Excess weight increases or decreases longevity?
In the research, a very large number of papers were included, originally 4142 articles, of which only 97 remained, after the inclusion and exclusion criteria were analyzed.
- Due to the large volume of papers included, there was an evaluation of mortality risk (BMI - the international measure used to calculate whether a person is at the ideal weight, determined by the division of the body mass index). mass of the individual by the square of his height). Some studies included in the study were performed based on the weight and height informed by the individual searched and not found by a physician, which may have influenced the results. Young women, for example, tend to report lower weight and height, and many older people do not have the correct perception of their weight and height over time.
- "The cardiovascular risk of weight-related mortality exists, with the presence of visceral fat. "
Although there was a risk analysis of all-cause mortality, there was no focus on the risk of cardiovascular mortality. That is: any cause of death was related to weight, even if there was no relation. For example, a death from a heart attack is very different from a car accident death. This may have influenced the results of the study in some way.
Analysis of body composition (amount of fat mass and muscle mass performed by specific methods) or abdominal circumference was also not performed, and cardiovascular risk of weight-related mortality exists mainly with the presence of visceral fat.
An overweight individual may have a low percentage of fat with a large amount of lean mass (muscle). In the balance, he is overweight (BMI between 25 and 30), but his body composition is excellent. An important tool that we have used in the office is the analysis of body composition by methods such as bioimpedance, for example. It consists of a device (as if it were a scale) that emits a wave and that, by the difference in the conduction of the emitted current, is able to define the percentage of fat and the lean mass of each person. research has encompassed the entire world, but 78 of the 97 studies were done only in North America and Europe, and there was a small sample of Asian offspring.
The "quality" of weight
For these reasons, caution in interpreting the data. One of the hypotheses of the study is that a little excess of adipose tissue could provide reserves of energy to help combat certain diseases. Another point in favor would be the fact that people with more weight tend to seek medical treatment more often.
What the study concluded was that there was a lower all-cause mortality in individuals who had a BMI of overweight, but it is I need to question BMI as an isolated index for risk assessment, which has not been done in clinical practice.In general, endocrinologists assess the "quality" of the weight (as much as there is fat mass and lean mass) more than the value (only the weight number of the scale) as an isolated parameter. Although more research needs to be done, we can say that the greater the degree of obesity, the greater the risk of mortality from various causes - not just the cardiovascular cause.
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