Category: Nutrition

  • Uses and Side Effects of Ozempic and Other GLP-1 Weight Loss Drugs

    Uses and Side Effects of Ozempic and Other GLP-1 Weight Loss Drugs

    Ozempic and others in a new class of weight-loss drugs have been called “the medical sensation of the decade.” Are they worthy of all the hype?

    For a deep dive, please see my primer on this topic. OZEMPIC: Risks, Benefits, and Natural Alternatives to GLP-1 Weight-Loss Drugs is available as an ebook, audiobook, and paperback. You can also view my video series for free on the Ozempic topic page or our YouTube channel. Here are some of the key takeaways.

     

    What Is GLP-1?

    A naturally occurring hormone in our body, glucagon-like peptide-1 (GLP-1) plays a role in regulating our blood sugar, appetite, and digestion. Our gastrointestinal tract releases more than 20 different peptide hormones, including GLP-1. The primary stimuli for secreting GLP-1 are meals rich in fats and carbohydrates, and GLP-1’s main action is to signal satiety to the brain. It also slows our digestion. Delaying the rate at which food leaves our stomach not only helps us feel fuller for longer, but also helps with our blood sugar control. When GLP-1 or an agonist (mimic) is dripped into people’s veins, appetite is reduced, leading to markedly reduced food consumption—a decrease in caloric intake by as much as 25 to 50 percent.

     

    About GLP-1 Drugs

    Our GLP-1 hormone acts as an appetite suppressant by targeting parts of the brain responsible for hunger and cravings. GLP-1-secreting cells don’t only line our intestines; they’re also in our brains. These new anti-obesity drugs are GLP-1 agonists, mimicking the hormone’s action by binding to GLP-1 receptors.

    Our body breaks down GLP-1 so quickly that it hardly makes it even one time around our circulatory system, which is why we can’t just take the hormone directly. A compound was discovered—in the venomous saliva of a lizard called the Gila monster—that mimics GLP-1 but is resistant to breakdown. Using that compound as a template, the first GLP-1 agonist was created and approved for the treatment of diabetes about 20 years ago. Instead of most of it being cleared from the body within two and a half minutes, like native, natural GLP-1, much of the drug remains in the body for two and a half hours. That still means twice-daily injections, though, so then came liraglutide, which lasts all day. 

     

    What Is Ozempic?

    Eventually, semaglutide was developed and branded as Ozempic, which could be injected just once a week. Ozempic was approved in 2017 to treat diabetes. Within a few years, a daily oral version had been developed, again for diabetes, but researchers running those clinical trials noticed a surprising side effect: People’s appetites diminished.

     

    How Does Ozempic Work?

    In a way, GLP-1 agonist drugs work like birth control pills. The Pill mimics placental hormones, thereby tricking our body into thinking we’re pregnant all the time. Ozempic-type drugs mimic GLP-1, thereby tricking our body into thinking we’re eating all the time. That’s how it dials down our hunger drive.

     

    Ozempic for Weight Loss

    In the longest trial to date, more than 17,000 individuals were randomized to injections of either high-dose semaglutide or placebo for four years. Overall, those on the drug lost 9 percent more body weight than those in the placebo group, but all the weight was lost in the first 65 weeks. Even though they continued to get injected every week for three more years, they didn’t lose any more weight over the subsequent 143 weeks.

    Weight loss tends to plateau because the same amount of effort to cut calories—whether through willpower, drugs, or surgery—is met with growing resistance as ongoing weight loss increasingly activates our feedback control circuit, stimulating our appetite. In the case of the GLP-1 drugs, the weight loss caused by the initial drop in appetite is undercut by an apparent exponential increase in caloric intake as our body ratchets up our hunger again. Within 12 months, this resistance, combined with the decreased caloric needs from being lighter, matches the persistent effort to cut calories, and weight loss plateaus. And, as soon as we stop taking the drugs, our full appetite resumes and we start regaining the weight we initially lost.

     

    The Cost of Ozempic

    Wegovy, the high-dose Ozempic used for weight loss, costs up to $1,350 a month, which, again, may have to be paid in perpetuity since any lost weight can pile back on if you stop taking it. So, that could cost more than $16,000 a year if paid out-of-pocket for those whose insurance doesn’t cover it.

     

    Ozempic Side Effects

    The most common side effects include nausea, vomiting, diarrhea, and constipation. Gallbladder issues are another side effect; excess cholesterol shed from fat cells can crystalize in our bile like rock candy, forming gallstones.

    Rare but serious adverse effects are also emerging. The package inserts for both semaglutide and tirzepatide list a series of “warnings and precautions” that include thyroid tumors, acute inflammation of the pancreas (pancreatitis), acute gallbladder disease, acute kidney injury (that may stem from dehydration due to excess vomiting or diarrhea), allergic reactions, a heightened risk of bottoming out blood sugars while on blood sugar–lowering medications, worsening eye disease for those with type 2 diabetes, an increase in heart rate requiring monitoring, and suicidal thoughts and behaviors.

     

    What Is “Ozempic Face”?

    “Ozempic face” is a term used to describe a distorted facial appearance among users of the drug. (Similar accounts have been made of “Ozempic butt.”) Media reports have linked the drug with facial aging, but the sagging appearance has been ascribed simply to the accelerated loss of fat in the face. While this interpretation seems logical, a review of the phenomenon concluded that “this explanation cannot fully account for the markedly accelerated facial aging….” Other factors suspected as being responsible for the appearance of premature facial aging include the loss of facial muscle mass, diminished structural integrity of the skin, and changes in stem cell function and hormonal secretion.

     

    Is Ozempic Safe?

    In the first quantitative benefit-versus-harm balance analysis, the researchers concluded that those achieving a 10 percent weight loss had a more than 90 percent chance that the benefits of taking the drugs outweigh the harms, but the opposite was found for individuals achieving only a 5 percent weight loss.

    At this time, we don’t know about the long-term harms or benefits because some of these drugs and dosing schedules are so new. To complicate matters, the American Academy of Pediatrics has suggested offering these drugs for teens and even tweens as young as age 12. These drugs work by acting on the brain, so who knows what effect they might have on childhood development and beyond if young people end up taking them for the rest of their lives. Although we now have evidence of near-term benefit over a few years, we cannot assume long-term safety until it has been demonstrated.

     

    Ozempic Alternatives

    We don’t need to take GLP-1-mimicking drugs. Not only can the ingestion of a plant-based meal more than double GLP-1 secretion, compared to a meat meal, but plant-based diets can also cause weight loss by boosting our resting metabolic rate and incorporating “calorie-trapping” high-fiber foods that flush calories away. The largest study of people eating strictly plant-based found they are about 35 pounds lighter on average.

