group skews the numbers. I don't see scores of muscular black men dropping over dead in their 50s.

***Bulked up professional football players have a notoriously low life expectancy.***

I'm sure several thousand violent collisions have absolutely nothing to do with that. Christ you're an idiot.

[Peter]

"***Bulked up professional football players have a notoriously low life expectancy.***

I'm sure several thousand violent collisions have absolutely nothing to do with that. Christ you're an idiot."

Many former athletes, former football players in particular, are notorious for porking up something wicked once their playing days are over. Many of them are just plain fat.

As for size and health, the most important measurement is not BMI but (for men, at least) waist size. Ideally a man's waist should not exceed the lesser of (a) one-half his height or (b) 35 inches. Under no circumstances whatsoever should it exceed 39 inches. Having a big waist measurement is just asking for a premature dirt nap.

[CK]

1. The problem is that we are a culture of runners. Running long distances is not healthy, and this is exactly how people in this country keep "in shape". How many of those underweight people are runners?

2. Lifting weight tends to be much healthier, and lifters tend to bulk up, thus weighting more.

I'd be interested in a study made not based on BMI, but rather based on body fat %.

[Linda]

You might be right Sigma. I certainly don't take anything the medical community claims at face value. And Michael Jackson's sad death certainly wasn't because he was overweight. According to his mug shot stats he was 5'11" and 120 lbs.

[AllanF]

On HS's repeated mentions of it I read Class back around Christmas. It was pretty good. What I found most interesting were the aspects in which the book has become dated. After Fussell picks apart the various classes and their naked status striving he notes a class above it all: the Bohemian. It is interesting that these 30 years later the middle class, in an effort to show they are above vulgar status striving, have adopted all the previous markers of, and then created a status hierarchy upon the Bohemian style originally described by Fussell. Today the look is immediately recognized as Bo-bo, or more recently SWPL, and we deride their thinkly veiled status hoaring. But the irony of its source is, one has to admit, delightful.

[Gil]

Not to mention who wants to live to advanced old age anyway? Very few people are particular active and nimble-minded over 70 years of age. Alpha males habitt allow them to 'get out while the going's good'.

[dearieme]

"The problem is that we are a culture of runners." I'm old enough to remember when Americans had a culture of not taking much exercise at all - and they were, on average, slimmer then.

[Silas]

Half-Sigma,

The real issue here is that over 30% of Americans are obese. Obesity (not overweight) is the number one contributor to chronic disease in adults.

So, great. Overweight isn't as bad as we thought. But this is kind of a red herring. We still have a huge obesity problem in this country.

Also, your assertion that Asians live longer than blacks, therefore muscle weight isn't necessarily healthier than fat weight is pretty absurd. There are a ton of reasons why blacks in this country have lower life expectancy which are completely unrelated to muscle mass.

Silas

[Silas]

I'd be interested to know on what evidence the classification into "underweight", "normal", "overweight and "obese" was originally made. Call me a cynic, but I'd guess that it was made on bugger all evidence.

[HS: It was obviously based on multiples of 5, 25 and 30. I'm not sure why underweight was set at 18.5 rather than 20.]

There's no conspiracy here. On the BMI scale, <18.5 (sometimes <19) is underweight, 18.51-24.99 is normal weight, 25.01-29.99 is overweight, etc.

Silas

[Peter]

"The problem is that we are a culture of runners. Running long distances is not healthy, and this is exactly how people in this country keep "in shape". How many of those underweight people are runners?"

I don't know ... while some people compete in marathons and 5K's and other road races, it's my impression that casual, recreational-type running is definitely on the decline. It's now a rather uncommon sight to see people out jogging. Especially people older than 30 or 35. The explosive growth of cartball has pretty much crowded out all other forms of physical exertion.

[Peter A]

"Running long distances is not healthy"

And how did you come to that conclusion? And what are you calling "long distance"? There's plenty of evidence that running 5-10 miles a day is very good for you - and was what the human body was designed to do.

[Capital R. Rob]

You guys can make all the excuses you want, but the only reason the "overweight" designation seems low these days is that so many Americans are fat and don't get enough exercise. Put a group of Americans next to their peers from 30 years ago, and you'll see just how flabby and unatractive they are.

The Japan study compared health in thin people to normal people. Using it to rationalize driving down to Applebees is just silly. People who are in shape make more money and have more friends. It's at least as important as IQ, and it's completely within an individual's power to change.

