7 ms·

This paper provides a helpful breakdown of types of mortalities and how they're associated with BMI. It's interesting to see that the lowest All-cause mortality

• hooverd 2y ago
  My guess: less cells mean less cancer, but it's good to have reserves if you're fighting off a virus?
  • ethagknight 2y ago
    More likely relates to diet. There was a recent WashU study directly linking high fructose diets to increased cancer. Cancer cells are vigorously growing, needs lots of available fuel, a diet full of corn syrup fuels both fat and cancer.
    • JumpCrisscross 2y ago
      > a diet full of corn syrup fuels both fat and cancer Or sugar. Or modern fruits. The problem with HFCS isn't that it's got fructose (so does cane sugar) or is made from corn, it's that it's cheap sugar.
      • enaaem 2y ago
        How much fruit do you have to eat before it becomes harmful? I can imagine juice can easily be over consumed but solid fruit is very satiating.
        • BobaFloutist 2y ago
          >solid fruit is very satiating. Very briefly.
        • JumpCrisscross 2y ago
          > How much fruit do you have to eat before it becomes harmful? Unclear. The aforementioned study fed mice sugar water [1], and cautions against extending its findings to fruit as "natural fructose obtained from plants typically confers metabolic benefits due to its slower absorption rate and the presence of beneficial plant fiber and antioxidants." It does mention, however, that "human physiology...confronts challenges when metabolizing fructose beyond 25g/day." That's like a cup of grapes, a medium pear or half a mango [2]. [1] https://www.ijbs.com/v20p3480.pdf https://www.ijbs.com/v20p3480.pdf [2] https://www.webmd.com/diet/ss/slideshow-fruit-sugar https://www.webmd.com/diet/ss/slideshow-fruit-sugar
          • deleted 2y ago
            [deleted]
        • hollerith 2y ago
          I've stopped eating fruit (and carrots, which have fruit-like levels of sugar) with the exception of tart (i.e., less sugary) cherries out of a desire to limit my fructose intake. I was eating raspberries, too, which are much lower in sugar than most fruit, but stopped because of their high levels of oxalic acid, but I do expect to restart raspberries in a few years because I expect my ability to tolerate oxalic acid in my diet to improve slowly over the next few years. (In contrast, high-fructose foods including most fruit are probably gone for good.) Of course, I'm not asserting that everyone should do as I am doing. There is substantial variation between individuals here.
      • homero 2y ago
        It's funny all the modern fruit I see is bigger but dry and not sweet at all
    • pengaru 2y ago
      AIUI cancer cells are also metabolically inflexible; they like glucose, not ketones.
      • voisin 2y ago
        Good evidence for this found here: “Tripping over the Truth: The Metabolic Theory of Cancer”[0] [0] https://www.goodreads.com/book/show/23496164 https://www.goodreads.com/book/show/23496164
      • JumpCrisscross 2y ago
        > AIUI cancer cells are also metabolically inflexible; they like glucose, not ketones Is there a selection effect at play? As in, a person with high serum glucose levels will tend to have cancer that likes glucose? That would imply the solution isn't ketones per se, but changing the fuel from whatever the cancer grew up with.
        • pengaru 2y ago
          iirc the talk I learned this from said there's simply not many cancer variants that don't need abundant glucose to grow tumors. That the whole defect stems from hijacking the energy side to fuel uncontrolled growth, and it needs glucose.
      • circlefavshape 2y ago
        I know someone who tried to use keto to manage her bowel cancer, and died. Used to know rather than know I guess
        • ifwinterco 2y ago
          Yeah I see this take all the time and it's dangerous, it might have an element of truth but it's definitely dangerously simplistic. You can find advocates of low fat high carb diets also claiming that very low fat intakes improve cancer survivability. I'm sorry for your loss
          • 2y ago
  • moduspol 2y ago
    Perhaps people getting cancer treatments tend to lose a lot of weight before dying?
    • strict9 2y ago
      Another possibility is that unexplained and unintended weight loss is associated with increased risk for many types of cancers.
• Izkata 2y ago
  Yet another showing "overweight but not obese" might not actually be bad, and this post's title is wrong? ("Overweight" is the BMI range 25 - 30, "obese" is 30+)
  • gklitz 2y ago
    Being overweight increases the risk of developing quality of life reducing conditions and that is bad (it’s not being overweight itself that is bad). This is the case even if it doesn’t lead directly to dying. I would be careful about pushing the narrative that being overweight but not obese is just fine just because it won’t significantly increase your chance of straight up dying. Type 2 diabetes is a treatable condition so might not lead to a significant increase in deaths, but not exactly something you would want to develop if you can avoid it. And your chance of developing just that does increase if you are overweight even if you are not obese.
    • Izkata 2y ago
      I'd like to emphasize the "might not": The impression I get from all these studies (I've seen them pop up pretty regularly for as long as I've been paying attention, nearly two decades) is that the border is actually wrong, that going from "normal" to "overweight" should be increased slightly from 25 to 27 or so. We're probably getting mixed signals in the "overweight" classification because "okay" and "bad" levels are being combined.
• wjnc 2y ago
  The focus on kg/m2 (BMI) I cannot understand. Surely the lowly “body fat percentage” should be a better variable than kg/m2? Bodies are three dimensional you know!
  • coldpie 2y ago
    It is much easier to measure, and is a good enough proxy for the vast majority of people.
    • deleted 2y ago
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    • bumby 2y ago
      To quantify, I've heard MDs say that the outliers (relatively high BMI but low body fat) constitute less than 1% of high BMI people. They also said that those outliers are still at risk of certain health troubles, like sleep apnea. The suggestion of using BMI + waist circumference is an easier to measure risk factor than bodyfat percentage and helps to better capture those outliers.