    When we eat a donut, its fat, sugar, and starch get absorbed quickly, high up, before reaching the part of our digestive tract where we produce most of the hormone that suppresses our appetite, GLP-1. Since the cells that produce GLP-1 in response to calorie exposure are concentrated at the end of our digestive tract, while the majority of the calories we consume are absorbed early on, most calories never make it down far enough. That’s why our appetites aren’t suppressed very much these days. From a GLP-1 standpoint, when we have that donut, it’s like we never ate much of anything. No wonder we reach for donut number two.

    Our prehistoric ancestors are believed to have consumed as much as 100 daily grams of fiber, which is more than six times what most of us are getting these days. We evolved eating massive amounts of whole plant foods—the only places fiber is found in abundance. That enabled out natural satiety mechanisms to keep us from overeating. By eating the way nature intended, we can release GLP-1 the way nature intended. That helps explains why in the medical literature, compared to any other way of eating that didn’t involve portion control, a whole food, plant-based diet has been shown to lead to greater average weight loss than any other diet.

     

    For more in-depth information on Ozempic and GLP-1, check out these resources:



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  • ‘A dietitian saved my life’

    ‘A dietitian saved my life’


    In this special episode for Feeding Tube Awareness Week, we’re joined by Alison Black, a world-renowned TV producer whose life took a drastic turn after a cancer diagnosis. Alison shares her powerful story of how tube feeding became part of her treatment and the profound impact her dietitian, Nina Bonner, had on her recovery. Feeding Tube Awareness Week is an important opportunity to raise awareness and support those living with feeding tubes. You’ll hear firsthand insights into the emotional and psychological aspects of tube feeding, and learn how dietitians can foster trust and support in these challenging times.

    Hosted by Bec Sparrowhawk 

    Biography

    Alison Black is a Logie-winning television producer behind two groundbreaking Australian documentary series, Choir of Hard Knocks and Changing Minds (ABC). Originally trained as a journalist, she worked in the UK before moving to Australia nearly 20 years ago. Now, she helps companies, charities and individuals refine their branding and messaging, alongside ghostwriting and filming life stories for those with life-limiting illnesses. In 2011, Alison was diagnosed with head and neck cancer. Now cured, she leads a dynamic life running her own business and volunteering at her local hospice.

     

     

    In this episode, we discuss:

    • Alison’s journey from TV producer to cancer survivor
    • Navigating the emotional challenges of tube feeding
    • The pivotal role of dietitians in cancer treatment and recovery
    • Trust-building with healthcare providers
    • Three key tips for dietitians working with tube-fed patients
    •  


    Additional resources

    This episode discusses sensitive topics related to body image and disordered eating. If these topics are triggering, please listen with care and we encourage you to seek support from a healthcare professional. For support, visit Butterfly Foundation.

    Click here to learn more about Feeding Tube Awareness Week

    Click here for Dietitians Unite 2025 tickets in Melbourne on 30 May

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


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  • Dietitians Unite 2025 Speaker Profiles

    Dietitians Unite 2025 Speaker Profiles

    Maz has been to more showbiz parties than The Clooneys in Oscar season, and down more red carpets than a Dyson vacuum. Her contacts contain bigger names than the toilet queue at the Oscars, and if you can stick a name plate on it and hand it over to loud applause, she's won it – BAFTAs, Logies, ASTRAS, Royal Television Society Awards, UK Comedy Awards, and a Bronze Rose De Montreux. If you'

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  • How Is Natural Killer Cell Function Boosted by Forest Bathing? 

    How Is Natural Killer Cell Function Boosted by Forest Bathing? 

    Can the aroma of wood essential oils replicate the immune-boosting effects of walking in a forest?

    Studies on the effects of “forest bathing,” or shinrin-yoku in Japanese, “a traditional practice characterized by visiting a forest and breathing its air,” have found it “can induce a significant increase in the number and activity of natural killer (NK) cells” that can last as long as a month. And because natural killer cells are one of the ways our body fights cancer by killing off tumor cells, the “findings suggest that visiting forest parks may have a preventive effect on cancer generation and progression.” How? “Why did the forest environment increase human NK activity? What kind of factors in the forest environment activated human NK cells?” What is it about the forest environment?

    One thought is that the boost may be related to a reduction in stress. If you measure the amount of adrenaline flowing through people’s systems, did spending time in a forest—but not in a city—lower adrenaline levels? Yes, as you can see at 0:58 in my video Why Does Forest Bathing Boost Natural Killer Cell Function?

    However, if you drip some adrenaline on human blood cells in a petri dish, there does not appear to be any effect on NK cells. The stress hormone cortisol, on the other hand, dramatically suppresses natural killer cell activity, as shown below and at 1:09 in my video. So, might being in the forest lead to less stress and less cortisol, which releases the natural killer cells under its thumb, giving us a boost?

    We know being surrounded by nature can decrease levels of cortisol in our saliva, but what about our bloodstream? Researchers found a significant drop in the stress hormone after a single-day trip to the forest. A week later, cortisol was normalizing, as you can see here and at 1:30 in my video, but the forest’s effects sometimes appeared to last an entire month. Anything else that could cause a longer-term immune system change?

    Maybe we’ve been missing some of our “Old Friends.” If you sample outdoor air, you can pick up an abundance of microorganisms from the soil and water that float around—but are absent from indoor air. (Indoor air is dominated by organisms that either live on us or try to attack us.) So, on a day-to-day basis, in terms of keeping our immune system on ready alert, it “might not be sufficient to encounter only the biased microbiota of the modern synthetic indoor environment that lacks some of the Old Friends and probably bears little resemblance to the microbiota we encountered throughout our evolutionary history,” the microbes we evolved to live with over millions of years.

    Or perhaps it’s the plants themselves. Maybe it’s the aroma of the forest. Trees produce aromatic volatile compounds called phytoncides, like pinene, which we can breathe into our lungs when we’re in the forest. Do these compounds actually get into our bloodstream? Indeed, after spending one hour in the woods, we get about a sixfold increase in pinene levels circulating throughout our system. To fully connect all the dots, phytoncides like pinene—those essential oils from wood—would then have to induce human natural killer cell activity. And guess what? The study title gives it away: “Phytoncides (Wood Essential Oils) Induce Human Natural Killer Cell Activity.” If you put natural killer cells in a petri dish with leukemia cells, our NK cells can wipe out some of the cancer cells. But, if you add a whiff of cypress, white cedar, eucalyptus, or pine, the cancer cells don’t stand a chance, as shown below and at 3:14 in my video

    A combination of wood aromas improved the recovery of mice put through the wringer, but this is the study I was looking for: “Effect of Phytoncide from Trees on Human Natural Killer Cell Function.” If we want to know if the magic ingredient is the fragrance of the forest, then let’s see if we can get that same boost in natural killer cell activity by just vaporizing some essential oil from one of the trees into a hotel room overnight. It worked! There was a significant boost in natural killer cell activity, as seen here, and a 3:40 in my video.

