The idea that it might be possible to be overweight or obese but not at increased risk of heart disease, otherwise known as the "obesity paradox," has been challenged by a study of nearly 300,000 people published in in the European Heart Journal today (Friday).
This latest research shows that the risk of heart and blood vessel problems, such as heart attacks, strokes and high blood pressure, increases as body mass index (BMI) increases beyond a BMI of 22-23 kg/m2. Furthermore, the risk also increases steadily the more fat a person carries around their waist.
[...] Although it is already known that being overweight or obese increases a person's risk of CVD [cardiovascular disease], as well as other diseases such as cancer, there have also been studies that have suggested that, particularly in the elderly, being overweight or even obese might not have any effect on deaths from CVD or other causes, and may even be protective, especially if people maintain a reasonable level of fitness. This is known as the "obesity paradox."
However, the authors of the EHJ study say their results refute these previous, conflicting findings. "Any public misconception of a potential 'protective' effect of fat on heart and stroke risks should be challenged," said Dr Iliodromiti.
She continued: "This is the largest study that provides evidence against the obesity paradox in healthy people. It is possible that the story may be different for those with pre-existing disease because there is evidence that in cancer patients, for instance, being slightly overweight is associated with lower risk, especially as cancer and its treatments can lead to unhealthy weight loss.
[...] The researchers suggest that the previous confusion over the "obesity paradox" may be due to many factors that can confound results of studies. For instance, smoking changes the distribution of fat in the body, smokers may have lower weight as smoking depresses appetites and so BMI tends to be lower. Another reason could be that some people have existing but undiagnosed disease, which can often lower their weight but also makes them more likely to die prematurely.
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When the Manchester-based [UK Biobank (UKB), a huge research project probing the health and genetics of 500,000 British people,] enrolled its first volunteer 13 years ago, some critics wondered whether it would be a waste of time and money. But by now, any skepticism is long gone. "It's now clear that it has been a massive success—largely because the big data they have are being made widely available," says Oxford developmental neuropsychologist Dorothy Bishop, a participant. Other biobanks are bigger or collect equally detailed health data. But the UKB has both large numbers of participants and high-quality clinical information. It "allows us to do research on a scale that we've never been able to do before," says Peter Visscher, a quantitative geneticist at the University of Queensland in Brisbane, Australia.
The crucial ingredient, however, may be open access. Researchers around the world can freely delve into the UKB data and rapidly build on one another's work, resulting in unexpected dividends in diverse fields, such as human evolution. In a crowdsourcing spirit rare in the hypercompetitive world of biomedical research, groups even post tools for using the data without first seeking credit by publishing in a journal.
(Score: 2) by dltaylor on Sunday March 18 2018, @05:50AM (15 children)
It's right in the summary: 22-23 kg/m2
For taller people, it is biased against their height, since mass increases by a cube factor, rather than a square. Fit athletes, such as basketball, American football, and larger rugby players are all obese, regardless of their body fat percentage.
(Score: 3, Interesting) by Anonymous Coward on Sunday March 18 2018, @06:23AM (4 children)
(Score: 2) by FatPhil on Sunday March 18 2018, @10:24PM (1 child)
The stupid thing is that they could mostly solve it simply using a different exponent. I seem to remember 2.6 works pretty well, it maps what people perceive as "equally fat" onto moer equal values, but don't remember where I saw that.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 1, Informative) by Anonymous Coward on Sunday March 18 2018, @10:40PM
(Score: 2) by wisnoskij on Monday March 19 2018, @11:42AM (1 child)
No. The study is actually specifically saying that no individual who has high BMI does not also have high CVD.
(Score: 0) by Anonymous Coward on Monday March 19 2018, @01:23PM
Are we reading the same article? Please read the actual study itself [oup.com], and tell me exactly where it makes such a ridiculously strong assertion that you almost never see in scientific papers, which generally deal in statistical arguments. Just from the abstract they say the following:
(Emphasis added). Funny, it seems to say exactly the opposite thing! They then go on to say that BMI is susceptible to confounding factors due to co-morbidities.
(Score: 4, Informative) by MostCynical on Sunday March 18 2018, @06:38AM (1 child)
These days, it is just adult stomach measurement that matters
https://www.heartfoundation.org.au/your-heart/know-your-risks/healthy-weight/waist-measurement [heartfoundation.org.au]
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 2, Interesting) by Anonymous Coward on Sunday March 18 2018, @03:39PM
That's still not a terribly good measure as it doesn't account for frame size. The waist to hip ratio is somewhat better because it does allow for at least some scaling. It's still not great, but it's not always practical to get a skindex done along with the other measurements needed for a fully representative assessment.
