Myth #1: ‘Overweight’ means ‘unhealthy’
A debate has raged in medicine for years: Can you be fat and fit?
To a degree, this debate boils down to a numbers game. Many doctors use body mass index (BMI) to determine whether a patient’s weight is healthy or unhealthy. The BMI is a number that describes the ratio of your weight to your height. According to the Centers for Disease Control and Prevention, having a BMI under 25 means your weight is normal, 25 to 25.9 means you are overweight, and 30 or higher means you are obese. It’s clear, however, that this breakdown is oversimplified and in some cases inaccurate. For starters, many buff athletes with chiseled pecs and bulging biceps have high BMIs, since muscle weighs a lot.
More important, research has shown that a person’s weight isn’t necessarily the best measure of overall health. One study of thousands of men by researchers at the Cooper Institute in Dallas underscored this fact. Researcher Steven N. Blair, PED (who once told the New York Times, “I may be short, fat, and bald, but I’m fit.”), led a team that tracked more than 25,000 men over 23 years. They recorded who got sick and who died and who didn’t.
In the end, Blair and his colleagues surprised the world by showing that men who were overweight or obese but exercised regularly had half the death rate of normal-weight men who were out of shape. In fact, Blair’s study found that being in poor physical condition was far more dangerous than simply being overweight, increasing the risk of premature death as much as having type 2 diabetes, high blood pressure or cholesterol, or smoking cigarettes does.
While this study suggests that heavyweights can be healthy people, it’s important to keep in mind that lugging around a lot of abdominal fat does appear to be unhealthy. In fact, having a big belly increases the risk of heart disease and type 2 diabetes. (What’s big? For men, 40 inches or more; for women, 35 inches or more. To measure your waist, wrap a tape measure around your bare abdomen just above the hipbones so it’s snug but not tight. Inhale, exhale, and measure.) Fortunately, exercise burns belly flab, which is all the more reason to keep hitting the treadmill if you’re overweight.
Myth #2: Your fate is already sealed
You often hear this kind of fatalistic remark from people whose parents died young of heart attacks or cancer: “What’s the point of jogging and eating broccoli if my lousy genes are going to kill me anyway?” Furthermore, each passing week seems to bring news that scientists have discovered yet another “disease gene.” If our health destinies are preprogrammed, does it really matter whether we take care of our bodies?
In short, yes. The so-called breast cancer gene, BRCA1, offers a good example. There’s no doubt the gene is powerful: Some 60 to 80 percent of women who have a mutation of this gene will develop breast cancer as compared to 13 percent of women who don’t have the mutation. But that means that as many as 40 percent of women who inherit a BRCA1 mutation never develop breast cancer, suggesting that perhaps their lifestyle choices give them some protection.
What’s more, scientists believe that the majority of cancer cases are not caused by inherited bad genes. Swedish researchers looked at the incidence of various cancers among nearly 45,000 sets of twins and concluded that “genetic factors make a minor contribution to susceptibility” to most forms of the disease. The evidence clearly shows, they stated, that the environment a person lives in has by far the greater influence on cancer risk.
The same scenario seems to hold true for other diseases that can rob you of years. Imagine a pie chart representing all the factors that influence how long you will live. Many studies suggest that the genes you inherited from your parents make up only about one-third of the pie, and maybe less. The other items in the pie include diet, physical activity level, and personal habits, such as tobacco use and alcohol consumption. In other words, you can’t change your DNA, but what makes up the rest of the pie is largely up to you.
Myth #3: Prescription drugs are guaranteed safe
About 10 percent of prescription drugs that hit the market are later discovered to cause serious side effects that didn’t turn up in clinical trials. With that in mind, you might think that pharmaceutical companies would want to keep close track of whether people become ill when they take new drugs the companies market. In fact, the FDA requires them to do just that. Yet drug companies fail to perform these follow-up studies 70 percent of the time, says Paul Brown, a consumer health advocate with the US Public Interest Research Group.
That’s why Merrill Goozner recommends that you change the channel or turn the page when you see an advertisement for a new drug. Goozner is director of the Integrity in Science project for the Center for Science in the Public Interest (another consumer watchdog group) and author of The $800 Million Pill: The Truth Behind the Cost of New Drugs. “There is no place for those ads in the practice of medicine,” he says.
That doesn’t mean new drugs have no value. If there are currently no medications available to treat your condition, and there’s solid evidence that a new medication is effective without causing intolerable side effects, the new drug could offer some hope. However, if a heavily hyped new drug would merely replace a medication that’s currently working well for you, then why switch and expose yourself to unknown risk? If your doctor recommends doing so, ask why.