    Only NK activity was boosted, though, rather than the number of the natural killer cells, and being in an actual forest can elevate both. So, perhaps it’s a combination of the tree fragrance and the lower cortisol levels working together.

    Ironically, these phytoncide compounds are part of the tree’s own immune system, which we may be able to commandeer. As you can see at 4:05 in my video, researchers speculate that these compounds may be playing a role in the fact that more heavily forested regions in Japan appear to have lower death rates from breast cancer and prostate cancer. Indeed, being in nature has been found to be an “important coping strategy among cancer patients,” but it may help us cope better, thanks to the fragrance of trees. 

    Spending time in a forest significantly increases NK cell activity. In my previous blog, I discussed Boosting Anticancer Immunity with Forest Bathing.

    You may recall that I’ve touched on this topic before. See Are There Health Benefits of Spending Time in Nature?.

    For more on aromatherapy, check out the related posts below.



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  • Forest Bathing to Boost Anticancer Immunity 

    Forest Bathing to Boost Anticancer Immunity 

    Natural killer cells are one of the ways our body fights off cancer, and visiting a forest can induce a significant increase in both their numbers and their activity.

    I’ve previously shown how exposure to nature can have self-reported psychological benefits, but there was a dearth of data on changes in objective measurements, so I was excited to see this paper on the effects of forest bathing, “a traditional practice characterized by visiting a forest and breathing its air,” on levels of the stress hormone cortisol in the participants’ saliva.

    The level of cortisol in our saliva is considered an indicator of our stress level, and study participants’ salivary cortisol levels were significantly lower after walking in a forest or even just hanging out in one (“forest watching”), compared to walking or just being in a city, as you can see at 0:49 in my video Boosting Anticancer Immunity with Forest Bathing

    However, the same effect was found before they went to the forest, too. Indeed, “forest bathing, in particular forest watching, was associated with significantly lower cortisol levels both before and after this practice if compared with visiting an urban area.” Therefore, it appears that just the thought of spending time in a forest relieves stress. So, “when comparing the effects of forest bathing versus urban visiting, the anticipated placebo effect…may play a more important role in influencing cortisol [stress] levels than the actual experience” of being in the forest. I was ready to dismiss this as just another nebulous psychological effect until I read this: “Studies on the effects of ‘Shinrin-yoku’ [forest bathing] on the immune function showed that visiting a forest can induce a significant increase in the number and activity of natural killer (NK) cells,” one of the ways our body fights off cancer. That got my attention. 

    It all started with this study: Twelve men were taken on a long weekend trip to walk in the forest, and nearly all of them (11 out of 12) showed higher natural killer cell activity afterward. It wasn’t just a little increase either; they had about a 50 percent increase in NK cell activity after the trip compared to before they went to the forest, as you can see at 2:00 in my video.

    Now, exercise alone can affect immune function, but “there were no significant differences in walking steps before and during the trip.” The study participants were just walking in a forest instead. However, they were taken on a trip somewhere, which introduced other variables, so what about randomizing them to go on a city trip versus a forest trip? If there were some special forest effect, how long would it last? Do you have to walk in the forest every day? Before jumping into all that, let’s first see if it works in women, too.

    This study had the same kind of set-up, and the same kind of results: a significant boost in natural killer cell activity from walking in the woods. What’s more, this time, the participants were retested a week later, and their natural killer cell activity was still up. When they were retested a month after the trip their levels were back to baseline, as you can see at 2:45 in my video

    So, walking in the woods once a week should do it, but the study involved a multi-day trip. Who can go to the forest all weekend, every weekend? How about just a day trip? The title gives it all away: “A Day Trip to a Forest Park Increases Human Natural Killer Activity and the Expression of Anti-Cancer Proteins in Male Subjects.” The same results and the same big jump measured the day after the trip compared to before and with the same staying power, as you can see at 3:08 in my video. And, natural killer cell activity was still boosted a week later. “This suggests that if people visit a suburban forest park once a week on a day trip, they may be able to maintain increased NK activity” and a boost in anticancer immune function. 

    I’m still not convinced, though. How can you attribute the benefit to the forest itself, when all you have are before and after data? To make the case that nature had anything to do with it, you’d need a control group of study participants who took the same kind of trip but went somewhere else instead. And here we go. Again, the study title says it all: “Visiting a Forest, but Not a City, Increases Human Natural Killer Activity and Expression of Anti-Cancer Proteins.” By the end of the forest trip, the participants experienced a boost of 80 percent in NK activity after forest bathing, compared to only a 10 percent bump for the city walkers, as shown below and at 3:58 in my video

    Both trips were matched for physical activity, alcohol, and sleep, too—other factors and behaviors that can affect immune function. So, we’ve got confirmation of boosted immunity, but only on the forest trip, “indicating that forest bathing does indeed enhance human NK activity.” Moreover, the researchers found that “the increased NK activity and numbers of NK cells induced by a forest bathing trip lasted more than 7 days, even 30 days, after the trip.” As you can see below and at 4:26 in my video, NK activity was still up a week later and even a bit up a month later. “This suggests that if people visit a forest once a month, they may be able to maintain increased NK activity. This may be important in health promotion and preventive medicine.” 

    Now that we know that forest bathing induces a real effect, the next question is, Why? What is it about forests that give us the boost? (You can imagine Big Pharma wondering if it can be made into a pill.) We’ll find out next.

    The video I mentioned at the start is Are There Health Benefits of Spending Time in Nature?.

    Stay tuned for the follow-up post: Why Does Forest Bathing Boost Natural Killer Cell Function?.

    For other ways to improve immune function, check out related posts below.



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  • Olive Oil vs. Vegetable Oil vs. Butter

    Olive Oil vs. Vegetable Oil vs. Butter

    Are vegetable and seed oils “toxic”?!

    From TikTok to bestseller lists, vegetable oils—a.k.a. “seed oils”—are a big topic right now.

    To be fair, folks have debated the merits of vegetable oils dating back to when they first entered the marketplace.

