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Being Overweight Increases Risk for Premature Death

Overweight people are at increased risk for dying prematurely, even if they exercise regularly. The largest study of its kind ever shows that being fit in your teens helps to prevent premature death later on (Int. J. Epidemiol, December 20, 2015). However you lose this exercise protection against dying prematurely if you are overweight, and the heavier you are, the higher your risk for dying prematurely.

The Study
More than 1.3 million Swedish 18-year old men were weighed and asked by their draft boards to cycle until they had to stop. Thirty years later, the researchers found that 44.000 of the men had died. Those in the highest fifth of the group on fitness tests had a 41 percent lower risk of death than those in the lowest fifth. The heavier the men were in their teens, the less they benefited from their level of fitness.

Men in the highest fifth level for aerobic fitness had a 48 percent lower risk of death from any cause compared with those in the lowest fifth. Not being overweight in the teen years reduced chances of:
• dying in the next 30 years by 80 percent,
• dying from heart disease by 45 percent,
• dying from abusing alcohol or drugs by 40 percent, and
• dying from suicide by 59 percent.

Being fit did not reduce the death rate of men who had BMIs greater than 35. A 6' tall man who weighs 250 pounds has a BMI of 35. (Calculate your BMI here)

The Swedish study agrees with many others that show that having too much fat in your body shortens your life, no matter what you do. The only way that you can prevent the health damage of being overweight is to lose weight, no matter how much exercising or dieting you do. Many studies have shown that being overweight in the teen years predicts being overweight as an adult. However, being overweight under the age of ten does not predict obesity as an adult.

Why Obesity and Lack of Exercise are Damaging To Your Health
Lack of exercise and weak muscles increase risk for heart attacks (BMC Med, April, 2014;12:62). Being overweight and having full fat cells releases chemicals that turn on your immunity to cause inflammation, which increases risk for heart attacks (BMJ, Oct 2013;347:f5446). Then the cells and chemicals that kill germs do that same thing to you that they are supposed to do to invading germs. The chemicals that are supposed to dissolve the outer membranes of invading bacteria dissolve the inner linings of your arteries to form plaques which increases risk for a heart attack.

Where You Store Fat Predicts Risk for Heart Attacks
Storing fat primarily in your belly is a far stronger risk factor for heart attacks, strokes and premature death than just being overweight. A study of 5696 adults used dual energy X-ray absorptiometry to classify them as storing fat primarily in their bellies or buttocks (Clinical Endocrinology, June 2014;80(6)). The more fat you store in your belly, the more likely you are to have high total cholesterol, triglycerides and bad LDL cholesterol. Storing fat primarily in your buttocks is associated with lower triglycerides and higher good HDL cholesterol.

When you store fat in your belly, you are likely to also store fat in your liver. Having extra fat in your liver prevents the liver from responding to insulin and controlling your blood sugar levels. High rises in blood sugar can damage every cell in your body to increase risk for diabetes, heart attacks, strokes, cancers and death.

Your liver controls blood sugar levels. When blood sugar levels drop, your liver is supposed to release sugar from its cells to raise blood sugar levels. When blood sugar levels rise, your liver lowers blood sugar levels by responding to insulin which drives sugar from the bloodstream into the liver cells.

How Exercise Helps to Prevent Disease and Prolong Life
This is not to say that exercising doesn't prolong lives; it does. Resting muscles remove virtually no sugar from the bloodstream, while contracting muscles can remove sugar from the bloodstream without even needing insulin. The more intensely you exercise, the more effectively muscles can remove sugar from the bloodstream.

My Recommendations
If you can pinch more than three inches of fat under the skin on your belly, you are overweight and are at increased risk for many diseases and premature death, even if you exercise regularly and eat a reasonably healthful diet (high in plants, low in meat, sugar and fried foods). You should make an extra effort to lose the excess weight.

I think that the most effective way to lose weight is Intermittent Fasting. This program does not recommend total fasting, which would be painful. On my "fast days", I eat oatmeal for breakfast and then snack on vegetables, fruits and nuts during the day. You can use any combination of foods you prefer, with a goal of no more than about 600 calories for the day. On your other days, follow your regular healthful eating pattern. While you are working to lose weight, do a fast day twice a week or as often as every other day. Once you have reached your desired weight, weigh yourself every morning. Do a fast day when your morning weight increases by more than two pounds.

December 27th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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