Earlier this year it was shown that people who had a body mass index (BMI) of between 25 and 30 actually lived longer than those who had a “healthy” BMI of between 20 and 25. Naturally those who profit from promoting an obesity crisis ridiculed this. Fortunately others have delved deeper to find out more.
The notion of “healthy obesity” seems a contradiction in terms and it is certainly the case that at some point excess weight is a health problem. However we do not know where that point is and it may indeed be different for different people. It certainly is not a BMI of 25.
New work is focusing on metabolic health.
This includes what is going on with our metabolism, our hormones, inflammation within the body and most intriguingly the bacteria in our guts.
What is starting to emerge is that obesity is a symptom of metabolic dysfunction rather then the cause of it. It was also shown clearly this year that excess consumption of refined carbohydrates (sugars) NOT obesity was the leading contributor to type two diabetes.
Indeed the promotion of low fat diets, which are generally high in sugar, has been a major factor in the twin problems of increased obesity and increased diabetes.
Inflammation is useful if we cut ourselves or have a virus. Blood flows to the area and proteins are released. Al this helps the body heal the wound or fight the virus.
So we want our bodies not to be inflamed on a long-term basis. This slow inflammation is the leading contributor to heart disease, strokes, many forms of cancer and degenerative conditions.
In a similar way, the fight or flight response, served our ancestors well in dealing with physical threats but is less helpful for threats that do not have a physical solution. Being in long term “fight or flight” keeps our stress hormones at higher levels. This inhibits fat burning and is, as you might be guessing,pro–inflammatory.
As we stand today the exact path to good metabolic health is not completely clear. However we have enough pointers to know what to do. It is the basics of regular exercise, eating a diet that is low in processed foods and high in real food. It includes, maintaining good hydration, getting enough sleep and managing our stress.
When we do not get enough sleep we tend to eat more sugary foods and our bodies are more “inflamed”. Our hormones are also affected. And the effects of stress we saw above.
The other fascinating part is the role of gut bacteria. We know that there are ten times as many bacterial cells in the human gut than there are human cells in the human body. The roles they play are only just starting to be understood.
Obviously they have a crucial role in digestion. They also have been shown to influence inflammatory markers and influence metabolism. Again this is via an effect on hormones and metabolism.
In simplest terms, we can forget BMI as the sole arbiter of health – it is not. It is a pointer and can be used as a tool to monitor progress. However calls about crises based on BMI are meaningless.
We also do not need to wait for the whole mystery to be unraveled to take steps now to reduce inflammation in the body and improve our metabolic health.
It is the basics of regular exercise, eating a diet, which is low in processed foods and high in real food. It includes, maintaining good hydration, getting enough sleep and managing our stress.
When we do not get enough sleep we tend to eat more sugary foods and our bodies are more “inflamed”. Our hormones are also affected. And the effects of stress we saw above. In addition to this we need to maintain good gut health and have adequate good bacteria.
The most fascinating bit is that all these points are connected. This means you can get into a virtuous cycle whereby each change you make helps spur another.
And for doctors, it is time we stopped promoting pills as the only solution. Genuine changes in lifestyle is what really improves health.