    More recently, however, with the advent of the carnivore diet, vegetable oil hate has roared back into the socials. Maybe you’ve come across posts that refer to these cooking oils as “toxic sludge,” “motor oil,” “the hateful eight,” and “the biggest cause of chronic disease that nobody knows about.”

    The anti-vegetable oil logic goes something like this…

    Animal fats have been with humans for thousands of years. Vegetable fats, on the other hand, were invented during the last century when profit-seeking companies wanted to find a way to sell cheap-to-grow foods to unsuspecting consumers.

    Another argument: Like margarine, vegetable oils were marketed as healthier alternatives for butter, and yet, people argue, these oils are worse than butter, raising your risk for obesity, anxiety, depression, ulcerative colitis, and more.

    In contrast to the above line of thought, other experts will tell you that vegetable oils are harmless, potentially even health-promoting—and absolutely better than butter.

    So, who’s right?

    Like so many nutrition topics, the truth is too nuanced to fit on a meme.

    In this story, we’ll help you sort the science from the pseudoscience so you can make informed decisions about the oils you choose to include in your diet.

    What are vegetable oils?

    Sometimes called “seed oils,” vegetable oils start, as you might suspect, from the seed of a plant. The most common ones you’ll find in a typical grocery aisle include:

    • Canola oil
    • Corn oil
    • Safflower oil
    • Sesame oil
    • Sunflower oil
    • Soybean oil
    • Grapeseed oil

    By the way, if you feel like there’s a bunch of oils missing from that list, it’s probably because those oils come from non-seed plants (such as olive, avocado, palm, or coconut oil, which all come from fruits, and aren’t considered vegetable or seed oils).

    How are vegetable oils processed?

    Non-vegetable oils—such as olive and avocado oil—are derived from naturally fatty foods. In fact, olives are so oily that you could theoretically make your own olive oil at home. (Just Google “how to make olive oil from scratch,” and you’ll find a number of videos walking you through the steps.)

    The same can’t be said of most vegetable oils, which mostly come from foods with a relatively tiny fat content to begin with.

    Case in point: A cup of green olives contains about 20 grams of fat,1 whereas a cup of corn has 2 grams.2

    As a result, manufacturers must use an extensive multi-step process to extract this small amount of oil from these non-oily foods. These steps include:

    • Crushing: A machine uses high pressure to press oil from the seeds.
    • Refining: The seeds are heated with a solvent, such as hexane, to extract more oil.
    • Deodorizing: To create a neutral taste and remove unwanted compounds, the extracted oil is then cooked at 400 F (204 C) for several hours.

    During this process, health-promoting polyphenols and other stabilizing nutrients are lost, and small amounts of unsaturated fats are transformed into trans fatty acids (also called partially hydrogenated fat).

    (Interesting fact: This also happens during deep frying. When vegetable oils sizzle in a restaurant’s deep fryer for hours, the trans fat content of the oil increases.)

    To call these processed oils “toxic” might be an exaggeration. However, nutrition scientists generally agree that people should avoid trans fats in the diet, and in 2018, the Food and Drug Administration banned manufacturers from adding trans fats to processed foods.3 4

    What cooking oils should you eat?

    At PN, we’ve created several visual guides people can use to make informed decisions about what to eat.

    (We’ve also created a shopping list, which you or your clients can print out and take to the grocery store. Check it out: Healthy Fats Shopping List)

    In these guides, we’ve placed a few vegetable oils—expeller-pressed canola oil, high-oleic sunflower, and safflower oils—in the “Eat Some” section. For us, “eat some” is another way of saying that these foods will neither improve health nor harm health—when consumed in reasonable amounts. In some cases, like in the example of dark chocolate, when consumed in small amounts, they might even improve health.

    The rest of the vegetable oils, along with butter and other saturated fats, fall into the “Eat Less” category, as the image below shows. You’ll find vegetable oils in bold.

    An infographic showing dietary recommendations for different cooking oils and fats, divided into three categories: 'EAT MORE' (including extra virgin olive oil, walnut oil, and avocado oil), 'EAT SOME' (including various oils like flaxseed and coconut), and 'EAT LESS' (including butter, margarine, and various processed oils).

    We’ve gotten hate mail from folks who say certain vegetable oils—especially cold-pressed canola oil—should appear alongside olive oil in the “eat more” category. Plenty of others say all vegetable oils belong in the “eat less” column, and that butter belongs in “eat some” or even “eat more.”

    To understand the scientific reasoning behind our recommendations, let’s explore some head-to-head matchups.

    Extra-virgin olive oil vs. expeller-pressed canola oil

    These oils are the least refined of their kind.

    To make extra virgin olive oil (EVOO), manufacturers grind and mechanically press olives, without using any heat. Similarly, expeller-pressed canola oil is made by mechanically pressing rapeseed, without the use of heat or chemical solvents.

    🟢 The case for extra virgin olive oil (EVOO)

    Olive oil is richer in heart-healthy monounsaturated fatty acids (MUFAs) than almost any other cooking oil.

    In addition, unlike the more refined “light” olive oil, EVOO maintains most of the olive fruit’s original polyphenols. These plant-based substances help to combat inflammation and protect cells from damage.

    Perhaps most importantly…

    More studies vouch for EVOO’s health-promoting qualities than for any other cooking fat.

    For example, researchers asked 22,892 adults from Southern Italy to self-report their olive oil consumption. People who consumed the most olive oil (more than two tablespoons a day) were 20 percent less likely to die over the 13-year study than people who consumed the least olive oil (less than one tablespoon a day).5

    Other research has linked the consumption of olive oil with a reduced risk of:

    • High blood pressure6
    • Heart disease
    • Type 2 diabetes7
    • Dementia8
    • Cancer9

    Consumption of olive oil is also associated with reductions in LDL cholesterol, especially when used to replace saturated fats like butter and coconut oil.10

    Smoke point: Should you avoid cooking with olive oil?

    Years ago, culinary experts recommended using EVOO only on salads and other uncooked foods. Back then, they assumed EVOO’s relatively low smoke point (350 to 410F) meant the oil would break down when heated, losing some of its distinctive flavor and health benefits.

    We now know that smoke point isn’t as big a deal as previously thought.

    That’s especially true in the case of EVOO, whose polyphenols and high concentrations of monounsaturated fats help keep the oil stable when heated.

    In research that heated a variety of cooking oils to 464 F (240C) and then held them at 356 F (180C) for several hours, EVOO remained more stable than any other oil tested, including canola oil.11

    🟡 The case for expeller-pressed canola oil

    One of the more affordable cooking oils on the shelf, canola oil, is made from a Canadian-made hybrid of the rapeseed plant.

