8 ms·

The underappreciated role of muscle in health and disease [pdf]

67 points by fasteo 12y ago

7Figures2Commas 12y ago
This is a good example of why the focus on developing magic pills that aim to curb obesity is so silly[1]. Body composition and strength are just as important, if not more important, than weight, especially as one ages. The reason this is ignored is that there's only so much you can do to significantly improve your body composition and strength without exercise and healthy eating. > Nonetheless, the maintenance of adequate muscle mass, strength, and metabolic function has rarely, if ever, been targeted as a relevant endpoint of recommendations for dietary intake. It's kind of sad that the "official" recommendations basically ignore what even the most inexperienced personal trainer could tell you. [1] https://news.ycombinator.com/item?id=8736567 https://news.ycombinator.com/item?id=8736567
- jessriedel 12y ago
  A magic pill that could curb obesity would deliver hundreds of billions of dollars worth of improved health outcomes in the US, regardless of whether getting everyone to put on more muscle would be preferable. (And that's not even accounting for the fact that people who hate exercise lose utility even if you can convince them to do it.)
  - 7Figures2Commas 12y ago
    You seem to be assuming that the health conditions and costs commonly associated with obesity are all primarily caused by obesity. I'd suggest you consider the possibility that obesity is just as likely to be a symptom of poor health as it is to be the cause of it. On this point, there are plenty of people who aren't obese who have cardiovascular disease, diabetes, etc. There's a lot we don't know about the human body, but based on what we do know, it's asinine to believe that folks can eat horribly and live sedentary lifestyles without serious consequence. That, however, is what magic pill research effectively promises.
    - jessriedel 12y ago
      > I'd suggest you consider the possibility that obesity is just as likely to be a symptom of poor health as it is to be the cause of it. I gladly acknowledge that possibility, but you should acknowledge the likelihood that the medical community is roughly correct in its belief that obesity does in fact cause a huge number of health related problems regardless of whether this is "primary". My claim above does not rest on obesity being the dominant factor. > it's asinine to believe that folks can eat horribly and live sedentary lifestyles without serious consequence. Misunderstanding someone's claim and then suggesting that their beliefs are asinine is not a good way to get people to engage productively with you.
      - rational-future 12y ago
        Haha, 7Figures2Commas got pwned.
      - 7Figures2Commas 12y ago
        First, please don't pretend that the "medical community" is a homogenous body that produces broad consensus on complex matters. There is and always has been a significant amount of debate amongst medical professionals on a variety of topics. The topic of cholesterol provides many examples of this. For years, it was widely believed that raising the levels of HDL cholesterol would reduce the risk of heart disease. On that belief alone, many doctors regularly prescribed niacin to patients. Yet a few years ago, a study basically revealed that while niacin did raise HDL levels, it didn't reduce heart disease risk[1]. What's worse, more recent studies have revealed that niacin may have exposed patients to unacceptable risk[2]. To be clear: if you were ever diagnosed as having low HDL cholesterol, there's a good chance that your doctor would have recommended that you consider a treatment that not only would have been ineffective but exposed you to risk. All based on a widely-promoted hypothesis we now have ample evidence is flawed. On the topic of obesity, there is growing evidence that obesity is not the cause of a significant number of the most expensive health problems thought of as being caused by or strongly associated with obesity. Take Type 2 diabetes. Recent studies[3] show that it's a very complex condition, and genetics likely plays a more significant role than thought. Somewhat disturbingly, a longitudinal study published last year in the New England Journal of Medicine found that "An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes." That calls into question the notion that even weight loss is a panacea for Type 2 diabetes. You may not like my use of the word asinine, but if you're going to suggest that a magic pill for obesity "would deliver hundreds of billions of dollars worth of improved health outcomes in the US," you should at least have some evidence to back it up. To do that, however, you have the very high barrier of establishing that a) obesity in meaningful part causes the costly conditions promoted as being obesity-related and b) reduction of obesity would provide a significant enough benefit to eliminate a meaningful portion of the costs associated with these conditions. More and more research shows this is not the case. [1] http://www.nytimes.com/2011/05/27/health/policy/27heart.html http://www.nytimes.com/2011/05/27/health/policy/27heart.html [2] http://www.cbsnews.com/news/taking-niacin-for-the-heart-may-pose-serious-health-risks/ http://www.cbsnews.com/news/taking-niacin-for-the-heart-may-... [3] http://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/obesity-isn-t-sole-cause-of-type-2-diabetes-691898.html http://consumer.healthday.com/diabetes-information-10/misc-d... [4] http://www.nejm.org/doi/full/10.1056/NEJMoa1212914 http://www.nejm.org/doi/full/10.1056/NEJMoa1212914
