2

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Hack this article: Obese people can be metabolically healthy

Answered on September 12, 2014
Created September 21, 2012 at 4:34 PM

Do we need another excuse for people to have crappy diets?

http://www.labspaces.net/123694/Obese_people_can_be_metabolically_healthy_and_in_good_shape

Prof. Ortega et al. observed in their study that between 30-40% of obese patients were metabolically healthy. "We made two findings: firstly, metabolically-healthy obese people exhibited better cardiorespiratory fitness ???or aerobic fitness-. Secondly, this subgroup has a lower mortality risk rate for heart disease or cancer than other obese people, and has the same mortality risk than people of normal weight."

"This study concludes that, regardless of body weight and fat, people with better aerobic fitness have a lower risk for heart or cancer disease and death", Dr. Ortega states.

What is this article not telling us?

Medium avatar

(10611)

on September 22, 2012
at 02:53 PM

Unless overeating is considered a metabolic derangement....but that would make everyone deranged....crazy enough world as it is and now we're all bozos on this bus....

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on September 22, 2012
at 02:32 PM

Excess adipose tissue necessarily implies metabolic problems? Weight gain is always a derangement of metabolism? I don't think that's necessarily true.

D7f404b29047b12e2c2f528934b7b80b

(133)

on September 22, 2012
at 06:50 AM

Right, you can be fat and healthy but why take the chance that you might be the fat unhealthy person? All we can do is try to be as healthy as possible and with that usually comes weightloss. I think thats why most thin people get stamped as being "healthy" with no regards to their metabolic health.

Medium avatar

(10611)

on September 21, 2012
at 07:14 PM

To start with, what was wrong with the 60-70% in the other group?. I was reasonably fit but had terrible blood work so I was in that group. My dr. wouldn't sign a release for me to join a gym because of his potential liability.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 21, 2012
at 05:35 PM

I found Primal Blueprint in December of 2011. This is long after college and after the asthma symptoms.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 21, 2012
at 05:34 PM

I had childhood asthma that disappeared when I was 13. When I was a freshman in college I got injured and had to sit out for a year, during my sophomore year (19, still recovering from injury) I developed pneumonia which caused me to have a bout of asthmatic bronchitis. This triggered my childhood asthma. I then suffered from asthma until I was 26 when I met a doctor who had a new treatment for asthma. That cured me of my asthma, and I have been symptom free for 4 years.

Cebbca9a78d5612bf3468b273c2010d5

(452)

on September 21, 2012
at 05:21 PM

That was a honestly a great answer. Except one thing. I would just like you to clarify the first sentence: You were a college track athlete and THEN you got sick and got childhood asthma? I am not understanding the "childhood" part, since it seems like you got asthma while in college? And did you find the Primal Blueprint after you had left the college track days, or was your coach able to witness the difference?

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7 Answers

5
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 21, 2012
at 04:54 PM

In college I was a track athlete, after getting a nasty injury my freshman year, followed by a series of sicknesses that triggered childhood asthma, I went from 165 lbs to 265 lbs in about six years. Then I decided to get back into shape, I had a doctor who helped cure my asthma, and I dropped 75 lbs in about five months. And got stuck.

That was me, the healthy obese. 5'9" and bouncing between 190 lbs and 200 lbs. I was eating "healthy" according to SAD. I could run 50+ miles per week, and I aced every test the doctors could throw at me. I was considered healthy, just -- obese.

And that's where I stood. Until a very injury laden 2011 which, in turn, caused me to top the scales at 217... Something had to change. I was healthy, low inflammation, low cholesterol, high V02Max, etc. But I knew this was not right. After finding the Primal Blueprint in December 2011, I dropped weight fast. I am now 165 lbs and actually healthy.

What those tests don't show you are things like:

I couldn't fall to sleep - I tossed and turned for hours every night. Now I go up to bed and am asleep within minutes

I couldn't evacuate my bowels. I know, gross. But eating high fiber, "healthy" whole wheat I couldn't go. I would sit there and push and push and nothing. Now I sit and out it goes, almost no wiping needed!

I couldn't wake up in the morning. Tied into troubles falling asleep, I probably had problems staying asleep. I was always tired, always struggling to get out of bed. Now I wake up before 6am without an alarm clock.

I couldn't miss a meal. I was like clock work, missed meal and I was cranky. Now I eat when I am hungry and I am hungry when I am ACTUALLY hungry not just when my body feel like it should eat.

I would wake up everyday with back pain, and told to deal with it, because people have chronic pain. Now there's no pain (well at the moment there's pain due to a herniated dics but you know what I mean). It's amazing to me every morning how little pain I have day-to-day.

I could go on, but I hope you get the point. The "healthy" tests are a baseline for a mediocre level of day-to-day life. Not tests to determine true health and happiness.

Cebbca9a78d5612bf3468b273c2010d5

(452)

on September 21, 2012
at 05:21 PM

That was a honestly a great answer. Except one thing. I would just like you to clarify the first sentence: You were a college track athlete and THEN you got sick and got childhood asthma? I am not understanding the "childhood" part, since it seems like you got asthma while in college? And did you find the Primal Blueprint after you had left the college track days, or was your coach able to witness the difference?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 21, 2012
at 05:35 PM

I found Primal Blueprint in December of 2011. This is long after college and after the asthma symptoms.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 21, 2012
at 05:34 PM

I had childhood asthma that disappeared when I was 13. When I was a freshman in college I got injured and had to sit out for a year, during my sophomore year (19, still recovering from injury) I developed pneumonia which caused me to have a bout of asthmatic bronchitis. This triggered my childhood asthma. I then suffered from asthma until I was 26 when I met a doctor who had a new treatment for asthma. That cured me of my asthma, and I have been symptom free for 4 years.