    (The word “canola” refers to the first three letters of “Canada” with a fun “ola” added to the end for marketing purposes.)12

    Among vegetable oils, canola is the richest in heart-healthy monounsaturated fats (though several non-vegetable oils have it beat) as well as alpha-linolenic acid, a plant-based omega-3 fatty acid.

    In addition, canola oil contains plant substances called phytosterols that help influence blood cholesterol for the better, especially when used as a substitute for butter, research has found.13 14 15

    The winner

    Extra virgin olive oil is the clear winner.

    The body of research in support of EVOO dwarfs the body of research in support of expeller-pressed canola.

    In addition, EVOO has a more favorable fatty acid profile. By the way, so does avocado oil, which is why you’ll also find it in the “eat more” column.

    However, you can buy roughly twice as much expeller-pressed canola oil for half as much money as EVOO. Because of this, expeller-pressed canola can be a good budget-friendly choice. In addition, because of expeller-pressed canola’s more neutral flavor, many people prefer it over EVOO for baking.

    When used in moderation, expeller-pressed canola can be part of a healthy diet. It is likely to be at least health neutral, if not somewhat health beneficial.

    Expeller-pressed canola oil vs. refined canola oil

    This match-up comes down to how processing methods affect the end product.

    🟡 Expeller-pressed canola oil

    An expeller press is a machine that squeezes oil out of seeds.

    It’s able to do this without the use of solvents or heat, which helps preserve beneficial compounds such as alpha-linolenic acid and phytosterols.

    🔴 Refined canola oil

    Refining removes some protective alpha-linoleic acid while adding small amounts of unhealthy trans fatty acids. This results in a product that is proportionally lower in omega-3 fatty acids and higher in omega-6 fatty acids.

    The winner

    Expeller-pressed canola oil wins, but only by a small margin.

    That’s because canola oil starts with a less controversial fatty acid profile than many other vegetable oils, as the chart below shows. Soybean oil, for example, has less heart-healthy monounsaturated fat and much more theoretically inflammation-contributing omega-6 fat.

    A chart titled 'Fatty Acid Ratios of Various Cooking Fats' comparing the percentages of different fatty acids (monounsaturated, polyunsaturated, omega-3, omega-6, and saturated) across six types of fats: extra virgin olive oil, avocado oil, walnut oil, canola oil, soybean oil, and butter.

    Are omega 6 fatty acids “inflammatory?”

    The typical American consumes around 16 to 20 times more omega-6 fats than omega-3s.

    This imbalance could theoretically increase inflammation in your body, potentially raising your risk for diabetes, obesity, and other health problems, argue some experts.16

    Years ago, the recommendation to balance your omega 6s with omega 3s was widespread. (The suggested “ideal” ratio: Anywhere from 1:1 to 4:1, in favor of omega 6s.)

    These days, there’s more debate among nutritional scientists as to whether this imbalance contributes to chronic inflammation, especially when those omega 6s are consumed in whole foods that contain many other beneficial compounds.

    For example, nuts and seeds—both naturally rich in omega-6 fats—have been associated with a range of health benefits, including reductions in blood cholesterol and inflammation.17 18

    In 2019, Harvard Health ran the headline “No need to avoid healthy omega-6 fats.” In support of their argument, a 2019 study from the American Heart Association journal Circulation determined that, if anything, the consumption of omega-6 fats reduced the risk for stroke, heart disease, and early death.19

    However, while nuts and refined canola oil may share a somewhat similar fatty acid profile, the two foods differ in one important way. As we mentioned earlier, refined canola oil is basically pure oil. Meanwhile, nuts and seeds come packaged with health-protective fiber, polyphenols, protein, vitamins, and minerals.

    Minimally-processed foods, like nuts or extra virgin oils, include a complex matrix of health-promoting nutrients. Highly-processed oils, on the other hand, have lost the vast majority of those healthful compounds, leaving mostly just the fatty acids which are more prone to oxidation (we’ll cover that next).

    Refined vegetable oil oil vs. butter

    This is the match-up that triggers the most arguing on the interwebs.

    Let’s cover the major claims from both sides—plus what the research says.

    🔴 The case for butter

    Butter proponents argue that saturated fats have been unnecessarily vilified. They point to nutrition recommendations during the 1980s and 1990s that recommended people replace butter with trans-fat rich margarine.

    (We all know how that went.)

    Margarine aside, others claim the research in support of reducing saturated fats is thin at best.20

    However, excessive saturated fat consumption (beyond 10 percent of total calories) does seem to boost cholesterol levels and may increase your risk of heart disease.21

    Some research has found that replacing 5 percent of the saturated fats in your diet with monounsaturated fats could reduce the risk of heart disease by 15 percent. Similarly, replacing 5 percent of the saturated fats in your diet with polyunsaturated fats (with most of that coming from refined vegetable oils) reduces the risk of a future heart attack by 10 percent, according to an analysis of eight studies involving 13,614 people.22 Many other studies support this finding.23

    But not all saturated fats affect blood cholesterol equally. In some dairy foods, a membrane—called a milk fat globule membrane—surrounds the saturated fats and seems to limit their cholesterol-raising properties.

    However, butter is low in this protective membrane, and consequently raises blood cholesterol more than other high-fat dairy products, like full-fat milk, cream, yogurt, or cheese.24 25 26

    The U.S. Dietary Guidelines recommend capping saturated fat at less than 10 percent of your calorie intake. A tablespoon of butter contains 7 grams of saturated fat—a third of the recommended daily limit in a 2000 Calorie diet.

    So, while you don’t necessarily need to eliminate butter, it’s worth moderating your intake.

    (Interested in learning about all the nuances of saturated fat consumption? Read: Is saturated fat good or bad for you?)

    🔴 The case for refined vegetable oils

    Due to their chemical structure, polyunsaturated fats are inherently less stable and more prone to oxidation than saturated or monounsaturated fats.

    During the refining process, protective phytochemicals and antioxidants are stripped, making these oils more prone to oxidation. The theory is that this oxidation increases inflammation in the body and elevates the risk of various health conditions.

    There’s some evidence to suggest that diets rich in polyunsaturated fats, especially from refined vegetable oils, are associated with increased levels of oxidized blood lipids, lipid peroxidation, and other markers of inflammation.27 28

    If you only use refined corn or safflower oils to lightly coat veggies before roasting them, you likely don’t have much to worry about.

    However, for the vast majority of people, the biggest source of refined vegetable oils isn’t home-cooked meals—it’s ultra-processed foods.

    The extra processing and repeated heat exposure used to create ultra-processed foods further oxidize these oils. Additionally, these foods are often loaded with potentially harmful ingredients like added sodium and sugars, and low in beneficial nutrients like fiber, vitamins, minerals, and phytonutrients.

