{"id":35,"date":"2012-12-03T04:10:13","date_gmt":"2012-12-03T04:10:13","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=35"},"modified":"2012-12-03T19:23:04","modified_gmt":"2012-12-03T19:23:04","slug":"you-cant-be-too-rich-or-too-thin","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2012\/12\/03\/you-cant-be-too-rich-or-too-thin\/","title":{"rendered":"&#8220;Ideal Weight&#8221; may be an Illusion"},"content":{"rendered":"<p>There\u2019s a social stigma attached to being fat, a cultural prejudice that is utterly unfair. It makes no distinction between those who are lax about their diet and those whose metabolisms incline them toward obesity even when they eat moderately. But Mother Nature is more equitable. She distributes the gift of longevity not according to weight, but according to how much you eat, <em>taking body type into account<\/em>. \u00a0And herein lies a resolution to a long-standing paradox of epidemiology.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>The Paradox<\/strong><\/p>\n<p>In experiments with animals, there is a very near linear relationship between food intake and life span. The less they eat, the longer they live. Here, for example, are some typical results with mice:<\/p>\n<p><a href=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2012\/12\/3ae7f896.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-36 aligncenter\" src=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2012\/12\/3ae7f896.jpg\" alt=\"\" width=\"432\" height=\"336\" srcset=\"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/3ae7f896.jpg 432w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/3ae7f896-300x233.jpg 300w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/3ae7f896-385x300.jpg 385w\" sizes=\"auto, (max-width: 432px) 100vw, 432px\" \/><\/a><\/p>\n<p>Notice that at the left end, the mice are eating less than a third of what they would like to eat if left to their own devices, but there is no sign of the curve flattening. In fact, experiments have shown the rate of aging continues to be slowed by caloric restriction right up to the threshold of starvation.<\/p>\n<p>But in humans, there seems to be an \u201cideal weight\u201d where the risk of mortality is minimum. BMI (for <a href=\"http:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/\">Body Mass Index<\/a>) is a standard measure of weight relative to height. It\u2019s certainly true that people with high BMI are at increased risk of cancer and heart disease, and their life expectancies are shortened. You might expect that people with the lowest BMI had the lowest mortality. <em>But this is not so. <\/em>Below BMI of 25, there appears to be no benefit from lower weight. For BMI below about 21, the mortality actually starts to climb, and is distinctly higher for BMI less than 18.<\/p>\n<p><a href=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2012\/12\/Body-Mass-Index-and-Mortality-Among-1.46-Million-White-Adults.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-38\" src=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2012\/12\/Body-Mass-Index-and-Mortality-Among-1.46-Million-White-Adults.gif\" alt=\"\" width=\"853\" height=\"545\" srcset=\"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/Body-Mass-Index-and-Mortality-Among-1.46-Million-White-Adults.gif 853w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/Body-Mass-Index-and-Mortality-Among-1.46-Million-White-Adults-300x191.gif 300w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2012\/12\/Body-Mass-Index-and-Mortality-Among-1.46-Million-White-Adults-469x300.gif 469w\" sizes=\"auto, (max-width: 853px) 100vw, 853px\" \/><\/a><\/p>\n<p>BMI of 25 is not especially thin. It corresponds to a man (say 5 foot 10) who weighs 174, or a woman (say 5 foot 4) who weighs 145. (Values are similar in these two recent studies (<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1000367\">2010<\/a>) and (<a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0140673609603184\">2009<\/a>)).<\/p>\n<p>There are some studies that suggest even higher values. For women over 70, there\u2019s a <a href=\"http:\/\/europepmc.org\/abstract\/MED\/9192224\">study<\/a> that found the minimum mortality at BMI=32, and for men over 70 it was BMI=29. (1997) Corresponding weights are 223 for men and 179 for women.<\/p>\n<p>What\u2019s going on? Are people so different from other animals, then?<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Habits and Heredity<\/strong><\/p>\n<p>Humans are genetically diverse. For any given person, his or her weight is determined by a combination of genetics and life style, including diet and exercise habits. A person may be slender because she has iron discipline, works out regularly and keeps to a low calorie diet; or she may one of those people who can eat whatever she wants and never get fat. Looking at the two people side-by-side, you might not be able to tell which was which; but their metabolic stats would probably tell their tales. Insulin sensitivity is likely to be better in the second person, and markers of inflammation probably higher in the first.<\/p>\n<p>Here\u2019s a clue from a <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/6608731\">1983 study<\/a>\u00a0at Jackson Labs in Maine. (For those of you who are not familiar with them, Jackson Lab is the world\u2019s leading supplier of lab mice, in many different strains, specialized by breeding or genetic modifications. Profits from selling lab mice are used to support a research agenda that would be the envy of any university.)<\/p>\n<p><a href=\"http:\/\/research.jax.org\/faculty\/david_harrison.html\">David Harrison<\/a> compared normal mice to mice that carried two copies of a gene for obesity (<em>ob<\/em>\/<em>ob<\/em>). He put groups of mice of each genetic type on various caloric regimes. The <em>ob<\/em>\/<em>ob<\/em> mice that were on restricted diets still looked fat, and in fact they had 50% body fat. Normal mice on a similar diet had only 13% body fat. But the two groups showed comparable life extension \u2013 both about 50% ahead of normal. In fact, the <em>ob<\/em>\/<em>ob<\/em> mice were less vulnerable to starvation, so they could survive with less than the normal mice. The group that lived longest was <em>ob<\/em>\/<em>ob <\/em>mice on severe calorie restriction, but they <em>looked like normal mice that were fully fed<\/em>.<\/p>\n<p>(Active and productive in his 70\u2019s, Harrison still leads a research group at Jackson Labs. Can you guess his body type?)