Comment: Why being ‘overweight’ means you live longer: the way scientists twist the facts.

OK, so a friend of mine recently posted a link on Facebook to an article entitled ‘Why being ‘overweight’ means you live longer: the way scientists twist the facts’. I can’t lie, just the title alone made my blood boil. My main concern was, aside from what appeared to be an oversimplification of a phenomenon that scientists know as the ‘obesity paradox’, the title also plays beautifully into the ‘us vs them’ notion that academics are somehow untrustworthy. But, after my blood pressure settled, I decided to give it the benefit of the doubt and read the whole article – I’ve heard at numerous ‘media training’ workshops that it’s not uncommon for editors to alter article titles just before print to make them more appealing and more likely to garner views, so perhaps the body of the article was a bit more nuanced?

The article overall gave the impression that the author was well versed in scientific literature, using well placed quotes from research papers to highlight important points. For example, the author quotes a study from 2005 which used medical data (collected between 1971 and 1994) to show increased mortality (risk of death) in those with BMI’s (Body Mass Index) over 30 (i.e. those classified as obese). He correctly points out that the title of this paper (‘Excess deaths associated with underweight, overweight and obesity’) is misleading and implies that being overweight (i.e. having a BMI of between 25 and 30) increases your risk of mortality, when the study actually finds lower mortality in those with BMI’s between 25 and 30 than for individuals in the ‘ideal’ BMI range (18.5-25), I.e. being moderately overweight is good for you.

These findings do actually agree with a number of similar studies. In fact, in addition to these findings, there are also a whole host of studies which suggest that being overweight can lead to better survival rates following a large range of medical conditions (for example coronary heart disease, chronic heart failure, stroke and more).

So, do I agree with this article? Well, partially.

I agree that the obesity paradox exists and these findings are not often spoken about. However, the reason that they are not often publicised is not because academics want to ‘twist the facts’ or, as the author states, that ‘no one can bring themselves to say: Sorry, we were wrong. A BMI between 25 and 29 is the healthiest weight of all. For those of you between 20 and 25, I say, eat more, become healthier’. It’s because there is much more to these findings than first meets the eye.

I don’t think many doctors or researchers would argue that obesity, especially weight carried around the stomach, is a major risk factor for type 2 diabetes, lipid disorders, hypertension, coronary heart disease and some cancers. A quick search of Google Scholar will turn up a stack of articles suggesting that increased weight is linked to a whole range of long-term conditions.

But, how can both these findings be correct? How can it be possible that being overweight can mean you live longer but you are also more likely to suffer from a chronic illness (i.e. diabetes or heart disease)?

I believe that this is the question we are yet to find a satisfactory answer to, and therefore the reason it’s best to be cautious about making statements such as “being “overweight” is the healthiest and most “normal” weight of all”.

A paper entitled ‘The Obesity Paradox Does Exist’ expressed this problem very well, stating: “the discussion over the existence of the obesity paradox cannot lead to an underestimation of obesity as a crucial risk factor for the development of cardiovascular and metabolic diseases that requires comprehensive prevention and management strategies”.

But what’s my overall impression of this article?

I believe that it does raise awareness of a medical phenomenon which needs to be discussed but, that it does so in a dangerous and inflammatory way. Blaming scientists and accusing them of manipulating/twisting results is not helpful. Neither is writing a biased article which does not acknowledge the breadth and depth of understanding around a topic – i.e. it’s just as dangerous to tell individuals that it’s entirely healthy to be overweight (in the case of this article to even go as far as to suggest that the dangers of obesity are greatly overrated) as it is to ignore this obesity paradox entirely and blame everything on excessive weight. We need to be smart and realise that any reference to things being ‘black or white’ is probably dangerously misleading.

So, what can we take from this article and the related research?

Well, certainly not that it’s always going to be OK to be overweight. But, perhaps that we put too much stock in BMI calculations? Especially when this calculation (weight in kilograms divided by the square of your height in meters) does not take into account the extra weight carried in muscles, an individual’s body shape, fat distribution across the whole body or overall fitness level – all of which are important indicators of whether or not the weight we carry could be harmful. In fact, many of the academics studying this paradox suggest that it may actually be caused by problems related to the BMI measurement rather than any actual protection afforded by excess weight. That means that if you eat well and exercise regularly, even If your BMI is high, you are probably going to be healthier than someone who eats badly, smokes, and rarely gets off the sofa (whatever their BMI). At the end of the day it’s just a number, we all know how healthy our lifestyles are so we shouldn’t believe that such measurements can 100% predict our health outcomes. Hopefully, in the future, researchers can plan studies which allow them to look beyond BMI and work out how different types of fat, where it’s stored on the body and our overall fitness level affect our health – this might give us a better picture of what is really good for us.