    Plus, they’re incredibly calorie-dense and difficult to stop eating, which can raise your risk for obesity. (Find out exactly why highly-processed foods are so “addictive”: Why you can’t stop eating ultra-processed foods.)

    Most ultra-processed foods list one or more vegetable oils as one of their ingredients. Even ultra-processed foods that you wouldn’t think of as “fatty” contain small amounts. You’ll find them in store-bought cookies, chips, crackers, sauces, frozen dinners, meal replacement shakes, boxed macaroni and cheese, salad dressing, boxed rice blends, and more.

    In a large review involving nearly 10 million people, the consumption of ultra-processed foods was associated with a higher risk of premature death.29 In addition, studies have linked high consumption of ultra-processed foods with the following health problems:30 31 32 33

    • Heart disease and heart attacks
    • Stroke
    • High blood pressure
    • Depression
    • Overweight and obesity
    • Diabetes
    • Reduced HDL cholesterol
    • Cancer

    You don’t have to abolish ultra-processed foods.

    But your health will benefit from capping your consumption to about 20 percent or so of your intake, with the other 80 percent or so from mostly minimally-processed whole foods.

    This alone will naturally lower your refined vegetable oil intake to a safer level, without much fuss. Plus, consuming refined vegetable oils in the context of a diet that’s rich in colorful plants, fiber, phytochemicals, and antioxidants may help offset the concern of oxidation. (For example, by putting a reasonable amount of commercial salad dressing on a large, colorful salad.)

    The winner

    This match-up is a draw.

    Ultimately, both should be limited in the diet, and neither are health-promoting.

    Most refined vegetable oils are lopsidedly rich in polyunsaturated fatty acids compared to monounsaturated fats, and are stripped of many protective compounds. As mentioned earlier, some experts argue that these omega-6-rich fats may contribute to inflammation (but the evidence here is mixed). Because of how they’re processed, seed oils also contain some of those trans fats that everyone agrees we should all minimize.

    In contrast, butter is low in omega 6s but high in saturated fat, which can be problematic in higher amounts. Especially since it’s so low in the protective milk fat globule membrane. However, compared to refined vegetable oil, butter is less processed. Like olive oil, it’s one of those fats you could theoretically make at home.

    Some final parting advice

    This might be obvious from the head-to-head matchups, but we’ll say it anyway.

    If you like it and can afford it, EVOO is a great choice.

    Cold-pressed avocado oil and walnut oil are also great options, as both are rich in antioxidant compounds. Like EVOO, avocado oil is a rich source of MUFAs. Walnut oil’s fat primarily comes from polyunsaturated fats, so it’s best used as a dressing rather than used for cooking (as it’s less heat stable).

    However, like EVOO, avocado and walnut oil tend to be expensive. If you or your client are budget-conscious, expeller-pressed canola oil is a solid runner-up.

    Similarly, high-oleic sunflower and safflower oils are richer sources of monounsaturated fats than their high-linoleic cousins. When substituted for saturated fats like butter, high-oleic oils have been associated with cardiovascular benefits.34 35

    Regardless of what cooking fats you or your client choose, you’ll also want to do the following:

    ✅ Prioritize minimally-processed whole foods.

    Whole and minimally-processed foods—such as nuts, seeds, avocados, olives, and salmon—are more likely to feature health-promoting monounsaturated (MUFAs) and omega-3 fats. They also come packaged with a wide array of other good-for-you nutrients such as fiber, protein, minerals, and antioxidants.

    In contrast, ultra-professed foods are generally devoid of everything you keep hearing you should consume more of. These foods also tend to be calorie-dense, highly rewarding, and hard to stop eating.

    If you’re not sure whether packaged food is minimally processed or highly processed, take a close look and consider:

    • Does anything in nature resemble this food?
    • Does it look like it came from an animal or a plant?
    • If you look at the list of ingredients, do you see animal or plant components?

    If you answer “no” to most of the above, the food is likely highly processed.

    ✅ Limit deep-fried foods.

    It doesn’t matter what source of fat is used to fry them.

    Sort all fried foods into the “eat less” category.

    ✅ Get most of your fats from food, not oils.

    EVOO is associated with longer, healthier lives. However, that doesn’t mean you should be doing shots of it.

    As a general rule, you’re better off getting most of your fat from foods like avocados, olives, nuts and seeds than from any cooking oil.

    Whole food fats are rich in fiber, phytochemicals, vitamins, and minerals, and are generally less calorie-dense than oils. (But having one to three servings of oils or butter per day is reasonable.)

    And if you want personalized advice to suit your body, your eating preferences, and your goals, check out our Nutrition Calculator to figure out how fats fit into your overall diet.

    References

    Click here to view the information sources referenced in this article.

    If you’re a coach, or you want to be…


    You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We’ll show you how.


    If you’d like to learn more, consider the PN Level 1 Nutrition Coaching Certification. (You can enroll now at a big discount.)

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  • Preorder The How Not to Age Cookbook

    Preorder The How Not to Age Cookbook

    I’m thrilled to announce that pre-orders are now open for The How Not to Age Cookbook, coming out on April 22. This much-anticipated culinary companion to my New York Times Best Seller, How Not to Age, is a beautifully-illustrated cookbook with more than 100 recipes developed again with Robin Robertson to help you age healthfully and vibrantly. Each of these simple, nutrition-packed dishes uses ingredients that have been proven to promote a healthy lifespan, and inspiration has been drawn from the places around the world where people traditionally live the longest. 

    For instance, the bright anthocyanin pigments in berries are thought to account for their benefits for our cognitive function, eyesight, inflammation, blood sugar, artery function, and cholesterol, so eat your berries, drink hibiscus tea, and enjoy savory sources like purple sweet potatoes. When it comes to our joints, strawberries, ginger, and turmeric, for example, have been found to help with osteoarthritis of the knees, a leading cause of disability in older adults. 

    Get a Signed Bookplate

    Once you pre-order your copy of The How Not to Age Cookbook, make a donation using this form and, as a token of my appreciation of your support, I’ll sign a bookplate that will be sent to you. The bookplate will fit perfectly into the front cover of the book and makes a great keepsake for yourself or an extra special gift for a loved one. As always, thank you for your support and dedication to the latest in evidence-based nutrition. Only a limited number of bookplates are available, so be sure to pre-order my new cookbook and make a donation today!