<\/p>\n<p>This suggests that fat can have a very different metabolic significance, depending on genetics and body type.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>My theory<\/strong><\/p>\n<p>Here\u2019s what I think is going on in people. The reason that you don\u2019t see consistently longer life expectancies with lower and lower BMI is that BMI <a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1038\/oby.2002.91\/full\">is mostly determined by genes<\/a>, not life style. \u00a0Some people look to be quite overweight, but are <a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0026049501619103\">healthy nonetheless<\/a>. People with low values of BMI are probably that way because of their genes, not their habits. \u201cSkinny genes\u201d don\u2019t improve your health or longevity statistics. Only eating less can do that.<\/p>\n<p>What is more, our prejudice against fat tends to magnify this apparent paradox. In our culture, people (especially women) are highly motivated to control their diets when their genes tend to make them overweight. Those whose genes are \u201cmore forgiving\u201d, are likely to be lax in their habits \u2013 they figure that weight isn\u2019t a problem form them, so they\u2019re less likely to cut calories or to work out.<\/p>\n<p>A lot of those people with BMI of 25 or more are genetically programmed to be heavier than they are, but they\u2019re working hard to keep their weight down. The reason that the health benefit of being skinny doesn\u2019t show up in the statistics is that the higher up the BMI scale you look, the more likely you are to find people who watch their calories.<\/p>\n<p>The reason that the \u201coptimal\u201d BMI for people over 70 appears to be so high is that people who weigh 223 pounds don\u2019t make it to age 70 unless they have good genes. The ones who survive to qualify for the study are a filtered sample.<\/p>\n<p>The reason that the \u201coptimal\u201d BMI is higher for women than men is that social pressure to diet is greater for women.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bottom line for health<\/strong><\/p>\n<p>The moral of this story is that we shouldn\u2019t be lulled into laxity by the fact that there doesn\u2019t appear to be a longevity benefit for lowering BMI past 25. <em>For any given individual, it\u2019s probably true that the less you eat the longer you live<\/em>. But this fact is masked in the demographic statistics for two reasons. First that genetics is more important than life style in determining BMI; and second, there is an <em>inverse<\/em> correlation between food intake and genetic propensity to be stout (as encouraged by our culture).<\/p>\n<p>Everyone can benefit from keeping weight down. But the difference seems to be greater for people who are genetically stout. People who are cursed with an \u201cefficient\u201d metabolism that stores fat get the most benefit from diet and exercise.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>There\u2019s a social stigma attached to being fat, a cultural prejudice that is utterly unfair. It makes no distinction between those who are lax about their diet and those whose metabolisms incline them toward obesity even when they eat moderately. But Mother Nature is more equitable. She distributes the gift of longevity not according to &#8230; <a title=\"&#8220;Ideal Weight&#8221; may be an Illusion\" class=\"read-more\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2012\/12\/03\/you-cant-be-too-rich-or-too-thin\/\" aria-label=\"Read more about &#8220;Ideal Weight&#8221; may be an Illusion\">Read more<\/a><\/p>\n","protected":false},"author":65,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-35","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>&quot;Ideal Weight&quot; may be an Illusion - Josh Mitteldorf<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2012\/12\/03\/you-cant-be-too-rich-or-too-thin\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"&quot;Ideal Weight&quot; may be an Illusion\" \/>\n<meta property=\"og:description\" content=\"There\u2019s a social stigma attached to being fat, a cultural prejudice that is utterly unfair. 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The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. This makes the mechanism challenging to understand and to model. more at http:\\\/\\\/mathforum.org\\\/~josh\",\"sameAs\":[\"http:\\\/\\\/AgingAdvice.org\"],\"url\":\"https:\\\/\\\/scienceblog.com\\\/joshmitteldorf\\\/author\\\/joshmitteldorf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"\"Ideal Weight\" may be an Illusion - Josh Mitteldorf","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/scienceblog.com\/joshmitteldorf\/2012\/12\/03\/you-cant-be-too-rich-or-too-thin\/","og_locale":"en_US","og_type":"article","og_title":"\"Ideal Weight\" may be an Illusion","og_description":"There\u2019s a social stigma attached to being fat, a cultural prejudice that is utterly unfair. 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may be an Illusion"}]},{"@type":"WebSite","@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#website","url":"https:\/\/scienceblog.com\/joshmitteldorf\/","name":"Josh Mitteldorf","description":"Aging Matters","publisher":{"@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/scienceblog.com\/joshmitteldorf\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#organization","name":"Josh Mitteldorf","url":"https:\/\/scienceblog.com\/joshmitteldorf\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#\/schema\/logo\/image\/","url":"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2024\/09\/1058476001.jpg","contentUrl":"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2024\/09\/1058476001.jpg","width":864,"height":363,"caption":"Josh Mitteldorf"},"image":{"@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/scienceblog.com\/joshmitteldorf\/#\/schema\/person\/214c5d1dad9f15c48f03128d5cfccdb1","name":"Josh Mitteldorf","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/d3a8498f3d727156673030716d233edc57840f110d501b1b523e1780e9043b92?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/d3a8498f3d727156673030716d233edc57840f110d501b1b523e1780e9043b92?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/d3a8498f3d727156673030716d233edc57840f110d501b1b523e1780e9043b92?s=96&d=mm&r=g","caption":"Josh Mitteldorf"},"description":"Josh Mitteldorf studies evolutionary theory of aging using computer simulations. The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. 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