Post by: Sarah Fox

References:

Excess deaths associated with underweight, overweight and obesity

The Obesity Paradox: Perception vs Knowledge

Obesity Paradox Does Exist

 

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Citizens across the North invited to get moving and help heart research in UK digital health first

The University of Manchester’s Connected Health Cities and Nokia partner to organise an 8 week step challenge across the North

Nokia and the Connected Health Cities (CHC) programme have launched CityMoves, an eight-week step challenge taking place from 23rd October to 21st December 2017.

I’ve already downloaded the app and am having a bit of fun logging my weekly activity. It seems I’m all systems go during the week but make up for it by lazing around over the weekend!

The challenge promotes healthy living and the positive use of data and technology in health and research. It’s also an opportunity for citizens across Greater Manchester to help advance science’s understanding of how low-intensity exercise improves heart health. Scientists know that intense exercise, like marathon running, will reduce your resting heart rate. But, they know less about how well moderate exercise such as walking can cause this reduction. Hopefully data from this app could provide an answer.

Participants will be able to track their steps through the Nokia Health Mate app, which also allows users to measure their pulse rate using their smartphones camera. Although this does take a bit of practice… Actually I was a bit worried by how my pulse spiked from simply climbing the stairs to my office, I’m blaming my technique but perhaps I just need a bit more gym time?

The project will be delivered across Connected Health Cities four city regions including Greater Manchester, Yorkshire, Liverpool and the North West Coast and Newcastle and the North East. Each region will be able to see how the amount of steps they have taken over the period compares to the others’.

As well as daily updates on the dedicated website, each week users get personalised feedback with information about their progress and how they compare to others from across the North – A bit of healthy northern competition! Throughout the eight weeks of the challenge CHC and Nokia will keep people motivated with motivational content, seasonal tips to get moving more, hundreds of fitness tracker give-aways and awareness messages on how to keep your heart healthy.

After the 8-week period de-personalised data will be sent to The University of Manchester’s Connected Health Cities programme where data scientists will look for changes in heart rate across the study period.

Prof John Ainsworth, Director of Connected Health Cities said:

“More effective use of data and technology has great potential to deliver health benefits for all of us. The CityMoves study is a great example for people to see the positive impact that their data can have.

“In CityMoves study we aim to develop a better understanding of the relationship between increased physical exercise and resting heart rate, a key indicator of health.”

To join the programme participants can register at nokia.ly/citymoves, choose their team and begin measuring their steps and watch as they rise up their team’s leader board.

www.connectedhealthcities.org @CHCNorth #DataSavesLives

 

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What colour is your pain?

If pain had a colour what would it be? Perhaps a throbbing headache would be a deep purple while a night-time leg cramp might be an intense flash of red jolting you from your slumber? If you were asked to describe the colour of your pain what would it be? And are there common colours associated with different types of pain?

Sometime ago I worked on an Arthritis Research UK (ARUK) stand at the Manchester (science?) Festival. Members of the public were asked to tie ribbons onto a skeleton to show where they experienced pain. The result was fascinating – so many people had knee problems! What was also fascinating to me was the public’s willingness to share their pain stories and get involved with demonstrating where their pain appeared. After this event it occurred to me that people might associate pain with, or experienced it as, a colour but I had no way of testing this theory. Then, I spotted a notice for the Citizen Scientist Showcase, part of the Manchester Science Festival. They were looking for members of the public to set up a stall and promote their own project as part of the Salford Science Jam. Just the avenue I was looking for! This means that I now get to explore my idea, and festival visitors get to contribute to an amazing visual mosaic that has an artistic value all its own.

My idea is really simple. Members of the public use a post-it note, piece of paper or maybe even a tablet if we can get the whole thing digitised to draw the colour, and possibly the shape, of their pain. I’m expecting everything from red blobs to electric green squiggles. These individual pieces of art will then be collected and displayed as a wall mural / mosaic showing the full spectrum of colours and shapes making up our perceptions of pain.

At the end of the day we will have a mosaic which beautifully combines the science and art behind our pain. The beauty of the exercise is that it can be carried out time and again either as a stand-alone piece or as part of a larger project with each event feeding into a larger work of art. I hope that this little project will create a legacy, perhaps informing further pieces of research looking at how colour can be used to help people describe their pain symptoms. Perhaps this could even lead to new avenues in the alleviation or relief of pain!

The Citizen Science Showcase takes place at Salford University’s Media City Campus on Saturday 21st and Sunday 22nd October from 11.00 am to 4.00pm each day.

I’m really excited about working on my first piece of “research”. So, if you would like to contribute to this work or have any comments or advice, I love to hear from you.

Post by: Kay Gallacher

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