3
Cc3ce03985eac5ebcbb95fc2329f13b0

on September 21, 2012
at 08:13 PM

Why are you assuming that they have crappy diets? You can't assume, regardless of what a person weighs, that you know anything about how they eat based SOLELY on their size. Using the BMI as a standard, many high caliber athletes are considered overweight and obese.

2
510bdda8988ed0d4b0ec0b738b4edb73

(20888)

on September 21, 2012
at 04:59 PM

Well I wouldn't correlate "cardiorespatory fitness" with "metabolic health". To me those are two different things.

I can see the possibility of an obese person still having good cardiorespatory fitness but I think the definition of obese implies metabolic problems.

Medium avatar

(10611)

on September 22, 2012
at 02:53 PM

Unless overeating is considered a metabolic derangement....but that would make everyone deranged....crazy enough world as it is and now we're all bozos on this bus....

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on September 22, 2012
at 02:32 PM

Excess adipose tissue necessarily implies metabolic problems? Weight gain is always a derangement of metabolism? I don't think that's necessarily true.

2
96440612cf0fcf366bf5ad8f776fca84

(19463)

on September 21, 2012
at 04:45 PM

See: Sumo Wrestlers. :)

Yes, you can be overweight, or obese and be healthy. I'm not so sure about metabolically healthy, but it is possible.

There is of course the usual thing of if you eat more sugar than your body can handle, the repeated insulin spikes will cause you to store as much of it as possible into fat to prevent the onslaught of glucose from damaging blood vessels, nerves, eyes, etc. After all, brains and muscles act as a glucose sponge.

The question remains, at what point will you be unable to do beta oxidation and have other health issues.

1
77877f762c40637911396daa19b53094

(78467)

on September 22, 2012
at 05:10 AM

Some people can tolerate significant amount of adipose mass without pathological consequences. Does this mean they would be less healthy if they were leaner? Very likely not. But it does mean, that for them, the need to get to a leaner body mass composition is not as urgent as for a person who is diagnosed with metabolic syndrome.

The corollary is extremely lean people who would be considered unhealthy. There will always be statistical outliers not consistent with the majority of the population. The question is why?

As always, there is no "one size fits all approach". Genetics, epigenetics and enterogenetics play a major role.

In respect to the study by Ortega, it is very likely that by adjusting his sample population according to geno/epigeno/enterogeno-type that a clearer relationship would have been established. At this point his study introduces a confusing and, for some, dangerous precedent.

D7f404b29047b12e2c2f528934b7b80b

(133)

on September 22, 2012
at 06:50 AM

Right, you can be fat and healthy but why take the chance that you might be the fat unhealthy person? All we can do is try to be as healthy as possible and with that usually comes weightloss. I think thats why most thin people get stamped as being "healthy" with no regards to their metabolic health.

1
77877f762c40637911396daa19b53094

(78467)

on September 21, 2012
at 08:27 PM

By definition being Obese is to be metabolically damaged. So what if the person's fat mass is protecting their organs from excess? So what if their heart is, for now, healthy? It won't last and they will suffer from other health issues.

The example of Sumo was given...go google "Sumo Health" and you will find all sorts of things about degenerative joint issues etc...

A healthy heart isn't much good if you can't get out of the way of a car that doesn't see you...unless you are an organ donor.

1
26e2364f7966432bbf8acfe930583674

(460)

on September 21, 2012
at 06:47 PM

The authors stacked the deck, picking their groups based upon bodyfat and biomarkers. The ???metabolically healthy and obese??? had metabolic syndrome risk factors similar to the ???metabolically healthy and normal fat??? group, whereas the ???metabolically abnormal and obese??? had metabolic syndrome risk factors that were vastly different from the other groups. The criteria used to define ???metabolically healthy??? were based on a government task force joint report discussing the risks for metabolic syndrome (see link at bottom), and are likely quite - even among us ??? agreed upon predictors of CVD, cancer and all-cause mortality. The criteria are: waist circumference, blood pressure, HDL level, and fasting blood glucose level.

I would make the theoretical argument that ???fitness??? as assessed by the authors is a proxy for good health practices more generally (think of the ???healthy user effect??? that leads us to over-estimate the efficacy of the flu vaccine as those who get it on average have better health and health practices), but is non-linearly related to the metabolic syndrome risks measured while being related to health outcomes such that it attenuates the hazard ratios such that the ???metabolically healthy and normal fat??? and ???metabolically healthy and obese??? groups hazard ratios approximate one another.

If the measure of ???fitness??? were to operate as the authors discussion dictates, then we observe the ???metabolically healthy and normal fat??? group to have hazard ratios on the order of 30% lower than the ???metabolically healthy and obese??? group and 40% lower than the ???metabolically abnormal and obese??? group, we would also observe the ???metabolically healthy and obese??? group to have a hazard ratio that was only 10% lower than that of the ???metabolically abnormal and obese??? group. This is not observed in the data, what is observed is that level of fitness is has a much larger effect on the morbidity and mortality of the ???metabolically healthy??? groups than it does on the ???metabolically abnormal??? group.

I think the take-home from the article is this: biomarkers for metabolic syndrome are the best criteria from which to predict morbidity and mortality, ???fitness??? helps, but is far more efficacious when your more basic health is in order. But that won???t get you published in the European Heart Journal.

http://circ.ahajournals.org/content/120/16/1640.full.pdf

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