New clues to the “obesity paradox”

Those studies used body mass index (BMI), which depends only on a person’s weight and height, as a proxy for body fat. The new study estimated the body fat and lean mass (mostly muscle) of 38,000 men using weight, height, waist size, age, and race.

Over 21 years, those with the least body fat had the lowest risk of dying. As body fat rose, so did the risk of dying—most often of cardiovascular disease or cancer.

In contrast, men with the least muscle mass had a higher risk of dying (especially of respiratory illness) than those with an intermediate level of lean mass. Why? Low muscle mass could be a sign of undiagnosed illness or frailty, even in people with a “healthy” BMI.

And that could explain the obesity paradox.

Bottom line: Don’t assume that a few extra pounds could be healthy.

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