    While you wait for the book to arrive, check out my anti-aging videos, stay tuned to our social media for some recipes, and try this delicious Tempeh and Mushroom Chili

    Tempeh and Mushroom Chili with Corn and Cilantro

    Makes 6 servings

    Chopped mushrooms and tempeh add great texture and heartiness to this flavorful chili that bursts with kidney beans, corn kernels, and cilantro. This recipe calls for cremini mushrooms because they hold up well in stews and chili. If unavailable, you can substitute white button mushrooms.

    • 8 ounces tempeh
    • 1 red onion, chopped
    • 1 red bell pepper, chopped
    • 1 tablespoon white miso paste blended with ¼ cup hot water
    • 3 garlic cloves, minced
    • 8 ounces cremini mushrooms, chopped
    • 2 to 3 tablespoons chili powder (mild or hot)
    • ½ teaspoon dried oregano
    • ½ teaspoon ground black cumin
    • ¼ teaspoon ground pippali or black pepper
    • 2 (14.5-ounce) cans salt-free crushed tomatoes, drained
    • 3 cups cooked or 2 (15-ounce) BPA-free can or Tetra Pak salt-free dark kidney beans, drained and rinsed
    • 1 cup fresh or thawed frozen corn kernels
    • ½ cup chopped fresh cilantro

    Steam the tempeh in a steamer basket over a saucepan with about 2 inches of boiling water for 10 minutes, then drain, coarsely chop, and set aside.

    Heat ¼ cup of water in a large saucepan over medium heat. Add the onion and bell pepper, cover, and cook until softened, about 5 minutes.

    Add the miso mixture and garlic, then stir in the reserved tempeh, mushrooms, chili powder, oregano, black cumin, and pippali. Cook until fragrant, about 1 minute. Add the tomatoes, beans, and corn.

    Cover and simmer over low heat, stirring occasionally, until the chili is thick and flavorful, about 30 minutes. Stir in the cilantro. If the chili is too thick, stir in a little water. Serve hot.

    As always, all proceeds I receive from all of my books are donated directly to charity. 



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  • Build a successful gut health practice

    Build a successful gut health practice


    In this special Gut Health Month episode, we’re joined by leading gut health expert Nicole Dynan. Nicole shares her journey as a gut health dietitian and offers practical strategies to help dietitians specialise and stand out in this growing field, along with ways to effectively communicate complex science with clients.

    Hosted by Brooke Delfino 

    Biography

    Nicole Dynan is the founder of The Gut Health Dietitian (est. 2013) and one of Australia’s leading gut health experts. After a decade in corporate chronic disease management, Nicole saw first-hand how gut health impacts energy, stress, mood, and overall well-being. Since then, and together with her team, she’s helped over 35,000 people improve their gut health, feel more comfortable, and regain control of their overall health through science-backed nutrition.

     

     

     

    In this episode, we discuss:

    • Nicole’s career journey as a gut health dietitian
    • Steps to position yourself as a trusted expert in gut health through branding, social media and networking
    • How to communicate complex gut health science in a way clients can easily understand and implement
    • The importance of collaborating with GPs, specialists and other allied health professionals
    • How to stay updated with the latest gut health research


    Additional resources

    Gut Health Month 2025 is supported by Activia Probiotic Yoghurt, Farmers Union, Life-Space Probiotics, Nerva, The Probiotics Institute, Swisse Nutra+, Coeliac Australia, Crohn’s & Colitis Australia and The Gut Foundation

    Click here to download ‘Your Complete Guide to Gut Health Month 2025’ to learn how you can get involved.

    Register for our free half-day Gut Health Symposium here.

    Click here for free gut health resources to use in your practice.

    Connect with Nicole Dynan at guthealthdietitian.com or in Instagram @the.guthealthdietitian

    Click here for Dietitians Unite 2025 tickets in Melbourne on 30 May

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


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  • An Ideal Waist Size 

    An Ideal Waist Size 

    The book Dieting Makes You Fat was published originally in the 1980s and then repeatedly republished. Since most people who lose weight go on to regain it, there is a concern that there may be adverse health consequences of “yo-yo dieting.” This idea emerged from animal studies that, for example, showed the detrimental effects of starving and refeeding obese rats. This captured the media’s attention, leading to “a pervasive view found in many media outlets” about “the ‘dangers’ of weight cycling,” discouraging people from even trying to lose weight.

    But even the animal data are inconclusive. For example, weight-cycling mice make them live longer. Most importantly, a review of the human data concluded that “evidence for an adverse effect of weight cycling appears sparse if it exists at all.” Bottom line? “Yo-Yo Dieting Is Better than None.”

    Ideally, we’d be at a body mass index (BMI) of 20 to 22. (You can see a unisex BMI chart below and at 1:05 of my video What’s the Ideal Waist Size?.) However, BMI doesn’t take into account the composition of the weight. Bodybuilders are heavy for their height, for instance, yet can be extremely lean. The gold standard measure of obesity is body fat percentage, but an accurate calculation can be complicated and expensive. All you need to measure BMI is height and weight, but it may underestimate the true prevalence of obesity. 

    The World Health Organization defines obesity as a body fat percentage above 25 percent in men or 35 percent in women. At a BMI of 25, which is considered just barely overweight, body fat percentages in a representative sample of U.S. adults varied from 14 percent to 35 percent in men and 26 to 43 percent in women. So, you could be at a “normal” weight but actually obese. Using the BMI cutoff for obesity, only about one in five Americans was obese in the 1990s, but based on their body fat, the true proportion even back then was closer to 50 percent. Half of Americans are not just overweight, but obese. 

    So, using only BMI, doctors may misclassify more than half “of patients with excess body fat as being normal or just overweight and…miss an opportunity to intervene and reduce health risk in such individuals.” What’s important is not the label, though, but the health consequences. Ironically, BMI appears to be an even better predictor of cardiovascular disease death than body fat percentage. That suggests that excess weight from any source—whether fat or lean—may not be healthy in the long run. The lifespan of bodybuilders does seem to be cut short. They have about a one-third higher mortality rate than the general population. The average age of death is around 48 years, but this may be due in part to the toxic effects of anabolic steroids on the heart, as shown below and at 2:57 in my video

    Pre-eminent nutritional physiologist Ancel Keys (after which “K-rations” were named) suggested the mirror method: “If you really want to know whether you are obese, just undress and look at yourself in the mirror. Don’t worry about our fancy laboratory measurements; you’ll know!” All fat is not the same, though. There is the pinchable superficial flab that we may see jiggling about our body, and then there’s the riskier, deeper visceral fat that coils around and infiltrates our internal organs. Measuring BMI is simple, cheap, and effective, but it does not take into account the distribution of fat on the body, whereas waist circumference can provide a measure of the deep underlying belly fat.

