Scientists Now Think That Being Fat Can Protect Your Health

[haidut]

Finally, the "obesity paradox" is becoming mainstream knowledge. The most plausible explanation is that as per another study I posted, overweight and mildly obese people tend to have higher metabolic rate then lean ones. A second plausible explanation is that, as the article itself points out, overweight and obese people actively avoid doctors and use less pharma drugs.

http://qz.com/550527/obesity-paradox-sc ... ur-health/

"...Since then, dozens of studies have confirmed the existence of the paradox. Being overweight is now believed to help protect patients with an increasingly long list of medical problems, including pneumonia, burns, stroke, cancer, hypertension, and heart disease. Researchers who have tried to show that the paradox is based on faulty data or reasoning have largely come up short. And while scientists do not yet agree on what the paradox means for health, most accept the evidence behind it. “It’s been shown consistently enough in different disease states,” says Gregg Fonarow, a cardiology researcher at the University of California, Los Angeles."

"...This seems questionable: studies show that overweight and obese people tend to avoid doctors, get fewer preventive screenings, and receive worse treatment because they’re often misdiagnosed as “fat” rather than with a specific medical condition."

 

[michael94]

You go to the doctor with heart health problems, they prescribe you a statin and tell you to eat chicken breast and avoid sat fat like the plague.

 

[tara]

Some proportion of lean people (not all) achieve/maintain leanness by under-eating. Under-eating means energy deprivation. Energy deficit is probably a key component of many degenerative health issues.
Also, severe health events/injuries can require a lot of extra energy to recover, and sometimes these events also interfere with eating/digestion/appetite too. So people with some extra stored energy reserves may sometimes benefit from that, too. Not saying always, but maybe often enough to count.

Anecdotal, and therefore trivial evidence-wise, but I know an elder who broke a leg a while ago. Considered to be 'overweight'. Lost a lot of weight (both fat and lean) over the first month of recovery. If there hadn't been some fat reserves, I guess even more of it would have come from lean tissue.

 

[Jake]

The researchers are presumably using BMI for their analysis here. What criteria was used to establish the BMI ranges? And if BMI itself is a flawed concept, does the paradox go away? (I do agree that generally there is an unfair perception that overweight automatically means less healthy)

 

[Westside PUFAs]

"Scientists now think being fat can protect your health"

"Scientists" think a lot of things. Just ask Ray Peat about his professors.

How is having metabolic syndrome healthy? How is the estrogenic effect and toxic cytokines from adipose tissue healthy? These are things I explore.

What is interesting about the article you posted Haidut is that they first mention a guy named Glenn Gaesser who wrote a book about it, "Big Fat Lies." He made a video responding to Dr. Oz and then Dr. Oz invited him on his show in 2011:

https://www.youtube.com/watch?v=5Q-sHS27PZU

I'm trying to find the clip of him on the actual show. I remember watching it in 2011 and thinking "F this guy, he's an idiot, he should read Gary Taubes and Weston Price!" But now 4 years later, I'm the opposite of that, well almost opposite.

So I'm intrigued by Gaesser's options on body fat because he's not fat himself and he promotes a HCLF starchy diet so I'll see what his arguments are. But he sure is odd by being a lean guy and promoting a fat free starchy diet. I like that in that video he says that french fries are not just "carbs" but they are fat as well. I like when people acknowledge that point because most ignore the fat content of "carbs."

 

[Westside PUFAs]

From one of the studies they cite:

"Conclusions and Relevance Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons."

http://jama.jamanetwork.com/article.asp ... D=1555137&

Showing that there is a limit. So should that limit be the starting point of calling it obese? I think some people in grade 1 just get lucky. That doesn't prove that the fat is protective, it just shows they got lucky or are just currently lucky because there are many who are in grade one who do have problems. It's a subject that has to be directly studied on the body fat itself and then you just have to take peoples word for what their lifestyle was/is like.

