The more fat the better?

You could hear at about 20:12 minute of another video of Dr Lustig that the more subcutaneous fat - the better. Really? 

He supported this claim by a single image: 

Of course, the intra-abdominal fat is far worse than the subcutaneous one (under the skin). No question about that. But is it really true that the more subcutaneous fat - the better? Is it better to be obese than slim? Not at all. 

I know that researchers reported that people with BMI in the overweight category (BMI 25-29.9) lived longer than those below BMI 18.5. But was it because they had more fat or because of something else? This article summarized the research quite well. Among other things there you can read that many of those overweight people received a preventative treatment with statins to cut down the risk of cardiovascular conditions which are associated with increased body weight and elevated cholesterol. It also said nothing about the quality of life of those people or the other diseases they suffered. It only summarized that overweight people had a lower chance of death in comparison to healthy weight and other weight categories. Those obese had a higher rate of mortality and those underweight even higher - also probably because of already having some disease that made them underweight. 

Therefore we can conclude that the mortality has little to do with the quality of life. This is also supported by the statistics: people die later in developed countries, but the amount of healthy years has decreased. We pay for living longer by increased healthcare costs and the increased medical treatments, the lack of which meant early death in the past. 

It was Dr Lustig that repeated at each video of how much money is being spent on the few major metabolic diseases and that the healthcare will collapse within two decades. You also may have heard in the media that this young generation is the first that has the change to be outlived by their parents - because of the youth obesity and associated ill health. Then you could see in one of my previous articles and in Dr Lustig's presentations: that while 80% of 30% of the population (obese) suffers ill health, it is the 40% of remaining 70% of the population that also suffers the same diseases. I brought more light into this manipulative picture and made it clear to you that about half of those 'normal weight' are actually overweight. So while they may die later, their quality of life is unlikely to be better than of those of really normal weight. The advanced medicine nowadays can keep an ill person alive for a pretty long time. 

One thing I would agree with, though: more subcutaneous fat (up to a certain, healthy, level) means sufficient amounts of estrogen in women. That means stronger bones for them and also a higher protection from metabolic disruption which are more prevalent in men (such as gout). Women after the menopause often start suffering the diseases typical for men, too. That is a fact. But saying that the more fat under the skin the better is a heresy, especially when it is not specified that this fat should rater be stored around hips and thighs, not in the abdomen, albeit under the skin. Excess fat tissue promotes inflammation and that is by no means healthy. Obese people have difficulties to move around, the fat mass weights on their lungs and heart during sleep and the excess weight also leads to early wear-off of the knee cartilage causing further health problems due to reduced mobility.

Meanwhile, high estrogen levels promotes various forms of cancers, of which the breast cancer is probably the best studied in women - the extra body weight has been linked with the increased incidence of breast cancer. 

Moreover, that particular study I mentioned above did not examine the difference between the intra-abdominal and subcutaneous fat. They only weighed the participants and assessed their BMI. The fact is, though, that you could hardly expect an obese person not having an excess fat wrapped around their internal organs. While there may be some significant difference in apparently normal weight individuals, in practice with every kilo of extra fat under the skin, more fat is allocated inside the abdomen too. 

Therefore I appeal on everybody to be careful about such one-sided statements that the more fat is better and I mean that regardless of where it is stored. It is doing no good service to anyone and people may wrongly assume that if they carry extra fat on their hips or the body in general then their inside is as slim as of a a poor African suffering famine right now.