"Weight gain among Americans is more uniform than one might expect on the basis of cross-sectional differences in the prevalence of obesity among subpopulations. Our findings confirm previous studies1–3 showing that average BMI is always higher for lower-education, lower-income groups and for non-Hispanic Blacks. However, our study also shows that, for the past decade and even longer, average weight gain has not varied by educational level, although a college degree was a protective factor. Few differences exist in average weight gain between lowest- and highest-income individuals after control for other characteristics, although heavier individuals (80th percentile of BMI) in the lowest-income group gain more weight than do heavier individuals in the highest-income group."
-
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1449404

[dearieme]

"There's no conspiracy here. On the BMI scale, <18.5 (sometimes <19) is underweight, 18.51-24.99 is normal weight, 25.01-29.99 is overweight, etc."

But what is the evidence that such-and-such is "normal", such and such "overweight"? Clearly an objective measure like longevity wasn't used - so what was?

[kurt9]

These studies are meaningless. As long as the medical industry insists on using BMI rather than body fat percentage, I regard any studies about weight as meaningless.

[JohnM]

From the article:
"Being overweight won’t kill you — it may even help you live longer. That’s the latest from a study that analyzed data on 11,326 Canadian adults, ages 25 and older, who were followed over a 12-year period."

I think the conclusion depends upon how many of the 11k were 70+.
Once you get passed 70-75, being thin doesn't help because if you get cancer you'll live longer if you have a fat reserve.

This might not be the case for middle aged folks where too much fat tends to promote heart problems and cancers and such.

But if the study has lots of thin old people who die before fatter old people, that might skew the data.

[X]

"The study took into account smoking status, physical activity, age, gender and alcohol consumption. "

What about PRESCRIPTION PILLS? Did the study take into account the types of medication the overweight people were on. Because if your arteries are clogged and your blood pressure is high, and your sugar is out of whack, you will die soon.

I'm not impressed if the study did not take this into account, as a LOT of overweight people are undoubtedly on some important prescription.

[kurt9]

As I said before, the BMI is meaningless. The only legitimate measurement of fatness is body fat percentage. As long as these studies are based on BMI, they are worthless.

Stop commenting on worthless studies.

[Peter]

"What about PRESCRIPTION PILLS? Did the study take into account the types of medication the overweight people were on. Because if your arteries are clogged and your blood pressure is high, and your sugar is out of whack, you will die soon.
I'm not impressed if the study did not take this into account, as a LOT of overweight people are undoubtedly on some important prescription."

I wouldn't imagine that many people who are merely in the overweight BMI category would be suffering from all these medical complication unless caused by reasons unrelated to weight. You're really looking at the obese category.

[X]

"I wouldn't imagine that many people who are merely in the overweight BMI category would be suffering from all these medical complication unless caused by reasons unrelated to weight. You're really looking at the obese category."

Overweight people tend to have the common medical conditions (although normal weight people have these as well) like Hypertension, Diabetes, Hyperlipidemia*. Not surprising given that the reason they are overweight in the first place is often related to their lifestyle. Now when it is discovered that they have these conditions they are usually given prescriptions to help with the problem. I would imagine that the prescriptions would have a preventative effect on serious outcomes of those basic conditions, like heart attacks, renal failure, strokes, etc.

What if the skinny person goes to the doctor less, and therefore is not screened as often for these basic conditions (skinny - males especially - can be afflicted with some of these conditions without obvious signs). They thus would have less of the preventative effect of some of the meds, and this might skew the study.

*at the very least their being overweight is clustered with these other conditions = METABOLIC SYNDROME

http://www.americanheart.org/presenter.jhtml?identifier=4756

[icr]

"The problem is that we are a culture of runners." "I'm old enough to remember when Americans had a culture of not taking much exercise at all - and they were, on average, slimmer then."

Yes, in those days('50's and early '60's) there were probably not much more than a handful of gyms in the whole country, if you did any weightlifting people would tend to assume you were a narcissist of suspect sexuality and an activity like backpacking would be considered outlandish and bizarre.

[Alex Birch]

This is more attention seeking imo; HS draws conclusions he knows are dead wrong from data on the survival rates of the overweight. Maybe longer life expectancy doesn't equal better health, omg?

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[JohnM]

Um, sure about that?
according to a meta-analysis taken in 2009 "In both sexes, mortality was lowest at about 22·5—25 kg/m2"
Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies
http://www.lancet.com/journals/lancet/article/PIIS0140-6736(09)60318-4/fulltext

Study also shows that, though about half of overweight people who are overweight have no metabolic side-effects, about half do.