Are you overweight? Good!

Overweight people live longer than supposedly “normal” weight people. This has been well documented and is irrefutable. For example, a study that followed 1.8 million people for ten years found that people with a body mass index (BMI) between 26 and 28 had the highest life expectancy. Not only that, they found that people with a BMI between 18 and 20 (supposedly optimal) had a lower life expectancy than those with a BMI between 34 and 36 (obese). The most recent study, published in the May, 2016 Journal of the American Medical Association, showed that people with a body mass index of 27 have the lowest risk of dying early from any cause. Another study involving 250,000 people with heart disease found that overweight patients had better survival rates and fewer heart problems than those with a “normal” index number.

The definitions of what is “overweight,” “normal,” and “obese” are defined by the World Health Organization, National Heart, Lung and Blood Institute, and other organizations. They are based on BMI figures. Don’t know your BMI? It’s easy to compute with an online calculator. Here’s a link to one: BMI calculator. You only need to know your height and weight.

As you’ll see on this site, here is what the National Heart, Lung, and Blood Institute says is normal, overweight, etc.:

Underweight = <18.5
Normal weight = 18.5–24.9 
Overweight = 25–29.9 
Obesity = BMI of 30 or greater

My BMI is 26, which makes me overweight, as well as 65 percent of my fellow Americans including Michael Jordan in his prime. Arnold Schwarzenegger, when he was Mr. Universe at age thirty-three, had a BMI of 33, which made him technically obese.

So what the heck? Where do the supposed experts come up with what is normal, etc.? I don’t know. Under the circumstances, it makes no sense to me.

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In defense of fat people--again

Hah! I have long maintained that fat people can’t help being fat—that their (our) bodies want to be a certain weight. I wrote an earlier post on that subject.  Now I have new ammunition to support my argument, as reported in the journal Obesity and The New York Times. 

For six years, researchers followed contestants on The Biggest Loser TV show to see how they fared following their weight loss.  Here is a nutshell summary. 

• Thirteen of the 14 contestant regained most if not all their lost weight; four are heavier now than before the competition; only one, with great effort, has managed to maintain her weight.
• Their metabolisms became dramatically lower—as much as 800 calories a day—and stayed that way. In other words, after losing weight, their bodies were not burning enough calories to maintain their thinner weight. They had to eat even less to maintain their weight.
• The hormones that regulate weight either rose or fell. For example, their levels of leptin, which controls hunger, went from normal at the start of the weight loss to nearly zero. The levels of the hormones that made them want to eat rose. The only way they could maintain their weight loss is to be hungry all the time.

What all this means, as one of the researchers said, “You can’t get away from a basic biological reality. The body puts multiple mechanisms in place to get you back to your weight.” As I’m sure you’ve noticed, there’s a weight you can maintain without any effort, and that is the weight that your body is going to fight to defend.

For a detailed account of the study, see this article from The New York Times.

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Forget fish oil supplements

I used to take them myself, although I tend to gag on large pills and hated doing it. I was happy to learn from a number of reliable sources that fish oil supplements have no value for preventing heart disease. For example, according to the National Institutes of Health: “Omega-3s in supplement form have not been shown to protect against heart disease.” Former president of the AMA, Robert Eckel has also stated that nearly all studies regarding fish oil supplements show no benefit at all.

My most reliable resource on this topic is Dr. John Ioannidis, a brilliant guy at Stanford University of Medicine, whose specialty is uncovering flaws in published research and who long ago showed the worthlessness of fish oil supplements. He says "These claims do not easily die away."  Indeed, every year people in the US spend $1.2 billion a year on fish oil and similar supplements. You are probably among them. I say this because the use of fish oil supplements have quadrupled over the last five years and because almost one in five older adults now take them. “There’s a major disconnect,” says researcher Dr. Andrew Grey. “The sales are going up despite the progressive accumulation of trials that show no effect.”

What’s more, fish oil supplements are largely unregulated. Tests performed on 30 top-selling fish oil supplements for levels of omega-3 fatty acids found that six of those products contained levels of omega-3s that were, on average, 30 percent less than stated on their labels. Tests that looked for two particular omega-3’s (DHA and EPA), found that, on average, these fats were 14 percent less than listed on their packaging.  

Although fish oil supplements have not been shown to be harmful, they can cause bleeding if you take blood thinners such as Coumadin, or even aspirin.

Might as well save your money and avoid choking down those giant pills.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Hidden fat research uncovered!