- fasteo 12y ago
  I wouldn´t say that it is silly. Rather, it is just pragmatic. Obesity costs billions of dollars per year and, sadly, only a pill can stop this.
  - toolz 12y ago
    I'm not sure what you're trying to say, but a pill is nowhere near as effective at causing weight loss as changing your diet can be.
    - taeric 12y ago
      It doesn't have to be "better than diet," per se. Though, I do note that diet has done a lousy job of helping most of the population. And the response that people aren't following the correct diet is missing the point. As that is the point. That is to say, which do you think you'd have better luck with, convincing a segment of the population to take a pill once a day, or to adopt a diet that will have advantageous results? Edit: And this ignores that you could go with both, of course.
    - fasteo 12y ago
      Couldn´t agree more, but how do you convince millions of people to change their diet with the promise that it will reduce their health problems in 20-30 years, saving their country billions of dollar a year in health care costs ?
      - sgt101 12y ago
        Tax unhealthy foods. In particular processed foods. So zero rate fresh vegetables and fruit, and fresh meat if you can manage that with the legal system (because it is processed). Then whack 25% on everything else. Now.. I shall make the comment to bring the downvotes! But I am tough so I shall do it. Bacon should be in the 25% tax bracket. -karma here I come...
        fasteo 12y ago
        upvote for the bacon. I am afraid that taxes would be a boomerang is this case. The industry will just lower production costs to offset the taxes. Lowering the costs meaning that crap food will be crapier and here we go again...
- fasteo 12y ago
  The pill[1] [1]https://www.fightaging.org/archives/2014/12/and-if-the-research-community-does-in-fact-find-a-viable-treatment-for-obesity.php https://www.fightaging.org/archives/2014/12/and-if-the-resea...
mrfusion 12y ago
So would this imply men should be healthier than women? Body builders healthier than other types of athletes?
- newaccountfool 12y ago
  I'm sure to an extent it helps you, then after a point like most things it will hinder you. I wouldn't expect some of the past and present Mr.Olympias to be very healthy.
- bronbron 12y ago
  The article doesn't say that. As an aside, long-term (which is where we really care about "healthy" anyway), you would probably expect body builders to be healthier than some classes of athletes, with various circumstances obviously influencing that. Professional sports are notoriously rough on the body (and mind) long-term. It's not a secret that athletes in certain sports (e.g. american football, boxing) often have debilitating health issues in their later years stemming from their career. I'd say Arnold is doing a hell of a lot better health-wise than Muhammad Ali, for example.
  - Floegipoky 12y ago
    Except for the damage caused by steroid use.
- fasteo 12y ago
  I don´t think the article is proposing "the more, the better". Rather, it is emphasizing that muscle mass is much more that pure force production or aesthetics in that it plays a key role in maintaining a healthy metabolism. Replying to your question: if you compare two identical women differing only in their percentage of muscle mass, yes, one is healthier than the other. As for the body builders; this is a tricky question, but I don´t think they are healthier than the general population...muscle mass being completely irrelevant.
  - ajcarpy2005 12y ago
    Some bodybuilders over-train, which can stress critical organ systems such as kidneys. EDIT: Rest/Recovery is necessary. Specifically, it's important not to increase the amount of metabolic requirements you stress yourself with too rapidly before the body has time to adapt. The body can adapt to stress and become stronger (hormesis) but it takes time, rest, and nutrition.
IndianAstronaut 12y ago
Interesting, I never realized muscle played a role in helping recover from critical injuries such as head trauma.
Mz 12y ago
However, over the past few years it has become evident that changes in the metabolic function of muscle itself plays a more direct role in the genesis of insulin resistance than previously appreciated. This makes logical sense. Given that people with CF do not process fats correctly, tend to be severely underweight yet are highly prone to developing CF Related Diabetes, fat just about can't be the right explanation as to cause. On the other hand: The central thesis of the glucose–fatty acid cycle is that elevated plasma FFA concentrations limit glucose uptake in muscle by inhibiting the oxidation of glucose (33). Thus, according to this theory, the genesis of insulin resistance lay entirely with the increased availability of FFAs, and the muscle responded normally to that signal to limit glucose uptake and oxidation. Can anyone tell me: If you are chronically insufficiently oxygenated for some reason (like lack of lung function), would that contribute to this process? I mean, it sounds to me like insufficient oxygenation of the system would play a role here. Any takers?
NIL8 12y ago
There are several interesting aspects of this article, but it could have used a little more editing. As I read through, I can hear my 7th grade English teacher saying, "structure and grammar." This lack of attention to detail makes me wonder what else might have been overlooked in the study.

