~ From the Annals of Internal Medicine
Many health experts will tell you that being skinny is not necessarily healthy. Lending support to that argument, a new study finds that the thinnest people, similar to those who have the most body fat, have higher rates of death.
Unlike many previous studies, the researchers did not rely on BMI — which is a measure of weight that includes both fat and muscle — as a proxy for fat.
A small subset of the individuals in the study had both excess fat and low BMI because of inadequate muscle. “That’s a double whammy in terms of adverse effects on health,” Leslie said.
Overall the study found that the best survival was among individuals who had a BMI that put them in the overweight category and who were middle of the road in terms of total body fat.
The finding agrees with the so-called obesity paradox, said Dr. Carl Lavie, medical director of cardiac rehabilitation and prevention at the John Ochsner Heart & Vascular Institute in New Orleans, who was not involved in the research. The paradox, which has been described by previous studies, is that middle-aged and older adults who are overweight or even moderately obese have lower death rates than those in the normal weight range.
According to the study, the battle of the bulge is not the only war that should be waged. While doctors should still advise patients who have a very high BMI and high body fat to lose weight, they may also want to stress to underweight (“undermuscled”) patients the importance of maintaining fitness, Lavie said.
Getting regular exercise could also be important for individuals like the ones in the current study who are at risk of osteoporosis.
The study involved primarily white adults in Canada. It is possible that the relationship between BMI, body fat and mortality could be different in other populations, such as black and Hispanic people, although Lavie suspects that the same trends would exist.
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