Obesity paradox: Study suggests being slightly overweight might be good

diabetes Representational image | File

Being slightly overweight may actually be a good thing, findings of a new study suggest. While looking at death rates among diabetic and non-diabetic Indians, researchers have found that those who were underweight had a significantly higher risk of "all-cause mortality" — death due to factors other than diabetes — compared to those who were “marginally overweight” or obese.

The findings of the study, done by the Madras Diabetes Research Foundation, support the newly emerging concept of an “obesity paradox”; being “slightly overweight”, especially for older folks, may not be such a bad thing, they say. “Though gross obesity is undoubtedly harmful, this study shows that being overweight in small degrees, especially in older people, may not be as bad as believed earlier. This is a newly emerging finding worldwide, and needs further study. Excess mortality noted among underweight individuals may reflect their poor health due to other underlying diseases such as TB, and undernutrition,” said Dr V. Mohan, Director, Madras Diabetes Research Foundation (MDRF).

In context of the findings, researchers explicitly caution that they are not asking people to be obese. “What we are saying is that being on both ends of the spectrum is bad. People need to be healthy, and follow the path of moderation. If you are a little overweight, then there's no need to kill yourself to become thin. Because when you do that, in India, other issues such as lower immunity, micro-nutrient deficiencies, and poor bone and muscle health come in. Young people go on fancy diets these days to drastically lose weight, that's what we need to avoid,” said Dr R.M. Anjana, managing director, Dr Mohan’s Diabetes Specialities Centre and vice president, MDRF.

The study, titled, Chennai Urban Rural Epidemiology Study (CURES) was done between 2001-2003, and included 26,001 adults from Chennai city, who were aged 20 years and above. Of these, around 3,000 people were followed up for detailed investigations for 15 years.

During the study, Anjana and her team also found that those with diabetes had three times higher death rates than non-diabetics. The excess mortality due to diabetes was found to be higher in the age group of 51-70 years. Most of this excess mortality due to diabetes was accounted for by renal disease and cardiovascular disease. “The fact that excess mortality due to diabetes was highest in the age group of 51-70 is possibly a reflection of the earlier age of onset of Type 2 diabetes in Indians,” said Mohan. Altering the risk factors for diabetes through increased physical activity, quitting smoking, good diabetes and blood pressure control and the use of statins could help in lowering death rates in Indians, even if they have type 2 diabetes, he added.

While there are several studies on death rates in people with and without diabetes from developed countries, there isn't much data from India. Such data is important because Indians, in general, are known to be at an increased risk of developing both type 2 diabetes as well as premature coronary heart disease, the authors say.

“To our knowledge, this is the first study from India to compare mortality rates in a representative population based cohort of individuals with and without diabetes. Coronary heart disease, that contributed 53 per cent of the risk of mortality in those with diabetes can be reduced if it is diagnosed and detected early and aggressively. Diabetes can also be prevented, and controlled to reduce these death rates,” said Anjana.

“Other important contributors to death rates such as physical inactivity, dyslipidemia (unhealthy levels of fat in the blood), smoking, alcohol consumption and hypertension are also easily modifiable risk factors,” she said.

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