鈥極besity paradox鈥 a myth for diabetics
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The “obesity paradox” — the controversial notion that being overweight might actually be healthier for some people with diabetes — seems to be a myth, researchers report. A major study in the United States finds there is no survival advantage to being large, and a disadvantage to being very large.
Weighing too much increases the chances of heart disease, cancer and premature death. But some small studies have suggested this might not be true for everyone, and that Type 2 diabetics might even benefit from a few extra kilograms — a “metabolic reserve” to help get them through sickness.
The new research — which looked at deaths according to how much people weighed when they were diagnosed with diabetes — dispels that idea.
“We didn’t see this protective effect at all,” said one study leader, Diedre Tobias of the Harvard School of Public Health. “The lowest risk was seen in the normal-weight category.”
The National Institutes of Health and the American Diabetes Association paid for the work. Results are in the New England Journal of Medicine.
“It’s a very convincing study” and large enough to give a clear answer, said one independent expert, Dr Patrick Remington, associate dean for public health at the University of Wisconsin-Madison.
It involved 11,427 female nurses and male health professionals diagnosed with diabetes after enrolling in two long-running health studies. They were grouped according to body mass index, a measure of height and weight. People with a BMI over 25 are considered overweight, and 30 or higher, obese.
During more than 15 years of follow-up, there were 3,083 deaths. The lowest risk was among those in the normal range — BMIs of 22.5 to 25.
For the rest, researchers saw a J-shaped curve — deaths trended higher at both extremes. Being just a little overweight did not substantially raise the risk of death, but the trend was in that direction.
More than 24 million Americans have diabetes.
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