 

[Westside PUFAs]

Someone from the comments section debunks this study:

"I love it, she went with BMI alone and didn't separate out the terminally ill or the extremely fit . So, on the side of "low weight makes you die young" she included patients emaciated by cancer and any other horrific disease you can think of, as well as terminal heroin and meth addicts; and on the side of "being slightly overweight makes you live a little longer" she included nearly all Olympic, professional, and dedicated amateur athletes, and exercise hobbyists (whose BMIs generally score 28-29+ due to the large quantities of healthy dense muscle tissue required by their occupation/hobby). It would appear that she has intentionally overlooked a couple of major confounding factors in pursuit of getting widespread attention and name recognition."

http://www.npr.org/sections/health-shot ... ive-longer

 

[haidut]

post 110424 Someone from the comments section debunks this study:

"I love it, she went with BMI alone and didn't separate out the terminally ill or the extremely fit . So, on the side of "low weight makes you die young" she included patients emaciated by cancer and any other horrific disease you can think of, as well as terminal heroin and meth addicts; and on the side of "being slightly overweight makes you live a little longer" she included nearly all Olympic, professional, and dedicated amateur athletes, and exercise hobbyists (whose BMIs generally score 28-29+ due to the large quantities of healthy dense muscle tissue required by their occupation/hobby). It would appear that she has intentionally overlooked a couple of major confounding factors in pursuit of getting widespread attention and name recognition."

http://www.npr.org/sections/health-shot ... ive-longer

I think you guys are missing the fact that her article refers to multiple studies that have confirmed the link in various conditions like heart failure and sepsis and those studies did control for the healthy people with high BMI or chronically ill with low BMI. Also, the issue is not so much whether being fat is good for you from the point of view of preventive effectiveness as it is about survivability benefits in people with already established conditions.
The rule of thumb is this. It is best to be lean IF this is your natural disposition - i.e. you have high metabolism without exercise or stimulants like ephedrine, clenbuterol. It is a high REE that is protective, not raising metabolism forcefully through methods that lead to adaptive downregulation of metabolism when done long term. If metabolism is low for whatever reason, then it is probably less dangerous being overweight as long as you are not morbidly obese. Being fat and trying to get lean through exercise is probably not a good idea unless it is concentric exercise with weights.
Just my 2c.

 

[brandonk]

post 110424 Someone from the comments section debunks this study:

"I love it, she went with BMI alone and didn't separate out the terminally ill or the extremely fit . So, on the side of "low weight makes you die young" she included patients emaciated by cancer and any other horrific disease you can think of, as well as terminal heroin and meth addicts; and on the side of "being slightly overweight makes you live a little longer" she included nearly all Olympic, professional, and dedicated amateur athletes, and exercise hobbyists (whose BMIs generally score 28-29+ due to the large quantities of healthy dense muscle tissue required by their occupation/hobby). It would appear that she has intentionally overlooked a couple of major confounding factors in pursuit of getting widespread attention and name recognition."

http://www.npr.org/sections/health-shot ... ive-longer

Fat tissue comes in two kinds, adipose that is just under the skin, and mesentary that is a hidden layer around the intestines and adjoining organs. Mesentary fat was only discovered when surgeons noticed it in the 1920s and is by now well-known to be very deadly.

Surgeons today almost always find mesentary fat during surgery on people of all body types. Adipose fat around the belly is amost always correlated with mesentary fat around the intestines.

 

[tara]

post 110434 Fat tissue comes in two kinds, adipose that is just under the skin, and mesentary that is a hidden layer around the intestines and adjoining organs. Mesentary fat was only discovered when surgeons noticed it in the 1920s and is by now well-known to be very deadly.

Surgeons today almost always find mesentary fat during surgery on people of all body types. Adipose fat around the belly is amost always correlated with mesentary fat around the intestines.