67 points by fasteo 12y ago

This is a good example of why the focus on developing magic pills that aim to curb obesity is so silly[1]. Body composition and strength are just as important, if not more important, than weight, especially as one ages. The reason this is ignored is that there's only so much you can do to significantly improve your body composition and strength without exercise and healthy eating. > Nonetheless, the maintenance of adequate muscle mass, strength, and metabolic function has rarely, if ever, been targeted as a relevant endpoint of recommendations for dietary intake. It's kind of sad that the "official" recommendations basically ignore what even the most inexperienced personal trainer could tell you. [1] https://news.ycombinator.com/item?id=8736567 https://news.ycombinator.com/item?id=8736567

jessriedel 12y ago
A magic pill that could curb obesity would deliver hundreds of billions of dollars worth of improved health outcomes in the US, regardless of whether getting everyone to put on more muscle would be preferable. (And that's not even accounting for the fact that people who hate exercise lose utility even if you can convince them to do it.)
- 7Figures2Commas 12y ago
  You seem to be assuming that the health conditions and costs commonly associated with obesity are all primarily caused by obesity. I'd suggest you consider the possibility that obesity is just as likely to be a symptom of poor health as it is to be the cause of it. On this point, there are plenty of people who aren't obese who have cardiovascular disease, diabetes, etc. There's a lot we don't know about the human body, but based on what we do know, it's asinine to believe that folks can eat horribly and live sedentary lifestyles without serious consequence. That, however, is what magic pill research effectively promises.
  - jessriedel 12y ago
    > I'd suggest you consider the possibility that obesity is just as likely to be a symptom of poor health as it is to be the cause of it. I gladly acknowledge that possibility, but you should acknowledge the likelihood that the medical community is roughly correct in its belief that obesity does in fact cause a huge number of health related problems regardless of whether this is "primary". My claim above does not rest on obesity being the dominant factor. > it's asinine to believe that folks can eat horribly and live sedentary lifestyles without serious consequence. Misunderstanding someone's claim and then suggesting that their beliefs are asinine is not a good way to get people to engage productively with you.
    - rational-future 12y ago
      Haha, 7Figures2Commas got pwned.
    - 7Figures2Commas 12y ago
      First, please don't pretend that the "medical community" is a homogenous body that produces broad consensus on complex matters. There is and always has been a significant amount of debate amongst medical professionals on a variety of topics. The topic of cholesterol provides many examples of this. For years, it was widely believed that raising the levels of HDL cholesterol would reduce the risk of heart disease. On that belief alone, many doctors regularly prescribed niacin to patients. Yet a few years ago, a study basically revealed that while niacin did raise HDL levels, it didn't reduce heart disease risk[1]. What's worse, more recent studies have revealed that niacin may have exposed patients to unacceptable risk[2]. To be clear: if you were ever diagnosed as having low HDL cholesterol, there's a good chance that your doctor would have recommended that you consider a treatment that not only would have been ineffective but exposed you to risk. All based on a widely-promoted hypothesis we now have ample evidence is flawed. On the topic of obesity, there is growing evidence that obesity is not the cause of a significant number of the most expensive health problems thought of as being caused by or strongly associated with obesity. Take Type 2 diabetes. Recent studies[3] show that it's a very complex condition, and genetics likely plays a more significant role than thought. Somewhat disturbingly, a longitudinal study published last year in the New England Journal of Medicine found that "An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes." That calls into question the notion that even weight loss is a panacea for Type 2 diabetes. You may not like my use of the word asinine, but if you're going to suggest that a magic pill for obesity "would deliver hundreds of billions of dollars worth of improved health outcomes in the US," you should at least have some evidence to back it up. To do that, however, you have the very high barrier of establishing that a) obesity in meaningful part causes the costly conditions promoted as being obesity-related and b) reduction of obesity would provide a significant enough benefit to eliminate a meaningful portion of the costs associated with these conditions. More and more research shows this is not the case. [1] http://www.nytimes.com/2011/05/27/health/policy/27heart.html http://www.nytimes.com/2011/05/27/health/policy/27heart.html [2] http://www.cbsnews.com/news/taking-niacin-for-the-heart-may-pose-serious-health-risks/ http://www.cbsnews.com/news/taking-niacin-for-the-heart-may-... [3] http://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/obesity-isn-t-sole-cause-of-type-2-diabetes-691898.html http://consumer.healthday.com/diabetes-information-10/misc-d... [4] http://www.nejm.org/doi/full/10.1056/NEJMoa1212914 http://www.nejm.org/doi/full/10.1056/NEJMoa1212914
fasteo 12y ago
I wouldn´t say that it is silly. Rather, it is just pragmatic. Obesity costs billions of dollars per year and, sadly, only a pill can stop this.
- toolz 12y ago
  I'm not sure what you're trying to say, but a pill is nowhere near as effective at causing weight loss as changing your diet can be.
  - taeric 12y ago
    It doesn't have to be "better than diet," per se. Though, I do note that diet has done a lousy job of helping most of the population. And the response that people aren't following the correct diet is missing the point. As that is the point. That is to say, which do you think you'd have better luck with, convincing a segment of the population to take a pill once a day, or to adopt a diet that will have advantageous results? Edit: And this ignores that you could go with both, of course.
  - fasteo 12y ago
    Couldn´t agree more, but how do you convince millions of people to change their diet with the promise that it will reduce their health problems in 20-30 years, saving their country billions of dollar a year in health care costs ?
    - sgt101 12y ago
      Tax unhealthy foods. In particular processed foods. So zero rate fresh vegetables and fruit, and fresh meat if you can manage that with the legal system (because it is processed). Then whack 25% on everything else. Now.. I shall make the comment to bring the downvotes! But I am tough so I shall do it. Bacon should be in the 25% tax bracket. -karma here I come...
      - fasteo 12y ago
        upvote for the bacon. I am afraid that taxes would be a boomerang is this case. The industry will just lower production costs to offset the taxes. Lowering the costs meaning that crap food will be crapier and here we go again...
fasteo 12y ago
The pill[1] [1]https://www.fightaging.org/archives/2014/12/and-if-the-research-community-does-in-fact-find-a-viable-treatment-for-obesity.php https://www.fightaging.org/archives/2014/12/and-if-the-resea...