Still, just measuring the waist alone is a huge step over the BMI that completely fails to distinguish any of this stuff on individuals.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @02:11PM (5 children)
This canard.
You're not a bodybuilder. You're not 7 feet tall. You're not a professional basketball, football, or rugby player.
But hey. Seeing as how most of the obese people I know are cisfemale, I guess I can only care so much what choices "superior beings" make with their bodies and what brain damaged thinking they use to justify it.
"Superior beings" my ass.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @03:16PM (4 children)
It's not a canard, the BMI was never intended for use on individual people. It's somewhat useful for what obesity does for the population at large and it's easier to calculate than other measures, but it fails miserably for individuals for multiple reasons.
It only takes your height and your weight into effect. Despite your ignorance, you don't need to be 7 feet tall or a professional body builder for this to fail on you. Having shoulders that are broader or narrower than the typical person are going to have the numbers not apply very well. Similarly, since this measure doesn't take into account the distribution of fat, you can have two different people who are the same height, same weight same BMI, but very different risk for obesity related illness.
What they're talking about in the article here is that on the population as a whole, there is little or no evidence to support the belief that being obese is healthy. At the individual level, there are better methods of assessing obesity than the BMI, but they're harder to use in statistical studies because they actually take other things into consideration. I've generally got a good waist to hip ratio, but my BMI is usually higher than it should be because I've got very broad shoulders and while the waist to hip ratio kind of takes that into account, the BMI makes no allowance for that at all making it seem like I need to lose more weight than I really do.
(Score: 0, Insightful) by Anonymous Coward on Sunday March 18 2018, @03:29PM (3 children)
No, what you're talking about is that you're a fat ass and you don't want to own up to it.
Lose some weight, fat ass. When you lose weight, your shoulders won't be so broad. Your fat is in more places on your body than your cookie dough gut. Being delusional and playing semantic games isn't making you any less fat and disgusting.
Your BMI doesn't say you're obese because of some fucking technicality. The healthy BMI range is wide enough for the vast majority of people. I say again, you aren't a professional athlete. Stop lying to yourself. Your BMI says you're obese because you're a fat ass and you need to lose weight.
You need to count calories. You don't even need to exercise. Just count calories, and eat less food. Get over your sugar addiction. You don't need that coffee in the morning that's half cream. You don't need a whole pizza for dinner. You won't starve if you start being more responsible about your consumption and your body. Maybe one day one of us will get through to you. On that day, you'll pull on a pair of size 4 jeans, and they'll fit you perfectly. We don't need your thanks. We just need you to lose some fucking weight.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @03:42PM (2 children)
The measure is not valid on individuals and was never intended to be used on individuals. You can insult me all you like, but it doesn't change the facts.
The only accurate way to know if somebody is obese is to measure their body composition. Anything else is going to be subject to false positives and false negatives. The most accurate readily available method is the skindex, it's kind of a pain, but it has a low error and gives a really good indication of whether or not a person is carrying excess fat.
(Score: -1, Troll) by Anonymous Coward on Sunday March 18 2018, @03:52PM (1 child)
You can be a fat ass all you want, but it doesn't change the facts. Stop rationalizing and stop stuffing your face. You wouldn't need all that mumbo-jumbo if you weren't a fat ass.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @04:59PM
What makes you think I'm fat? At least being fat is something that a person can do something about.
Being an ignoramus and an asshole tends to be rather permanent.
(Score: 2) by captain normal on Sunday March 18 2018, @06:06PM
Ah...the things we learn on SN. I just learned a new term for horse shit.
When life isn't going right, go left.
(Score: 2) by PartTimeZombie on Sunday March 18 2018, @10:51PM
I seem to remember that this bloke [wikipedia.org]was considered obese at the height of his rugby career, despite being the best player in the world at his position.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @06:24AM (21 children)
Stopped reading there. BMI is a bullshit measurement much like the "unemployment rate." It has no actual application in the real world but it sounds scientific and allows assholes to confuse morons, therefore it continues to be used.
According to BMI, this guy [wikipedia.org] is obese. 'nuff said.
