By Dawn Harris Sherling, M.D., F.A.C.P.
Or at least that’s what American Wallis Simpson, best known for marrying into the British royal family and causing the king to renounce his throne, thought, and to whom the quote is attributed. While the first part of the statement is for the politicians to sort out, the second is at least partially, a medical question.
As we ponder our New Year’s resolutions—which we may have already given up on—the question of what size we should be comes up for many.
“This year I will lose ten or twenty or more pounds!” is a familiar declaration at the approach of the new year—whether for health or appearance’s sake. It may be a mantra that is repeated from year to year and somehow never attained. Diets rarely work. Ms. Simpson, however, actually did achieve both of her goals of wealth and thinness, and lived to nearly ninety years of age.
So, was she right? Should we all be striving to be thin and then thinner? Well, there is reasonable scientific data to argue otherwise. While it is clear that obesity is dangerous to our health, a few extra pounds may not be.
Though many animal studies have shown increased longevity in those given calorie-restricted diets throughout their lives, these studies were historically done in small, short-lived animals like mice and rats. More recently, when larger primate studies started to produce data on calorie-restricted diets, the results were conflicting. While clear benefits could be found in a study where monkeys were fed a highly processed diet, with those being fed less of it living longer, when a whole-foods type diet was utilized in another study, there was no longevity advantage between underfed and well-fed monkeys.1
The monkey studies may be telling us something we already know—if you want to live longer, stop eating highly processed foods. According to a 2018 study from the Harvard School of Public Health, eating foods that closely adhere to a Mediterranean-type diet or other traditional foods type diets, is one factor that helps increase longevity. The other factors listed by the study include never smoking, drinking alcohol in moderation, exercising at least 30 minutes a day, and keeping a body weight in the normal range, which was defined as a body mass index (BMI) of 18.5 to 24.9.2 But wait! Isn’t that still pretty thin?
That’s a big range of normal. For a woman who is 5 foot, 3 inches, that translates to a weight range of 110 to 140 pounds. And there isn’t much to say that a svelte 110 is better than a hearty 140 from a health perspective. For a man who is 5 foot 10 inches, that’s a weight range of about 130 to 175 pounds. And if you aren’t putting the weight into your midsection, going above a BMI of 25 may be okay too.
In yet another study, being in the normal weight range or even underweight (which has been shown to produce a lower life expectancy in many studies), is more risky than being slightly overweight, having a BMI of around 27.5, if there is more fat around the waist area.3 And this makes sense if you think about physically active people who carry more of the weight in their limbs versus physically inactive people who tend to be paunchy around their midsections. In actual poundage, this means that 5 foot 3 inch woman could weigh 155 pounds and the 5 foot 10 inch man could weigh 195 pounds and be healthier than underweight or even “normal” weight men and women, provided they are pretty active with minimal gut fat.
This doesn’t mean we should give up on New Year’s resolutions completely, but maybe we could strive for healthier goals in 2020. Getting fit through physical activity and eating as few processed foods as we are able are definite improvements upon starvation diets and temporary weight loss. As for appearance, the glow of good health at any size will always be more beautiful than the hollowed out gaze of deprivation.
And remember that Harvard study? Having a drink (that’s one, maybe two for men) now and again may be good for us too. So, you can embrace a little extra weight if you happen to have it, grab a drink, and say “cheers” to a happy and healthy 2020! Then, hit the gym tomorrow.
1 Mattison, J., Colman, R., Beasley, T. et al. Caloric restriction improves health and survival of rhesus monkeys. Nat Commun 8, 14063 (2017) doi:10.1038/ncomms14063
2 Li Y, Pan A, Wang DD, et al. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population [published correction appears in Circulation. 2018 Jul 24;138(4):e75]. Circulation. 2018;138(4):345–355. doi:10.1161/CIRCULATIONAHA.117.032047
3 Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al. Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality. Ann Intern Med. 2015;163(11):827–835. doi:10.7326/M14-2525