What is more important: to lose weight or build muscle mass?
Is obesity always a disease?
About 10 years ago, a new term appeared in scientific publications - “metabolically healthy obesity”. It turned out that all fat people and even very fat people are not at the same risk of getting stroke, heart attack and diabetes. Some have impaired sensitivity to insulin, increased "bad" lipids and reduced "good", they have a catastrophically small muscle mass and stamina leaves much to be desired. They are the first candidates for the appearance of the above ailments. Others, despite their impressive body weight, are quite hardy, eat a meal that is considered useful, and do not absorb burgers and French fries at all every day, their physical activity is quite high, and the analyzes do not show any deviations. The risk of getting diabetes and “vascular catastrophes” is no higher for them than for a normal healthy person of normal physique.A third group of people with a normal body weight was also found, who, however, had exactly the same analyzes as corpulent patients from the first group. They were thin and at the same time - unhealthy.
This finding marked the beginning of scientific research, which showed that a complete person is not necessarily sick. Meta-analysis, which combined 27 studies worldwide, showed that the prevalence of "safe for health" obesity is from 10 to 51%. Not so little to disregard this fact!
Other interesting messages followed: more metabolically healthy among men were found among obese women. The more the age of the subjects, the more healthy complete people became less. In other words, the fact that at a young age a person has “safe” obesity is not at all a guarantee that by mature age overweight will not acquire adverse metabolic rates.
Endocrinologists talked about the fact that obesity - not a reliable harbinger of diabetes. What is more indicative of the presence of metabolic disorders: a decrease in sensitivity to insulin,tendency to accumulate fat in the abdominal cavity, an increase in the fat content in the liver, and possibly also signs of chronic inflammation
Cardiologists soon joined the statements of endocrinologists. Based on the European prospective study, which involved 520,000 people over the course of 12 years, it was found that the risks of developing coronary heart disease are higher for those with metabolic disorders. And the body mass index, that is, the presence or absence of obesity, did not affect these risks at all!
In women who have maintained a healthy metabolism, despite their fullness, fat was distributed mainly on the buttocks and thighs. And those who had high risks of seriously ill, usually accumulated fat around the internal organs - this type of obesity is called visceral. Some peculiarities of nutrition have also become clear: people with “safe for health” obesity consumed less meat and milk. In this group were those who followed the Mediterranean diet (a diet consisting of a large amount of fruits and vegetables, whole grains, sea fish and vegetable oils — cardiologists recommend it to reduce the risk of "vascular catastrophes"); such patients remained complete, but perfectly healthy.
In other words, the myth that any fat man is such a “Robin Bobin Barabek” who “ate forty people”, french fries and five muffins at each meal - and so every day, does not hold water.
Fat people presented a lot of surprises to scientists and in the study of endurance. Those who, despite being overweight, showed good indicators of exercise tolerance, subsequently had rather low risks of dying from oncology, "vascular accidents" and some other diseases.
Do I need to lose weight?
Here the opinions of researchers diverged. In some publications, resolutely all full patients are advised to lose weight. Like, it looks logical, although no reasonable evidence in favor of this strategy is given. In other publications, people with obesity and normal metabolism are strongly advised to leave alone, confining themselves to a recommendation to maintain high physical activity. In 2008, the results of a study conducted at the University of Quebec in Montreal showed that a 6-month-calorie-restricted diet leads to an improvement in metabolic rates in metabolically unhealthy people.However, for those who were obese without any problems with metabolism, this diet did not lead to anything good: there was an increase in the sensitivity of tissues to insulin, which means that “healthy fat men” confidently took the path of ill health.
But there is another problem: how to deal with deadly breathing stops in a dream, as well as back and joint pain, which often annoy full people, regardless of their metabolic rate? Researchers have no answer to this. Practitioners believe that decisively all patients with obesity need to be persuaded to lose weight. In spite of the fact that for 10–50% this recommendation will be unjustified, reducing one, but increasing other health risks.
Do the fat people always risk losing more lean ones?
Fat people made a mystery to the scientific community. Overweight in patients with certain diseases (for example, chronic heart and kidney failure) suddenly turns into a bonus that reduces the risks of mortality. People with reduced and normal body weight have no such advantages over a terrible disease.The causes of the “paradox of obesity” are still unknown.
Muscle, Fat and Health
In the debate about whether to leave fat people alone or recommend them to severely limit the calorie intake, many copies are broken. However, in battles regarding aesthetics and medical problems of obesity, the role of muscle tissue is somehow forgotten.
With age, muscle volume begins to rapidly decline. And the risks of cardiovascular diseases, on the contrary, increase, even if a person has a normal body weight. Sarcopenia - a critical loss of muscle mass, which leads to increased mortality risks, is found in half of 80-year-olds. A detailed study of thousands of patients on a multispiral computer tomography showed that if a person prefers to move by car or public transport, he despises fiber-rich food and consumes a lot of sugar, at the age of 40 to 60 he will lose about 40% of muscle tissue. And further the loss of muscles will only progress.
The World Health Organization recommends exercise as a means of preventing "vascular accidents", depression, hypertension, type 2 diabetes and certain types of cancer.Physical activity reduces the risk of breast cancer in women by 25%. The norm recommended by WHO is 30 minutes of any activity, be it aerobic or power loads. An ordinary walk is also counted. Of course, the choice of load should be agreed with the doctor and reasonably assess their capabilities, avoiding overloads or traumatic activities. For example, a pensioner who last played sports in his youth, when he passed the standards of the TRP, should not begin his journey to health with a game of basketball or rugby. It is much more reasonable to have a dog and walk with her in the park twice a day.
Physical activity affects health risks on almost all fronts: it increases the sensitivity of tissues to insulin, improves hormonal levels, and reduces inflammatory activity in the body. In other words, sport has a positive effect on the factors of metabolic ill health and helps to return to normal carbohydrate metabolism, blood lipid spectrum, hormone levels. The result is a 30–35% reduction in mortality. And for obese people, it is also an opportunity to go into the “safe for health” group of obesity, if deviations in tests were recorded before regular physical exertion.
The question of the need to limit calories in the diet for obesity is uniquely solved only among the inhabitants on the Internet, who are ready to diagnose any avatar, predict a quick death from extra pounds and create an individual weight loss program in the style of Maya Plisetskaya called “need to eat less”. For the scientific community, the need to strictly limit the nutrition of fat people is not so straightforward, and the more research is done, the more questions arise.
However, muscle mass is something for which it is worth fighting. And not only for the sake of aesthetics, but also for the high quality of life, the pleasure from the capabilities of your body, as well as a serious chance to delay the onset of old age and many diseases.
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