(Score: 4, Touché) by Anonymous Coward on Sunday March 18 2018, @06:27AM (3 children)
Fatty detected.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @07:01AM (2 children)
If "fatty" means being able to see bullshit for what it is then I accept the compliment. On that note, you sound skinny. Underweight, even.
(Score: 1, Funny) by Anonymous Coward on Sunday March 18 2018, @07:14AM (1 child)
Nope. I'm legit fat and drunk as shit.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @03:55PM
Lose weight you fat ass. Start treating your body right instead of being a lard bucket.
(Score: 5, Insightful) by bradley13 on Sunday March 18 2018, @07:54AM (11 children)
It's funny, how people get all upset about BMI, and pick edge cases (usually body builders) to claim BMI is nonsense. For the average person, however, it isn't unreasonable at all, and gives a rough guideline. If you are a body builder, feel free to ignore it. Otherwise, ask yourself just why you are protesting so hard. Stand up straight, look down: can you see your belt buckle? No? Then maybe that high BMI means something after all...
Everyone is somebody else's weirdo.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @08:26AM (1 child)
I'm not wearing a belt on my swimmers, especially when I'm pregnant, you insensitive clod.
(Score: 1, Funny) by Anonymous Coward on Monday March 19 2018, @07:35AM
Doctor: Hmm, it looks like you are pregnant.
Patient: I'm not pregnant!
Doctor: I said, it looks like you are pregnant.
(Score: 2, Flamebait) by rondon on Sunday March 18 2018, @01:03PM (3 children)
It is not edge cases when half of an American high school football team (full of fit athletes, for the most part) would score as obese on your silly test. That is a large enough proportion to say the test is bogus, and not the complainers.
Edge cases should be the rare exception to the rule, not the, "well, if you perform any type of athletics or are short and stocky, you may fail this horribly imprecise and mathematically unsound test."
(Score: 2, Touché) by Anonymous Coward on Sunday March 18 2018, @01:34PM
> It is not edge cases when half of an American high school football team (full of fit athletes, for the most part) would score as obese on your silly test. That is a large enough proportion to say the test is bogus, and not the complainers.
Wow. A whole half of a group of 30-50 athletes out of 1000 students in a school? Terrible, just terrible. Why, that's almost two percent! If you added up all of the athletes, not only football, it may go all the way up to 5-10 percent! That gives only 90-95 percent of students for whom BMI might give somewhat relevant results -- this is obviously unacceptably low for a rough estimate and should be completely purged from existence.
(Score: 0, Troll) by Anonymous Coward on Sunday March 18 2018, @03:57PM (1 child)
You're not a football player. You're not an athlete. You're so fat it's making your reading comprehension shit. You are the vast majority of people that BMI provides guidance for. Your BMI isn't high because you spend an hour or two lifting weights every day. Maybe you should start lifting instead of stuffing your face and being a worthless virgin fatass.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @09:40PM
Hey! There's nothing wrong with being a virgin.
(Score: 5, Informative) by bzipitidoo on Sunday March 18 2018, @02:12PM (3 children)
There's abundant (no pun intended) reason to be upset. The medical community has really dropped the ball on this problem, and totally blamed the victims. It's all fat people's fault for not eating right and not exercising enough. Or it's your bad genes, which is a total copout. Then it's your ancestors' fault, or biology and nature's fault, or God's fault, that you're fat, and no one and nothing need accept any blame or responsibility.
This ignores how hard society has made it to eat right and exercise. Try to use a mode of transportation such as walking or bicycling. Walkways are so often unfinished, automobile drivers tend to resent the use of a street by anything human powered with its attendant slowness, and if that's not enough, cars are regarded as more than just transportation, they're also status symbols. People traveling on foot could mean that they have no car, and are the lowest status of all. Motorists might even roll down the window and spit on them as they drive past. And then there's food, and the efforts corporations have put into lying about the healthiness so they can keep on using the cheapest tasty ingredients, fat and sugar, plus salt, to great excess.
Then there's the matter of all the chemicals that could be interfering with our bodies, messing up the signaling the body uses to maintain weight at as close to an ideal level as possible. Stuff like bisphenol A, bisphenol S, phthalates, and our old buddy lead. Most fat people aren't deliberately stuffing themselves, they're eating because they feel hungry, and they feel hungry more than they should. But industries that use these chemicals have been all too proactive in suppressing inquiry into the matter.
Yet another interesting cause of obesity is artificial lighting.
