The SA Journal Diabetes & Vascular Disease Volume 16 No 2 (November 2019)

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SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE
VOLUME 16 NUMBER 2 • NOVEMBER 2019 61
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Being too fat or too thin ‘can cost four years of life’
Being overweight or underweight, as
measured by the body mass index
(BMI), could knock four years of life
expectancy, a five-year UK population
cohort study of nearly two million people
found.
Researchers found that, from the age
of 40 years, people at the higher end of
the healthy BMI range had the lowest risk
of dying from disease. But people at the
top and bottom ends of the BMI risked
having shorter lives.
BMI is calculated by dividing an adult’s
weight by the square of their height. A
‘healthy’ BMI score ranges from 18.5 to
25 kg/m2 . According to the report, most
doctors say it is the best method they
have of working out whether someone is
obese because it is accurate and simple to
measure.
The study showed that life expectancy
for obese men and women was 4.2 and
3.5 years shorter respectively than people
in the entire healthy BMI weight range.
The difference for underweight men and
women was 4.3 (men) and 4.5 (women)
years.
The report says BMI was associated
with all causes of death categories, except
transport-related accidents, including cancer,
cardiovascular diseases and respiratory
diseases. However, not everybody in the
healthy category is at the lowest risk of
disease, according to report author Dr
Krishnan Bhaskaran at the London School of
Hygiene & Tropical Medicine.
He is quoted in the report as saying:
‘For most causes of death we found that
there was an “optimal” BMI level, with risk
of death increasing both below and above
that level. At BMIs below 21 kg/m2, we
observed more deaths from most causes,
compared with the optimum BMI levels.
However, this might partly reflect the fact
that low body weight can be a marker of
underlying ill-health. For most causes of
death, the bigger the weight difference,
the bigger the association we observed
with mortality risk. So a weight difference
of half a stone would make a relatively
small (but real) difference; we could detect
these small effects because this was a very
large study.’
Some experts have questioned whether
BMI is an accurate way of analysing a
person’s health. However, the report
says, Dr Katarina Kos, senior lecturer in
diabetes and obesity at the University of
Exeter, believes it is. ‘For the majority of
people, BMI is a good measure.’
Kos said the study did not contain
any surprises but added that overweight
people who could lower their BMI may
reap the health benefits. ‘We know from
the diabetes remission data how low-
calorie diets and weight loss can improve
diabetes, for example,’ she said. ‘And
we know weight loss can also help in
improving risk so that would also then
improve mortality rates.’
The study suggested that a higher
BMI in older people may not be as
dangerous, because a bit of extra weight
was ‘protective’ for them. But Kos, who
worked on a study on this topic in 60 to
69-year-olds last year, disagreed with the
findings. Her study on what is known as
the obesity risk paradox, did not ‘support
acceptance’ of the theory.
Source: Medical Brief 2018