I thought the fat around the vital internal organs tended to be highly saturated, while the subcutaneous adipose tends to more unsaturated? Peat repeatedly makes the point that the unstaturated fats cause more trouble when they are released into circulation.
Has a causal link been established, or just a correlation, between mesentary fat and mortality? My understanding was that some kinds of stress tend to encourage more abdominal fat. Possibly the same kinds of stresses as tend to mess with metabolism in other ways, and therefore also increase mortality?

One example is people recovering from anorexia, etc. When they begin eating enough they tend to first lay down fat round the vital organs. This provides much needed insulation and reserve fuel, and is generally a step towards improving health and life-expectancy. Eventually, if they continue to eat enough, this often redistributes itself over the rest of the body. But if the research didn't control for a history of inadequate nutrition (includin calories), you could mistakenly concude that the abdominal fat was dangerous. Whereas actually, it was the previous starvation that was dangerous, and the fat may be part of a protective mechanism.

 

[tara]

post 110426 Also, the issue is not so much whether being fat is good for you from the point of view of preventive effectiveness as it is about survivability benefits in people with already established conditions.
The rule of thumb is this. It is best to be lean IF this is your natural disposition - i.e. you have high metabolism without exercise or stimulants like ephedrine, clenbuterol. It is a high REE that is protective, not raising metabolism forcefully through methods that lead to adaptive downregulation of metabolism when done long term.

This makes sense to me.

(There may also be a smaller subset of people who are fatter even when they are in optimal high-metabolic health. Just like there is a small set of people whose natural height is taller that most.)

 

[tara]

post 110408 The researchers are presumably using BMI for their analysis here. What criteria was used to establish the BMI ranges? And if BMI itself is a flawed concept, does the paradox go away? (I do agree that generally there is an unfair perception that overweight automatically means less healthy)

BMI itself, as originally devised, was a statistical way to describe a population. It did not start out with any prescriptive meaning. The labels and the exact ranges have been added later, and recent lowering of the range limits has apparently had significant (predominant) input from members of the weight-loss and dieting industries.

To me there is something nonsensical (flawed) in calling the range that contains the minimum in the BMI mortality curve 'overweight'. At least as a measure of health.

It makes perfect sense, though, as part of a marketing strategy to make most people think they are overweight and should do whatever it takes to get (or stay) thin, including buying their products. And blame themselves when it doesn't work. And come back for more.

 

[brandonk]

post 110447 anorexia, etc. When they begin eating enough they tend to first lay down fat round the vital organs

One study claimed that small amounts of visceral fat are deposited when refeeding after anorexia. http://www.ncbi.nlm.nih.gov/pubmed/15941877

There's no basis in that study to support any claim that this visceral fat is healthy or protective. One could speculate the visceral fat during the refeeding is more likely an inflammatory response to the high cortisol and estrogen levels in a recovering anorexic (perhaps avoidable if the anorexics were refed with a no-starch ketone-rich diet). Over the course of a year, assuming recovery, the body begins to deposit fat in a more distributed way.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762154/

Yes, visceral fat obesity is known now as syndrome X (or the deadly quartet) and it is a syndrome with multiple risk factors for atherosclerosis such as glucose intolerance, hyperlipidemia and hypertension.

http://onlinelibrary.wiley.com/doi/10.1 ... 0462.x/pdf
http://onlinelibrary.wiley.com/doi/10.1 ... 0481.x/pdf

 

[tara]

@ brandonk
It may not be proven one way or the other whether that visceral fat itself is more protective than not. There are probably mechanisms by which it can be both helpful and not at the same time, and it might be hard to distinguish. It does provide insulation, and since maintaining core temps is important, and it is more difficult while either severely underweight or with a reduced metabolism (either or both of which are usual in anorexia).

However, whether the fat itself does more good than harm, it seems to be a normal consequence of refeeding /recovery from anorexia. Refeeding in this context definitely improves mortality. So whether the fat itself is a mechanism for that improvement may be moot, since mortality is likely to be worse if you don't acquire it (at least temporarily). Once recovery is well underway, general metabolism is likely to improve, and make maintaining body temperature easier. I don't know if this is part of the reason for the later redistribution, but it might be.