(Score: 0, Insightful) by Anonymous Coward on Sunday March 18 2018, @04:09PM (1 child)
All that shit is more excuses. Your post started out promising, then you did a complete 180 and started making excuses for your fat ass. It's the fault of car drivers. It's the fault of nebulous "toxins." It's the fault of corporations. It's the fault of "chemicals." No. It's your fault you're a fat ass.
The only person who dropped the ball on your fat ass problem is your fat ass. Stop making excuses. Stop blaming everything except the person in the mirror. What do you expect your doctor to do when you don't follow his advice and just lose weight? He probably can't tell you bluntly that you're an unattractive lard ass. I'm telling you that you're a lard ass and you need to lose weight. Your extra weight isn't "insulation." You haven't just put on a few extra pounds for winter. It needs to come off, and you're the only person who can be that change.
(Score: 0) by Anonymous Coward on Monday March 19 2018, @03:20AM
Well you may not be obese but you have an even worse personality disorder. Sadly those are harder to change, but its your own fault anyway.
(Score: 2) by FatPhil on Monday March 19 2018, @11:16AM
Only in shithole countries.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Monday March 19 2018, @12:41PM
Barely, but that might be related to wearing by belt pretty tight, otherwise I can't hold up my size 32/32 jeans.
(Score: 1, Informative) by Anonymous Coward on Sunday March 18 2018, @11:12AM (2 children)
(Score: 0, Disagree) by Anonymous Coward on Sunday March 18 2018, @03:45PM (1 child)
No, the BMI was originally developed in the 19th century by Adolphe Quetelet
https://en.wikipedia.org/wiki/Body_mass_index#History [wikipedia.org]
Dr. Keys didn't even come along until over a hundred years later.
(Score: 0) by Anonymous Coward on Monday March 19 2018, @03:29AM
According to your own link:
(Emphasis added). Dr. Keys might not have invented BMI himself, but it was his analysis in 1972 that showed it to be useful as a population metric for obesity. And the study of the TFA is of course exactly the sort of population study Dr. Keys found that BMI was perfectly appropriate for. No, if you want to argue the results of the study you need to find some other objection to it than its use of BMI, which is 100% appropriate in the context.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @02:17PM
You're not a Tsunkatse competitor. You won't win against a liberated Borg drone. Stop this shit.
You are a fat slob is what you are.
According to you idiots, when I was 50 lbs overweight with a beer belly, I was "anorexic."
You are fat, and you should be ashamed.
(Score: 1, Informative) by Anonymous Coward on Sunday March 18 2018, @03:20PM
The BMI is completely valid when used on a population at large. The number of false positives is generally balanced against the false negatives.
Where it has issues is when it's used as a determiner for an individual's obesity as it fails to include things like muscle mass, frame size, proportion or physical fitness in any direct way. It's a perfectly fine measurement for using on the population at large, but it fails miserably and predictably when used on individuals. But, it's simple and relatively hard to get wrong and it's been around long enough that researchers can use it to compare against older studies to see if there's been any general trends going on.
If you're trying to figure out if you personally are obese, either measuring the body composition or just taking the hip to waist ratio is probably a better choice, but those are too complicated for use in large statistical analyses.
(Score: 0, Flamebait) by Anonymous Coward on Sunday March 18 2018, @12:55PM
Porkers gonna pork. Can't stop 'em.
Big fat ugly slobs.
Disgusting.
(Score: 2) by Techwolf on Sunday March 18 2018, @01:36PM (5 children)
Has anyone personally meet or seen any really old obese people? I mean folks well into there 70s and 80s and extremely fat.
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @03:20PM
Yes. They lived their whole lives being winded from taking two steps and getting by popping out babies. Then when old age comes, they have no career and end up in minimum wage jobs they can barely handle.
We need to stop funding that lifestyle.
(Score: 2) by captain normal on Sunday March 18 2018, @06:19PM (2 children)
Well our great orange leader is in his early 70s and is obviously quite rotund. Wonder what that means?
When life isn't going right, go left.
(Score: 2) by takyon on Sunday March 18 2018, @08:26PM
Fat helps you win in business and life, and helps you prevail over female Presidential candidates.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Monday March 19 2018, @07:40AM
It means he's not fat enough, but his end is closer than you can imagine. Statistically speaking, he's on borrowed time now. Nevertheless, he probably takes max dosage statins to keep his arteries open. Those drugs save lives, especially fat lives.
