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PaperclipPerfector  10mo ago (text post)   26437 thread views

Culture War Roundup for the week of January 15, 2024

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But it’s not just cancer patients. Peripheral vascular disease too.

As your study says:

Recent studies conducted in patients with chronic diseases have reported an inverse association between body mass index (BMI) and mortality.

So where doesn't it? A dozen specific explanations aren't satisfactory.

Like regular ice cream and alcohol consumption, overweight BMI is one of those things that annoy modern medicine by stubbornly correlating with lower mortality.

One more reason I give the poor bastards ice cream, beyond the cardiovascular benefits.

And the fun. But don’t forget the alcohol. My grandma’s universal cure showed a deeper understanding of the human body than all of modern medicine: If I even thought about looking pale, she would forcefeed me delicious desserts, baba au rum, black forest cake, rinced down with a warm grog.

https://www.bmj.com/content/353/bmj.i2156

Overweight and obesity is associated with increased risk of all cause mortality and the nadir of the curve was observed at BMI 23-24 among never smokers, 22-23 among healthy never smokers, and 20-22 with longer durations of follow-up. The increased risk of mortality observed in underweight people could at least partly be caused by residual confounding from prediagnostic disease. Lack of exclusion of ever smokers, people with prevalent and preclinical disease, and early follow-up could bias the results towards a more U shaped association.

https://www.bmj.com/content/370/bmj.m3324

Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.

https://europepmc.org/article/pmc/4855514

Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.

TLDR: Being overweight and grade 1 obese are not that bad for you, and being slightly overweight can tentatively be considered beneficial. Confounders abound, beyond my ability to unconfound. But being fat fat? Bad idea.

My grandma’s universal cure showed a deeper understanding of the human body than all of modern medicine: If I even thought about looking pale, she would forcefeed me delicious desserts, baba au rum, black forest cake, rinced down with a warm grog.

My grandfather calls me anemic every time he sees me, and to be fair, last time I passed out and hit my head, the VBG showed I was 0.3 g% below the cutoff. Though his solution was iron tablets. And he's a doctor too.

https://www.bmj.com/content/353/bmj.i2156

Imo they're trying to get it as low as possible, just mining for the right combination of factors:

In the analysis of all participants the lowest mortality was observed in those with a BMI of around 25. In subgroup analyses, however, the lowest mortality was observed in the BMI range of 23-24 among never smokers, 22-23 among healthy never smokers, and 20-22 among studies of never smokers with longer durations of follow-up (≥20 and ≥25 years).

On the curves, the mortality at 30 BMI is roughly the same as 20, and 18 is way worse than 32, so I strongly suspect aesthetic (and perhaps ascetic) considerations tainted the definition of the seemingly ‘healthy range’ of 18-25.

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