    Both BMI and waist circumference can be used to predict the risk of death due to excess body fat, but, as you can see below and at 3:53 in my video, even at the same BMI, there appears to be nearly a straight-line increase in mortality risk with widening waistlines. Someone who has “normal-weight central obesity”—meaning someone who isn’t overweight, according to their BMI, but is fat around the middle—may have up to twice the risk of dying compared to someone who is obese, according to their height and weight. This is why the current guidance recommends measuring both BMI and waist circumference. This may be especially important for older women. “Between the ages of 25 and 65, the average woman will lose approximately 13 pounds of bone and muscle mass, while her visceral fat will nearly quadruple in size….” (Men tend to only double their visceral fat.) So, even if a woman doesn’t gain any weight according to the bathroom scale, she may be gaining fat. 

    What is the waistline cut-off? Increased risk of metabolic complications starts at an abdominal circumference of 31.5 inches (80 cm) in women and 37 inches (94 cm) in most men, though it is closer to 35.5 inches (90 cm) for South Asian, Chinese, and Japanese men. The benchmark for substantially increased risk starts at about 34.5 inches (88 cm) for women and 40 inches (102 cm) for men. Once you get above an abdominal circumference of about 43 inches (110 cm) in men, mortality rates shoot up about 50 percent compared to men with 8-inch-smaller (20-cm-smaller) stomachs, and women suffer 80 percent greater mortality risk with waists of 37.5 inches (95 cm) compared to 27.5 inches (70 cm). The reading of a measuring tape may translate into years of one’s lifespan. 

    The good news is the riskiest fat is the easiest to lose. Our body appears smart enough to preferentially shed the villainous visceral fat first. Although it may take losing as much as 20 percent of our weight to realize significant improvements in quality of life for most individuals with severe obesity, disease risk drops almost immediately. At 3 percent weight loss, which is only 6 pounds (2.7 kg) for someone weighing 200 pounds (91 kg), for instance, blood sugar control and triglycerides start to improve. At 5 percent, blood pressure and cholesterol improve. Our risk of developing diabetes may be cut in half by just a 5 percent weight loss, about 10 pounds (4.5 kg) for someone starting at 200 pounds (91 kg), for instance.

    This is the final video in this series on obesity and weight. If you missed any of the others, see related posts below.

    I cover all of this and more at length in my book How Not to Diet, and its companion, The How Not to Diet Cookbook, has more than 100 delicious Green-Light recipes that incorporate some of my 21 Tweaks for the acceleration of body fat loss. 



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  • An Ideal BMI 

    An Ideal BMI 

    Is there a unisex chart for optimal weight based on height?

    We seem to have become inured to the mortal threat of obesity. If you go back in the medical literature almost a quarter of a century ago when obesity wasn’t run-of-the-mill, the descriptions are much grimmer: “Obesity is always tragic, and its hazards are terrifying.” Not just obesity, though. Of the four million deaths attributed to excess body fat each year, nearly 40 percent of the victims are overweight, not obese. According to two famous Harvard studies, weight gain of as little as 11 pounds (5 kg) from early adulthood through middle age increases the risk of major chronic diseases, such as diabetes, cardiovascular disease, and cancer. The flip side, though, is that even modest weight loss can have major health benefits.

    What is the optimal body mass index, commonly known as BMI? The largest studies in the United States and around the world found that having a BMI of 20 to 25 is associated with the longest lifespan. Put all the best available studies with the longest follow-up together, and that can be narrowed down even further to a BMI of 20 to 22. That would be about 124 to 136 pounds (56 to 62 kg) for someone who’s five-foot-six (168 cm), as you can see below and at 1:22 in my video What’s the Ideal BMI?.

    Even within a “normal” BMI range, the risk of developing chronic diseases, such as type 2 diabetes, heart disease, and several types of cancer, starts to rise towards the upper end—starting as low as a BMI of 21. BMIs of 18.5 and 24.5 are both considered to be within the “normal” range, but a BMI of 24.5 may be associated with twice the risk of heart disease compared to a BMI of 18.5. 

    Below and at 2:05 in my video is a graph of diabetes risk and BMI among women. There is a fivefold difference in diabetes rates within the so-called ideal range with a BMI under 25.

    Just as there are gradations of risk within a normal BMI range, there is a spectrum within obesity. Class III obesity (BMI over 40) can be associated with the loss of a decade or more of life. At a BMI above 45, for example, a person standing at 5’6″ (168 cm) and weighing 280 pounds (127 kg), life expectancy may shrink to that of a cigarette smoker. 

    However, “skeptics have argued that the consequences of rising obesity levels have either been greatly exaggerated or are unclear.” A “motley crew,” “obesity skeptics are made up of a kaleidoscope of interest groups…includ[ing] feminists, queer theorists, libertarians, far right-wing conspiracy types and new ageists.” It “has also been popular on far right-wing, pro-gun, pro-America websites where the idea that obesity alarmists are nanny-state communists who simply want to stop us from having fun plays well….”

    Unlike activists who organized to raise consciousness and stamp out the AIDS epidemic, for example, some in the size acceptance movement appear to have the opposite goal and “have called for less public awareness and intervention regarding obesity,” less treatment of the problem. I’m all for fighting size stigma and discrimination—I have a whole section on weight stigma in my book How Not to Diet—but the adverse health consequences of obesity are an established scientific fact.

    Can’t you be fat but fit? In a study of more than 600 centenarians, only about 1 percent of the women and not a single one of the men were obese. There does appear to be a rare subgroup of individuals who are obese and do not suffer the typical metabolic costs, such as high blood pressure and cholesterol. This raises the possibility that there may be such a thing as “benign obesity” or “metabolically healthy obesity.” It may just be a matter of time, though, before the risk factors develop. Even if they don’t, though, when followed long enough, even “metabolically healthy obese adults” are at increased risk of diabetes, as well as increased risk of fatty liver disease. They are also at greater risk of cardiovascular events, such as heart attacks, and/or premature death, as shown below and at 4:20. 

    Bottom line? There is “strong evidence that ‘healthy obesity’ is a myth.”

    Many “fat activists” try to downplay the risks of obesity, even as they may be among “the greatest victims” of the epidemic. “Leading fat acceptance activist Lynn McAfee, who is director of medical advocacy for the Council on Size and Weight Discrimination and takes part in obesity conferences and government panels on obesity,” is quoted as saying, “‘I’m not actually particularly that interested in [health] and God I hate science….”

    If you missed the previous blog posts in this series on obesity, see related posts below.

    The final video in this series is What’s the Ideal Waist Size?.



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