mrfusion 12y ago

So would this imply men should be healthier than women? Body builders healthier than other types of athletes?

newaccountfool 12y ago
I'm sure to an extent it helps you, then after a point like most things it will hinder you. I wouldn't expect some of the past and present Mr.Olympias to be very healthy.
bronbron 12y ago
The article doesn't say that. As an aside, long-term (which is where we really care about "healthy" anyway), you would probably expect body builders to be healthier than some classes of athletes, with various circumstances obviously influencing that. Professional sports are notoriously rough on the body (and mind) long-term. It's not a secret that athletes in certain sports (e.g. american football, boxing) often have debilitating health issues in their later years stemming from their career. I'd say Arnold is doing a hell of a lot better health-wise than Muhammad Ali, for example.
- Floegipoky 12y ago
  Except for the damage caused by steroid use.
fasteo 12y ago
I don´t think the article is proposing "the more, the better". Rather, it is emphasizing that muscle mass is much more that pure force production or aesthetics in that it plays a key role in maintaining a healthy metabolism. Replying to your question: if you compare two identical women differing only in their percentage of muscle mass, yes, one is healthier than the other. As for the body builders; this is a tricky question, but I don´t think they are healthier than the general population...muscle mass being completely irrelevant.
- ajcarpy2005 12y ago
  Some bodybuilders over-train, which can stress critical organ systems such as kidneys. EDIT: Rest/Recovery is necessary. Specifically, it's important not to increase the amount of metabolic requirements you stress yourself with too rapidly before the body has time to adapt. The body can adapt to stress and become stronger (hormesis) but it takes time, rest, and nutrition.

IndianAstronaut 12y ago

Interesting, I never realized muscle played a role in helping recover from critical injuries such as head trauma.

Mz 12y ago

However, over the past few years it has become evident that changes in the metabolic function of muscle itself plays a more direct role in the genesis of insulin resistance than previously appreciated. This makes logical sense. Given that people with CF do not process fats correctly, tend to be severely underweight yet are highly prone to developing CF Related Diabetes, fat just about can't be the right explanation as to cause. On the other hand: The central thesis of the glucose–fatty acid cycle is that elevated plasma FFA concentrations limit glucose uptake in muscle by inhibiting the oxidation of glucose (33). Thus, according to this theory, the genesis of insulin resistance lay entirely with the increased availability of FFAs, and the muscle responded normally to that signal to limit glucose uptake and oxidation. Can anyone tell me: If you are chronically insufficiently oxygenated for some reason (like lack of lung function), would that contribute to this process? I mean, it sounds to me like insufficient oxygenation of the system would play a role here. Any takers?

NIL8 12y ago

There are several interesting aspects of this article, but it could have used a little more editing. As I read through, I can hear my 7th grade English teacher saying, "structure and grammar." This lack of attention to detail makes me wonder what else might have been overlooked in the study.