  • mannykannot 2y ago
    I imagine the missing spatial dimensions are correlated with weight, for any given height.
  • swatcoder 2y ago
    BMI is trivial to measure conclusively, using tools that are almost universally available and ready. And at population scale, it's proven to be a strong and pretty signal for analyzing in studies like these as the ways in which BMI can fail for individuals is too uncommon for it to matter to population studies. It's a perfect tool to use for studies like these, as it can contribute understanding society-level concerns about the obesity epidemic and what impact we can expect it to have if it continues not to be tackled. But like with almost all medical and nutritional research, drawing conclusions for yourself as an individual based on these population-scale studies is inevitably fraught. In the case of BMI studies, you can often get a fair sense of whether you should be concerned or not, but do need to take into account other things that you know about your lifestyle and health. Your doctor, presumably, does exactly that. Meanwhile, body fat percentage tends to be very hard to measure accurately in the first place and has different techniques that tend to have different error characteristics, making it hard to correlate it between studies done through different clinics, let alone against someone's personal assessment at home or with their personal doctor/trainer/whatever. It probably has high relevance to some medical and nutritional outcomes, but isn't a very useful input variable for research because its inescapably noisy.
• thr3000 2y ago
  This particular statistic has a ton of problems. It's impossible to disassociate the various causative pathways that land you at a BMI below 25. A ton of them involve diseases and chronic conditions. Unfortunately, it's very hard to impossible to RCT this. And if a study has no RCT, take it with as much salt as your diet allows. You definitely don't want to intentionally gain weight on the basis of this. If weight control is easy for you, I would personally strive for a lower BMI. If losing weight below 25 is hard for you and your body just seems to refuse to do it, then you might be OK at 25.
  • 0xffff2 2y ago
    What's RCT?
    • tptacek 2y ago
      Randomized controlled trial.
    • Cumpiler69 2y ago
      Roller Coaster Tycoon
  • pessimizer 2y ago
    > This particular statistic has a ton of problems. It's impossible to disassociate the various causative pathways that land you at a BMI below 25. A ton of them involve diseases and chronic conditions. I'd beware of using this sort of hand-waving to ignore the studies, there are also effects pushing the relationship between average health outcomes and BMI in the other direction. Your ethnic origin seems to be very important, and for ethnicities who already have a high propensity for Type 2 diabetes, higher BMI is a factor, but not a huge one. > Strikingly, in those with a normal weight, the prevalence of diabetes was 5.0% in whites, 10.1% in Asians and American Indians/Alaskan Natives, 13.0% in Hispanics, 13.5% in Blacks, and 18.0% in Hawaiians/Pacific Islanders. > Furthermore, when they examined the relative risks for diabetes for each BMI category by race/ethnicity, Zhu et al. reported that across all racial/ethnic groups whites had the steepest BMI gradient, followed by Asians, American Indians/Alaskan Natives, Hispanics, Hawaiians/Pacific Islanders, and blacks. https://diabetesjournals.org/care/article/42/12/2164/36251/Diabetes-in-Normal-Weight-Individuals-High https://diabetesjournals.org/care/article/42/12/2164/36251/D... Another potential distortion comes out of this when you consider that black and Hispanic people are the fattest in the US. Blacks and Hispanics can have lower lifespans for reasons other than BMI, such as access to health care, high-quality food, exposure to violence, physical jobs, etc... So just these two factors complicate the picture in general (your fattest have the least access to health care and most exposure to danger and neglect), and and in the other direction specifically for white people (an increase of BMI in white people makes a huge difference in their incidence of diabetes.) Anecdotally, I'm black, and there's a lot of thin diabetes in my family. My dad usually runs about 20-21 BMI, and is pre-diabetic. His mother, who is also small, though not quite as small, is also diabetic. As far as I can tell, the fatter people in both sides of my family are no more likely to be diabetic than the thinner ones.
• patorjk 2y ago
  This kind of stat is misleading and is seen in many health metrics - blood pressure, cholesterol, etc. In fact, it's sometimes known as the "cholesterol paradox" because people with higher cholesterol have a lower risk of dying. However, it's misleading because blood pressure, weight, and cholesterol often come down as people suffer from chronic disease or malnutrition. The chronic diseases people get are often from their weight, blood pressure and cholesterol, and when this is corrected for, the all-cause mortality curves better reflect what a healthy person's numbers should be. So in reality the lowest point of the all-cause mortality curve for BMI is below 25. 25 is not optimal. Dr. Carvalho recently made a video on this topic (he even mentions the BMI curve). You can watch it here: https://www.youtube.com/watch?v=n4h135SBebc https://www.youtube.com/watch?v=n4h135SBebc
  • apwell23 2y ago
    Thats interesting because I am healthy in other ways but my cholestrol has been high ( high ldl, total and high apob) . My trigs, a1c, bmi, homa insulin score ect are in line. No history of heart disease in either side of family. My cardiologist has been asking me to get on statins for a while but i've been not able to convince myself to get on board to take a pill for the rest of my life.
    • patorjk 2y ago
      There's something called a "lean mass hyper responder", it's a type of person with high LDL but they're still healthy. You may fall into that category. However, high apob is more correlated to heart disease than high LDL. A lot of the online doctors who say high LDL isn't bad are saying that because some people have large LDL particles, and it's apparently the number of particles that's the problem, not the amount of LDL cholesterol. I've dug into this topic a lot sense there's a lot of heart disease in my family. I've found that eating a bowl of oatmeal once a day reduces my LDL under 130 (I've been taking quarterly cholesterol blood tests to keep an eye on things). It's probably the fiber content that's doing the work, but I haven't tried other high fiber foods yet. However, I'm not a doctor so make of this what you will.
      • 2y ago