But the great orangutan is not morbidly obese, just a fat slob. Little rocket man is quite a bit fatter.
(Score: 2) by deimtee on Monday March 19 2018, @09:49AM
Plenty of them make it into their seventies. A few into their eighties. Anyone over ninety is probably skinny.
If you cough while drinking cheap red wine it really cleans out your sinuses.
(Score: 4, Insightful) by cocaine overdose on Sunday March 18 2018, @01:46PM (5 children)
I don't like fat people. Having been intimate friends with skinny people and fat people, of both poor and rich, I'll always take the skinny person. There is most often something very wrong with the mental processes of a fat person (less predictably than a skinny one), and my gut tells me to fear.
This isn't a troll by the way.
(Score: 0, Troll) by Anonymous Coward on Sunday March 18 2018, @02:46PM
Which fat slob modded you down? Have an insightful.
You're absolutely correct, especially about comorbidity of mental illness and obesity. I used to be overweight, too, though not so much that I had loose skin when I worked it off. Congratulations on getting healthy, btw. Obese is not healthy and cannot be healthy. While mental illness, stupidity, and obesity all seem to be related, it's a big 3-way chicken and egg problem. I've learned that obese people, in addition to being revolting.
Obese women at least seem to also be the dumbest bitches I've ever had the displeasure of needing to be around. Aren't there a few women on this board? When you're so fat you don't realize you're pregnant until the 3rd trimester, you have serious goddamned problems. I don't know if your fat makes you stupid or if your stupid makes you fat, and I don't really care. You keep popping out babies, and the female ones all become obese just like mommy and learn how to milk the welfare system while men with skills they could be contributing to society are starving and homeless because all our wealth goes to feeding and housing your useless, bottomless fucking appetite.
Your extra 200 lbs of body weight is why you can't find a decent boyfriend. It has nothing to do with "all men." Your fat overweight ass really is that unattractive. So I guess I should be thanking y'all, because thanks to your arrogance and stupidity, simply weighing 110-120 ish lbs is enough to turn heads.
You want to feel like "superior beings?" Think long and hard what having a 400 lbs body and being unable to walk more than a few steps without getting winded says about the state of your mind. If you treat your body like that, what else in your life have you completely let go? What else are you neglecting and abusing? What other urges are you unable to control? "Superior beings" my ass.
I refuse to feel bad about "omg ur cant git laid lolz" when maybe the problem is all you women are disgusting, revolting pigs.
(Score: 2, Touché) by Anonymous Coward on Sunday March 18 2018, @03:24PM (2 children)
So, let's get this straight. You were fat in the past, but now you are skinny. But still an asshole. Got it.
(Score: 1) by cocaine overdose on Sunday March 18 2018, @03:29PM
(Score: 0) by Anonymous Coward on Sunday March 18 2018, @03:33PM
That's right. Call it being an asshole if that's how you need to rationalize it to your fat ass. GP realized they had a problem and corrected it. Why can't you do that?
Nobody is forcing you to be a lard ass. Nobody is holding a gun to your head and forcing you to eat empty calories all day long. That's all on you. Stop making excuses. You have a problem. You have to admit it to yourself. Being in denial just makes you a dumb fat ass.
Quit rationalizing. Quit making excuses. Just lose some fucking weight.
(Score: 3, Interesting) by Reziac on Monday March 19 2018, @04:51AM
They're looking at the wrong end of the horse.
Check thyroid first, THEN look at BMI and cardiac. Because usually the root cause of both is low thyroid (half of all fatal cardiac events are found to have low T3 syndrome). Person who is fat because of low thyroid (which can both derive from and instigate bad eating habits -- the soyboy problem is real) is likely to develop cardiac issues due to its effects on protein and calcium metabolism. Fat person with good thyroid but heavy solely due to overeating probably won't have cardiac issues, and if they change their habits, can readily shed the weight. There is a lot of data on this, tho it can't really be ethically researched in the normal way of double-blind studies (you can't deliberately do something that's known to give test subjects heart disease).
And low thyroid also causes a variety of mental problems, notably depression, bipolar, memory issues, rage-fits, and eventually, dementia (due to loss of white matter in the brain). So, yeah, I too have noticed that fat people are more likely to have unpleasant mental issues, but it's not due to their weight per se; rather, it's a concurrent symptom of the root problem.
And there is no Alkibiades to come back and save us from ourselves.