FAT? SKINNY? NORMAL? APPARENTLY, NO EFFECT ON LONGEVITY.

Every so often, medical science announces something astounding.  Here is the latest.  It apparently does not matter if you're fat, skinny or normal, we all die at the same rate.  While this is a simplification of that article, this general thought is now probably closer to reality than the previous one, which says that being normal was by far the best weight. 

Most of my life I've noticed that extremely thin people tended to die early, while those who are far overweight, are more troubled by diabetes, heart problems and a range of other ailments,  so therefore must have a lower longevity.  Was I imagining things?  Not really, for everything I also read said about the same thing.

Health publications in the past indicated that your Body Mass Index (BMI) determined your life expectancy.  

• People live to be 100 and older by preventing chronic diseases.
• Those overweight have more of these ailments.
• The best way to avoid getting sick is to have a normal BMI.
• In a nutshell, life expectancy and disease-free healthspan are on average 7 years longer in women and 9 years longer in men who maintain stable healthy BMI throughout their adult lives.
• There was one exception.  For those over the age of 65, the 21-25 BMI should be increased to 26-29 BMI to minimize mortality risk.  The reason is that older people with more stored resources can better combat life-threatening illnesses.

Well, during the pandemic I changed my diet, eating mostly vegetables and proteins, to drop my weight from slightly overweight into the normal Body Mass Index range.  I was once 165 pounds at a height of 5'7".  It took me a couple of years to slim down to 152 pounds.  My BMI became a normal 24.  One other positive was that this 13 pound drop reduced knee pains.  But now that I am considerably over 65, I'm beginning wonder if I should raise my BMI to 25 or 26.

To calculate your BMI (in this American version), multiply your weight in pounds by 703, then divide by your height in inches, then finally divide that answer by your height in inches again.

The National Institutes of Health says:

If your BMI is higher than the normal range, you aren’t alone. A 2018 CDC survey found that over 42% of adults in the US are considered obese. But this trend comes with serious consequences. Studies show that a high BMI increases your risk of developing a number of diseases and serious health conditions. It also increases your risk of premature death.

As much as the above has held for all these years, there have been caveats.  For example:

In addition, and probably most importantly, BMI does not provide any direct information about metabolism. Research demonstrates that many people with a BMI >30 kg/m2 (which the CDC classifies as obese) can can also be metabolically healthy. Metabolically healthy obese individuals have lower risk and higher longevity potential across their lifespan than normal weight metabolically unhealthy individuals. Put another way, metabolic health matters more than weight when it comes to healthspan and lifespan.

BMI certainly isn’t perfect, as metabolic health is also clearly essential for assessing overall health and longevity. That said, BMI is superior to its “ideal body weight equation” predecessors. BMI is also less complicated (and less expensive) than measuring body composition, which requires specialized equipment, equations, and training. For most adults striving to extend healthspan and lifespan, BMI is an accessible way to assess health risk in relation to their body weight. This makes BMI a valuable tool for pursuing better health and longevity.  So it should not be a total surprise to read that:  A high BMI is not necessarily associated with a higher risk of death:

• 
  This new study just published in the journal PLOS One, found that a BMI in the overweight or obese range is NOT necessarily associated with a higher risk of death.
• BMI alone is NOT an accurate indicator of a person's health.
• This research assessed the relationship between BMI and the risk of death from any cause based on data from more than 550,000 U.S. adults over an overage of 9 years.
• THE RESULTS SHOWED NO SIGNIFICANT INCREASE IN THE RISK OF DEATH FOR THOSE 65 AND OLDER WITH BMIS BETWEEN 22.5 AND 34.9, and the same for younger adults between 22.5 and 27.4.
• A BMI of 25 and above is considered overweight, while 30 or above is obese.
• Only last month the American Medical Association adopted a new policy advising physicians to use additional measures to assess a patient's health, like waist circumference, fat distribution and genetic factors.
• In fact, it is appearing that waist circumference is a stronger indicator than BMI to predict longevity.
• Additionally, substance abuse, tobacco use and disordered eating leading to a leaner physique is not healthy.
• This might confuse you, but:

In a 2016 study, nearly half of the participants considered overweight and 29% of those considered obese were found to be metabolically healthy, while over 30% of people with weights considered “normal” were metabolically unhealthy.

• 
  To further befuddle you, one of the study researchers, Dr. Aayush Visaria of Rutgers, said people with normal BMIs may still be obese.
• Comparing older studies to the most recent, one weakness of this latest study was that only 27% of the participants had a BMI greater than 30, but today 42% of U.S. adults are obese.
• A second defect is that Whites were 85% of earlier studies, while this percentage has now dropped to 69%.
• Also keep in mind that the CDC has reported that people with BMIs of 25 or higher do face an increase risk of high blood pressure, Type 2 diabetes and several types of cancer.
• In other words, it might still be best to maintain a BMI of less than 25.
• Keep in mind that this study also said that participants with a BMI of 30 or more did face a higher mortality risk, and among younger adults, anything over 27.5 was associated with a nearly 20% greater risk of death.

So what is the bottom line?  Is it okay to be fat or thin?  Almost every study, even the new one, indicates that at any age, it's best to avoid the low and high end of the BMI scale.  For older people like me, we need some added resources in time of serious illness, so I should not be too skinny.  But I also need to avoid serious maladies, so obese is definitely not where I should be.  Further, I would imagine that 15 pounds of added weight would seriously increase knee pain when I walk.  So for me, not you, I can probably go up from 152 to 155 pounds, or slightly higher, thereby enjoying more snacks and food to enhance my lifestyle, while tolerating some added knee pain.

Now that I can eat more, I would like to someday soon go to Three Peacocks in Singapore:

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