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Dr K K Aggarwal

Fat but fit no longer good for health

By Dr K K Aggarwal
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A study published in the International Journal of Epidemiology challenged the concept that by being physically fit, individuals who are obese can fully compensate mortality risk. The study suggested that physically fit obese men have a higher risk for death compared to men who are of normal weight but are physically unfit. And it also found a graded association between aerobic fitness at the age of 18 years and the risk of early death.

The study by Gabriel Högström, Dept. of Community Medicine and Rehabilitation at Umeå University, Sweden, and colleagues, obtained data from the Swedish Military Conscription Registry and included 1,317,713 Swedish men (mean age, 18 years) conscripted into the Swedish military from 1969 to 1996. At the time of conscription, they were subjected to baseline assessments for aerobic fitness testing, wherein they cycled until fatigue set in. Investigators assessed all-cause and cause-specific deaths, using national registers. Mortality information was obtained from the National Cause of Death Registry.

Over a mean follow-up of 28.8 years, 44,301 of them died. After adjustment for age and conscription year, those with the highest aerobic fitness levels were found to have a 51% lower risk for all-cause death compared to those with the lowest fitness levels. Similar findings were seen from analyses of weight-adjusted fitness.

Alcohol and narcotic abuse were found to have the strongest associations with death (HR, 0.20; 95% CI, 0.15 – 0.26).

Obese men obtained lesser benefit than normal-weight men from being physically fit (P < .001). Additionally, normal-weight men in all levels of aerobic fitness had lower risk for all-cause mortality (30% – 48%; P < .05 for all) in comparison with obese men with the highest levels of aerobic fitness.

The benefits of aerobic fitness appeared to decline with increase in weight. After adjusting for age and year, normal-weight men in the upper half of aerobic fitness had 34% lower risk for death compared to those in the lower half (HR, 0.66; 95% CI, 0.64 – 0.68). The benefit was seen to decrease to 28% among overweight men, and disappeared completely in those with the highest levels of obesity… (Medscape)

Gaining weight & losing strength vs losing weight & gaining strength

By Dr K K Aggarwal
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When we gain weight, we must acquire more strength and when we lose weight, we must lose the strength. This is a fundamental principle. If we gain weight and feel weak, it is a disease and when we lose weight and gain strength, we are recovering from the disease. One should not gain more than 5kg of weight after the age of 20 years. Any weight gain after that will only be due to accumulation of fat, which leads to insulin resistance. Insulin resistance does not allow food to convert into energy. In the state of insulin resistance, whatever you eat is converted into fat. As it is not converted into energy, you feel weak. When you reduce insulin resistance by drugs or walking, the metabolism becomes normal and whatever you eat gets converted into energy and you start gaining strength.

Fat but fit no longer good for health

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Fat but fit no longer good for health

A study published in the International Journal of Epidemiology has challenged the current concept that by being physically fit, individuals who are obese can fully compensate mortality risk. The study suggests that physically fit obese men are at higher risk for death than men who are of normal weight but are physically unfit. And it also found a graded association between aerobic fitness at the age of 18 years and the risk of early death.

The study by Gabriel Högström, PhD, a postgraduate student in the Dept. of Community Medicine and Rehabilitation at Umeå University, Sweden, and colleagues, drew data from the Swedish Military Conscription Registry and included 1,317,713 Swedish men (mean age, 18 years) conscripted into the Swedish military between 1969 and 1996. At the time of conscription, the men underwent baseline assessments that included aerobic fitness testing, in which they cycled until fatigue caused them to stop. The researchers looked at all-cause and cause-specific deaths, using national registers. Mortality information came from the National Cause of Death Registry.

During a mean follow-up of 28.8 years, 44,301 of the men died. After adjusting for age and conscription year, men with the highest aerobic fitness levels had 51% lower risk for all-cause death (hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.47 – 0.51vs those with the lowest fitness levels. Similar findings resulted from analyses of weight-adjusted fitness (HR, 0.52; 95% CI, 0.50 – 0.54).

Alcohol and narcotic abuse had the strongest associations with death (HR, 0.20; 95% CI, 0.15 – 0.26). Obese men benefited less than normal-weight men from being physically fit (P < .001). Normal-weight men in all levels of aerobic fitness had lower risk for all-cause mortality (30% – 48%; P < .05 for all) compared with obese men with the highest levels of aerobic fitness.

The benefits of aerobic fitness decreased as weight increased. After adjusting for age and year, normal-weight men in the upper half of aerobic fitness had 34% lower risk for death than those in the lower half (HR, 0.66; 95% CI, 0.64 – 0.68). This benefit decreased to 28% in overweight men, and disappeared entirely in men with the highest levels of obesity… (Medscape)

Do not replace saturated fat with refined carbohydrates: white sugar, white rice and white maida may be more harmful

By Dr K K Aggarwal
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It is wrong to say eat less fat; the real message should be eat more fresh fruits and vegetables.

White advocating low–fat diets it is easier for patients to understand advice given in terms of foods e.g., “Eat more fresh fruit” rather than nutrients or “Reduce your intake of fat to less than 30 percent of your total energy intake.”

The message to reduce fat has been translated by food manufacturers and consumers into a potentially harmful set of food choices.

Instead of replacing high–fat foods with naturally low–fat foods with other benefits, such as fruits, vegetables, legumes, and whole grain foods, consumers have often increased their consumption of low–fat or “fat–free” varieties of naturally high–fat foods, such as fat–free snack or junk foods.

The result is an increase in refined carbohydrates which lower good HDL–cholesterol concentrations with a possible increase in the incidence of type 2 diabetes and obesity, and failure to gain the benefits of more.

Carbohydrates substitute to saturated fat not the answer

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More than 20 prospective studies have addressed components of diet and the risk of heart disease.

The type of fat consumed appears to be more important than the amount of total fat.

Trans fatty acids increase risk of heart disease while polyunsaturated and monounsaturated fats decrease risk.

There is controversy about whether it is optimal to substitute saturated fats with carbohydrate. An increase in carbohydrate tends to reduce the level of good high density lipoprotein (HDL) cholesterol in addition to total and low density lipoprotein (LDL) cholesterol.  Thus, the reduction in heart disease risk may be less than predicted by the reduction of saturated fat alone.

Observational studies have consistently shown that individuals consuming diets high in vegetables and fruits (which are rich in antioxidant vitamins) had a reduced risk of heart disease.

Results of a number of randomized trials are now available and show largely no significant clinical benefits of antioxidant vitamins on heart disease.

Supplemental vitamin C, E, and beta carotene cannot be recommended in the primary prevention of CHD.

Taking supplements without clinical benefits could, in theory, increase the risk if individuals mistakenly avoid therapeutic lifestyle changes or drug therapies with proven benefits.