From 1968 until 1973 Dr. Ivan Frantz Jr. of the University of Minnesota Medical School conducted a controlled clinical trial comparing diets containing saturated fats with those containing vegetable oils and no saturated fats. He hoped to prove that replacing saturated fat, such as butter and other animal fats, with corn oil would protect them against heart disease and lower their mortality. The research subjects lived in mental hospitals and a nursing home where diets can be strictly regulated. Half the subjects were fed meals rich in saturated fats from milk, cheese and beef; the others ate a diet where the fat consisted of corn oil. The result: the participants who ate the low saturated fat diet reduced their cholesterol by an average of 14 percent. Nevertheless, the low-saturated fat diet did not reduce mortality. In fact, the study showed the greater drop in cholesterol, the higher risk of death during the trial.

Even though this research was one of the largest controlled clinical trials ever conducted, the data were never fully analyzed or published. In fact, they’d been virtually hidden away and were only recently discovered in a dusty box by Dr. Frantz’s son (Frantz senior died in 2009). “My father definitely believed in reducing saturated fats,” he said, noting also that his father was probably startled by what seemed to be no benefit in replacing saturated fat with vegetable oil. In other words, the trial results were a disappointment.

While some nutritionists protest these findings, which have recently been published in the journal BMJ, plenty of other scientists find support for them. For example, one scientists analyzed four similar trials in which vegetable oils were substituted for animal fats. Those trials also failed to show any reduction in mortality from heart disease. In 2013, Dr. Christopher Ramsden, who is a medical investigator for the National Institutes of Health, discovered a similar trial that been carried out in Australia in the 1960s, but also had not been fully analyzed or published. Like the others, the results showed that those who replaced saturated fat with vegetable oils lowered their cholesterol, but were also more likely to die from a heart attack than the control group who ate more saturated fat.  “One would expect that the more you lowered cholesterol, the better the outcome. But in this case the opposite association was found. The greater degree of cholesterol-lowering was associated with a higher, rather than lower, risk of death.”

I love this. For a long time, I have believed that those who have instilled a fear of saturated fat and cholesterol have done us a terrible disservice. Because I get quite exercised about these topics, you can find more posts about them: one on why I refuse cholesterol checks and one on the misinformation about saturated fat.

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Checking a doctor’s record: good luck with that

It's next to impossible to find out whether your doctor has been sued for malpractice or has been the recipient of disciplinary actions for gross negligence, substance abuse, sexual misconduct, and over-prescribing controlled substances. The National Practitioner Data Bank collects data on medical malpractice payouts and certain levels of disciplinary actions, but only hospitals, doctors, law enforcement, insurance companies, and a few other select groups are granted access.

The May, 2016 Consumer Reports magazine describes a case in point. They tried to find information about Dr. Leonard Kurian, an obstetrician-gynecologist in Southern California who had numerous cases of malpractice, including two deaths and the removal of a healthy ovary instead of the diseased one. After filing requests for information plus much delving into California’s State Medical Board site, they were able to obtain Dr. Kurian’s records. I tried it and had no luck.

In the case described in the magazine, a pregnant woman selected Kurian as her doctor after having performed a typical online search, including Yelp. In fact, she was persuaded by reviews on Yelp to choose him, not knowing that he had already been reprimanded by the state medical board in 2006 for negligent and incompetent care as well as dishonest behavior. On Yelp, he had a rating of four out of five stars. On another site, Healthgrades, he had 3.4 out of 5 stars. Healthgrades did mention a sanction against him, but it was for “failure to keep adequate medical records.” That site showed no malpractice lawsuits against him even though the Los Angeles County courthouse has a record of 18 in which he was named.

At any rate, in the final weeks of her pregnancy, the patient went to the emergency room with excruciating pain in her side. While there, her labor began. But the pain didn’t subside after the birth of her daughter. It turns out her appendix had ruptured, yet Kurian stuck with an alternative diagnosis. Not only that, he never read the nurses notes and was unresponsive to phone calls (it took 10 hours and seven phone calls before Kurian went to see her after she was readmitted). Four days after giving birth she died. Kurian is still practicing medicine.

I entered his name into docinfo.org. There’s an “Action” category that showed an action had been taken against him in California (underlined). I clicked on California, and it took me to the California State Medical Board website, but I couldn’t find any more information. At least that “Action" note was a clue that something was amiss. Better than nothing, I guess. 

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.