I think it is a mistake to conflate markers or risk factors with proven mechanisms. You know, fire alarms are a risk factor for fires. Or high cholesterol is a risk factor for CVD. Or grey hair correlates with increased mortality. The association doesn't prove the causal relationship.

 

[brandonk]

I think it is a mistake to conflate markers or risk factors with proven mechanisms.

That's fine. I was just answering your question with what the authors of the study conclude, that visceral fat syndrome is itself a clinical entity, based on their own experiments, and the literature they survey.

These findings support the identification of visceral
fat syndrome as a clinical entity characterized as a multiple
risk factor syndrome in which visceral fat accumulation,
glucose intolerance, hyperlipidemia, and hypertension
cluster to predispose to the development of atherosclerosis.
This syndrome is similar to and may be a refinement of
syndrome X or the deadly quartet.

 

[cantstoppeating]

Good to know that being fat isn't healthy: it's a symptom of a poor metabolism.

In this context, if we frame being fat as "protective" we'd also have to frame adrenaline as "protective" because both are compensatory results of a poor metabolism.

What's becoming clear is that being fat isn't a required step on the way to Peating, most of the self-professed health bloggers/people claiming that getting fat is part of the "recovery" process have nothing behind it in the same way there's nothing behind to the notion of a "green tea and grape fruit" detox.

When people arrive to Peating and begin to smash carbs, getting fat isn't a part of recovery, or a protective mechanism, it's a consequence of having poor insulin sensitivity and poorly functioning liver after years of low carb, pufa etc and all the consequences of disregulated HPA axis (high cortisol, adrenaline etc).

 

[XPlus]

I think there are many different cases to consider when drawing a conclusion about this.

In theory, people who quickly burn the PUFA before it's stored are likely to be healthiest and the leanest.
In reality, those people come from good health backgrounds. Their food preferences steer away from PUFA for the most part and include things like milk, sugary foods and good sources of protein like meat.

Some other people, in theory, have dietary fat (i.e. PUFA) deposited in tissues causing obesity as a long-term result.
Their slowed metabolic rate could be thought of as protective in that PUFA FFAs aren't constantly wreaking havoc on their system. The metabolic rate is slowed but is not frighteningly too low. It just can't keep up with their feeding habits.
In reality, those people might initially come from good to OK health backgrounds. They look healthy, have nice hair, clear skin, vibrant personalities. Their food choices likely compromise of a lot of starch, some protein, moderate PUFA and sugar.
Their most concern probably comes from the size and weight of fat deposits that might impair their mobility and appearance.

Then you've got those lean people with a lot of health issues.
They're likely to come from backgrounds of poor or slightly poor health. Their metabolism might be in good shape but they don't eat enough and eat the wrong kinds of food. There's a constant tendency to store PUFA and release it at times of hunger, aggravating their health problems even further.
Those are probably the people who'd have no breakfast and go for a donuts midday and then piece of fried food for dinner. Eventually, their metabolism slows down.
Lean people with diabetes - for example - could fit nicely in this category.

Fat people, who come from ill backgrounds: contraceptive pills, baby formulas, cheap food choices usually develop affinity for starch and PUFA as well as other junk like imitation food . Their metabolic rate runs very low for the most part of their life.
Their already weak system cannot keep up with their terrible food choices and environmental stressors for too long, so they develop serious health problems early in life.

The list could go on.
Take that slightly healthy fat fella and put them on a popular diet and exercise programme. Then you have a completely different case scenario.

