Health issues related to excess weight have been covered in several previous columns.
However, as many of us continue to practice social isolation and perhaps consume more so-called “comfort” foods, the consequences of excess weight gain can contribute to deterioration in one’s health status.
This column highlights some of the relevant information provided in a past column which continues to be of concern, particularly during these unprecedented times of the coronavirus and COVID-19. In reality, there are many things you may not realize as relates to extra weight and the potential for producing negative health outcomes.
Extra pounds means extra cancer risk
According to Walter Willett, Professor of Epidemiology at the Harvard School of Public Health, “The evidence is extremely clear that excess weight increases the risk of cancer.” Willet, who co-authored a report on obesity by the International Agency on Cancer Research noted that it is “…probably the second most important cause after smoking.”
Cancers of the breast and uterus are most clear for post-menopausal women who are obese as their blood estrogen levels are about three times higher than lean post-menopausal women (fat cells make estrogen).
Another potential problem for pancreatic, kidney and colorectal cancers in overweight individuals is that his often leads to higher blood insulin levels. For breast cancer, estrogen and insulin may both matter. One study which took estrogen into account noted that postmenopausal women with the highest blood insulin levels had 2 ½ times the risk of breast cancer when compared to women with the lowest blood insulin levels.
Being overweight is a cause of gastric reflux and heartburn, according to Willet, and the acidity causes cell destruction and inflammation, a process that increases the risk of cancer. Obese individuals are five times more likely to get esophageal cancer, which has an 18% five-year survival rate — than those who are normal weight.
Fat cells are hard to lose
A Mayo Clinic study on extra calories when you overindulge provided 400 to 1,200 extra calories to 23 lean men. The individuals had gained about 8 pounds which was distributed in two different areas. Almost all of the weight gain in the abdominal area was an increase in fat cell size while fat storage accumulation in the leg area was due to the creation of new fat cells.
These individuals then followed up for two months cutting calories and increasing exercise. Everybody lost all or most of their abdominal subcutaneous or visceral fat.
The only fat not yet lost was some of the leg fat. The researchers concluded that it was easier to shrink fat cells down to their original size than to make fat cell go away.
However the researchers noted that one shouldn’t assume that you’ll never gain new fat cells around the abdomen. From an average small fat cell to the biggest of the big is about a four-fold increase in size. So, these cells can only get so big.
Interestingly enough, the leg fat that’s the hardest to lose is also the least harmful.
A large waist is not good
Even if one maintains about the same weight but increases their waist circumference — a common pattern in middle-aged men — that can be a problem, according to Willet.
Pooled data on roughly 650,000 men and women revealed that the risk of dying over nine years rose significantly for every two additional inches of weight, even in individuals who weren’t overweight.
Although our methods of measuring obesity are not perfect, we know that someone with a big belly is not due to a big muscle there. Even more alarming is the fact that a larger waist could signal a larger deposit of visceral fat that’s buried deep in the belly, which is more harmful than the subcutaneous fat that’s just under your skin.
Visceral fat accumulation is more closely linked with type 2 diabetes and coronary heart disease, according to Ulf Riserus, associate professor of clinical nutrition and metabolism at Uppsala University in Sweden.
Theories and beliefs related to excess visceral fat include its accumulation in the liver causing metabolic disorders, the release of inflammatory proteins, and its link to insulin resistance, which may lead type 2 diabetes. A fatty liver also produces more triglycerides, which can also increase the risk of cardiovascular disease in the long-term.
If visceral fat cells reach their limit, they may end up in muscle, the liver and elsewhere.
As these organs don’t package the fat very well, cell function can be impaired.
As we continue in this pandemic make it your goal to eat a better diet and increase your activity level (following the recommended guidelines by the Centers for Disease Control and Prevention (CDC). And, make sure you consult reliable sources of health/nutrition information, which is evidence-based and focuses on best practices. Some of these are provided under the resources section at the end of this column. Thanks to CSPI for much of this content.
A fact sheet on obesity and cancer discussing causes and prevention is available through the National Cancer Institute (NCI) at cancer.gov.
Additional Information on how fat cells work can be accessed at
An obesity prevention resource by Harvard University’s T.H. Chan School of Public Health (with an explanation of waist size) and its implication for health can be found at:
Go to the following link provided by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for more specific information on various health risks associated with being overweight at niddk.nih.gov
Mark A. Mahoney, Ph.D. has been a Registered Dietitian/Nutritionist for over 34 years and completed graduate studies in Nutrition & Public Health at Columbia University. He can be reached at firstname.lastname@example.org.
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