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What is a Healthy Pregnancy Diet for Obese Women?
In previous articles we have discussed the value of reaching a healthy weight before planning a pregnancy. However, life doesn't always go according to recommendations. If you are overweight or obese and pregnant, what does a healthy diet look like for you?
The long-term consequences of obesity
If you've been reading News Bites or my columns on the website for a while, you've heard all about the health risks of obesity. The RAND Corporation, a non-profit research organization that provides objective analysis in a wide range of fields, has released a "Research Highlight" summarizing its research on the long-term economic consequences of the United States' dash toward obesity ("Obesity and Disability":www.rand.org/health).
The impact of obesity on the elderly
We know that obesity in adults is linked to serious conditions such as heart disease and diabetes, and last week I reported on a study that links obesity to disability and its impact on the cost of health care (The long term consequences of obesity, 4/25/07). In fact, for those under 55, studies show that a lower Body Mass Index is directly related to the lowest mortality rates from all causes. But the inverse appears to be true for the elderly: some studies seem to link a BMI of 27 to 29 (near-obese) to a reduced risk of mortality.
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The research I'll be discussing today really got people's attention: the editor of the Annals of Internal Medicine set the tone by writing an editorial titled "The Myth of Healthy Obesity." It's the secondary results of this study that I find even more interesting, however.
Researchers at the University of Toronto, Canada, analyzed the data from 12 studies that included a total of over 72,000 people and collected such information as Body Mass Index and details of risk factors such as waist circumference, blood sugars, cholesterol scores, and blood pressures (Ann Intern Med 2013;159(11):758-769). Those with one or more risk factor (other than weight) were considered "metabolically unhealthy," while those with no risk factors (other than weight) were considered "metabolically healthy."
When the researchers compared those considered metabolically healthy and of normal weight with those who were metabolically healthy and overweight or those metabolically healthy or obese, they found that over a ten-year period those who were metabolically healthy and obese were 24% more likely to experience a heart attack or stroke or to die of any cause.
It's clear that over the long term, being clinically obese (having a Body Mass Index over 30) puts you at a significantly greater risk of illness and death - and that's the practical definition of "unhealthy."
That said, what the news outlets did not tout with nearly as much glee is the comparison of those who were metabolically healthy and overweight (with a Body Mass Index between 25 and 30) with those who were metabolically healthy and of normal weight: their risk of heart attack or stroke or death from all causes was not increased.
While being obese in and of itself appears to be a risk factor, being overweight is not.
This does not mean that the definition of normal weight has suddenly increased from a Body Mass Index of 18 to 25 into the overweight area of 25 to 30. All this means is that if you are overweight and otherwise healthy, it is even more important for you to exercise and eat healthfully so that you remain metabolically healthy. We do know that losing weight will often help those who are metabolically unhealthy improve their scores in everything from blood sugars to cholesterol, so that doesn't mean you might not need to lose weight. Being metabolically healthy is not a "get out of jail free card" in terms of weight, whether you are obese or just overweight.
First posted: December 11, 2013