Differentiating between the healthy thin and the sick thin

    Just a quick post regarding the uproar over the study that indicated lower weight persons did not live as long as mildly overweight ones and the somewhat associated Mortality Index.
   Unfortunately, the current issue of the Nutrition Action Healthletter is not yet available on line.  It does a great job breaking down the recent study published in JAMA.  The research findings got a lot of people excited and a few scientists upset.  Recall that Walter Willett referred to them as "rubbish."  Read more at Harvard School of Public Health HERE.
   The problem, many scientists agree, is two fold.  One is including smokers or former smokers into the study and the other is not excluding people with chronic diseases that cause weight loss.  I appreciate the desire to leave out former smokers, but I think instead of ruling out all former smokers, another criteria could be set.  For example, a person who smoked 15 years or less and has been completely tobacco free for 15 years before the study.  That could be further nuanced by adding a pack per day limit. What is clear, smoking is a big problem.  It makes people sick and smokers have lower weights than nonsmokers, in general.  (I read that all the time, but I sure know a lot of obese smokers).
    The second issue is the Mortality Index constructed by researchers at UCSF.  This assessment is meant to be used by physicians and only with patients over the age of 60.  Of course, you know that if we have access to it, we are going to "test" ourselves.  I did.  The issue again is the weight question.  Here if your BMI is under 25 you get a point and "low score wins!"  To handle this possible error, my thought is this:   A physician giving this test to a patient he or she knew, could decide whether or not the patient's normal or low normal weight was healthy or concerning. If the patient was not ill (points for smoking are in another question) and had a normal or low normal weight for most of their adult life, they should not get penalized.  The problem with low weight is its association with wasting diseases or smoking and nothing more.
   Remember you are not supposed to take this test yourself, but don't you want to know what the fuss is about?  Click here.