 

[YuraCZ]

post 110426

post 110424 Someone from the comments section debunks this study:

"I love it, she went with BMI alone and didn't separate out the terminally ill or the extremely fit . So, on the side of "low weight makes you die young" she included patients emaciated by cancer and any other horrific disease you can think of, as well as terminal heroin and meth addicts; and on the side of "being slightly overweight makes you live a little longer" she included nearly all Olympic, professional, and dedicated amateur athletes, and exercise hobbyists (whose BMIs generally score 28-29+ due to the large quantities of healthy dense muscle tissue required by their occupation/hobby). It would appear that she has intentionally overlooked a couple of major confounding factors in pursuit of getting widespread attention and name recognition."

http://www.npr.org/sections/health-shot ... ive-longer

I think you guys are missing the fact that her article refers to multiple studies that have confirmed the link in various conditions like heart failure and sepsis and those studies did control for the healthy people with high BMI or chronically ill with low BMI. Also, the issue is not so much whether being fat is good for you from the point of view of preventive effectiveness as it is about survivability benefits in people with already established conditions.
The rule of thumb is this. It is best to be lean IF this is your natural disposition - i.e. you have high metabolism without exercise or stimulants like ephedrine, clenbuterol. It is a high REE that is protective, not raising metabolism forcefully through methods that lead to adaptive downregulation of metabolism when done long term. If metabolism is low for whatever reason, then it is probably less dangerous being overweight as long as you are not morbidly obese. Being fat and trying to get lean through exercise is probably not a good idea unless it is concentric exercise with weights.
Just my 2c.

Isn't this exactly Peat approach? Always push and push metabolism with sugar, stimulants(coffee) with synthetic hormones etc. ?? I'm really confused right now haidut.

 

[Tarmander]

This is an interesting issue. As someone who used to be skinny, and then gained weight later on by choice (going off the veggies and meat and onto the carbs and calories), I can say definitively that I feel more healthy, can do more, and am generally happier then when I was skinny. So reading an article like this, I can definitely empathize.

I think this topic does "rub" people though. From my observation the general belief out there is that being fat is your fault. Just reading reddit, and other places that are about health, many people talk about weight profile as something within control if a person just has the willpower to change it. So when articles like this come out, people may feel triggered because it almost seems to be validating other people's "laziness."

Like Tara said, it is probably a complex issue where correlation and causation get mixed up. Just saying that visceral fat is bad for you, is probably too simplistic. That all important word context probably matters the most. In my own case, gaining weight was fantastic, and my life has improved immeasurably. However, if I was really healthy, and naturally skinny, setting out with the goal that I should gain some belly fat to get healthy is probably misguided.

 

[halken]

post 111218

post 110426

post 110424 Someone from the comments section debunks this study:

"I love it, she went with BMI alone and didn't separate out the terminally ill or the extremely fit . So, on the side of "low weight makes you die young" she included patients emaciated by cancer and any other horrific disease you can think of, as well as terminal heroin and meth addicts; and on the side of "being slightly overweight makes you live a little longer" she included nearly all Olympic, professional, and dedicated amateur athletes, and exercise hobbyists (whose BMIs generally score 28-29+ due to the large quantities of healthy dense muscle tissue required by their occupation/hobby). It would appear that she has intentionally overlooked a couple of major confounding factors in pursuit of getting widespread attention and name recognition."

http://www.npr.org/sections/health-shot ... ive-longer

I think you guys are missing the fact that her article refers to multiple studies that have confirmed the link in various conditions like heart failure and sepsis and those studies did control for the healthy people with high BMI or chronically ill with low BMI. Also, the issue is not so much whether being fat is good for you from the point of view of preventive effectiveness as it is about survivability benefits in people with already established conditions.
The rule of thumb is this. It is best to be lean IF this is your natural disposition - i.e. you have high metabolism without exercise or stimulants like ephedrine, clenbuterol. It is a high REE that is protective, not raising metabolism forcefully through methods that lead to adaptive downregulation of metabolism when done long term. If metabolism is low for whatever reason, then it is probably less dangerous being overweight as long as you are not morbidly obese. Being fat and trying to get lean through exercise is probably not a good idea unless it is concentric exercise with weights.
Just my 2c.

Isn't this exactly Peat approach? Always push and push metabolism with sugar, stimulants(coffee) with synthetic hormones etc. ?? I'm really confused right now haidut.