Obesity vs. smoking: What's worse?

[swingdoc]

The obvious answer here is smoking, only because the term "obese" is so terribly defined. Anyone with a BMI of 30 or greater is obese.

Urlacher - 6'4" 258lbs - BMI = 31.4

[LondonBroil]

I got halfway through reading this thread and now I'm starving.

[dylan's alias]

[ QUOTE ]
[ QUOTE ]
[ QUOTE ]
Skip -- it's true. People with very low cholesterol (under 150 total) don't get heart attacks. It just doesn't happen.

[/ QUOTE ]

Would you prefer the refutation to this to come in the form of personal anecdotal evidence (I have someone in the intensive care unit right this very second who proves you wrong) or published study evidence?

[/ QUOTE ]

Please refute me with published study evidence.

[/ QUOTE ]

I'll help out. Here's the abstract of a study looking at men under 55 and women under 65 who came to the hospital with a heart attack, had their cholesterol checked and were not on a cholesterol lowering medication.

One thing you need to know about cholesterol numbers. LDL (bad cholesterol) is the measurement in this study, as all current guidelines are based on LDL and HDL separately, not as a total. Your benchmark of total cholesterol of 150 would probably best correspond to an LDL of about 110. I made that estimate by using 200 as a total cholesterol that was considered borderline high in a patient without other coronary risk factors. 130 LDL probably is the equivalent number.

Here's the important line from the abstract: [ QUOTE ]
Measurements and results: Of the 183 patients who met the inclusion criteria, as many as 68% (124 patients) had LDL cholesterol levels of <= 130 mg/dL, 29% (53 patients) had LDL cholesterol level of <= 100 mg/dL, and only 14% (26 patients) had LDL cholesterol levels of >= 160 mg/dL.

[/ QUOTE ]

So 29% of their heart attack patients had low cholesterol and only 14 had extremely high cholesterol.

Link to abstract


As for which is worse, smoking or obesity, I say smoking. Here's some data which assesses additional risk of heart attack based on smoking vs non-smoking and obesity vs. non-obesity:

[ QUOTE ]
FINDINGS: Current smoking was associated with a greater risk of non-fatal AMI (odds ratio [OR] 2.95, 95% CI 2.77-3.14, p<0.0001) compared with never smoking; risk increased by 5.6% for every additional cigarette smoked. The OR associated with former smoking fell to 1.87 (95% CI 1.55-2.24) within 3 years of quitting. A residual excess risk remained 20 or more years after quitting (1.22, 1.09-1.37).

[/ QUOTE ]
Link to abstract

For obesity, Body Mass Index was not found to correlate particularly well with heart attack risk, but waist to hip ratio was.

[ QUOTE ]
For waist-to-hip ratio, the odds ratios for every successive quintile were significantly greater than that of the previous one (2nd quintile: 1.15, 1.05-1.26; 3rd quintile: 1.39; 1.28-1.52; 4th quintile: 1.90, 1.74-2.07; and 5th quintiles: 2.52, 2.31-2.74 [adjusted for age, sex, region, and smoking]). Waist (adjusted OR 1.77; 1.59-1.97) and hip (0.73; 0.66-0.80) circumferences were both highly significant after adjustment for BMI (p<0.0001 top vs bottom quintiles). Waist-to-hip ratio and waist and hip circumferences were closely (p<0.0001) associated with risk of myocardial infarction even after adjustment for other risk factors (ORs for top quintile vs lowest quintiles were 1.75, 1.33, and 0.76, respectively).

[/ QUOTE ]

Link to abstract

SHORT SUMMARY:

The odds ratio for smoking was 2.95 (about 3x more likely to have a heart attack of you smoke). The odds ratio for being obese was 2.52 for the heaviest quintile.

So, for heart disease, there is strong evidence that smoking is worse for you than obesity.


Dylan's Alias - Pulmonologist

[Subfallen]

Haha, mjkidd == soooo pwned. Nice post dylan.

[GiantWalleye]

[ QUOTE ]
The obvious answer here is smoking, only because the term "obese" is so terribly defined. Anyone with a BMI of 30 or greater is obese.

Urlacher - 6'4" 258lbs - BMI = 31.4



[/ QUOTE ]

I am 6'3" 245lbs so I guess I would be technically overweight or obese. (I'm a pretty built/fit 245) I would challenge any heavy smoker to any physical activity just because I feel I am in better health than about 99.9 percent of heavy smokers.

[bwana devil]

[ QUOTE ]
The obvious answer here is smoking, only because the term "obese" is so terribly defined. Anyone with a BMI of 30 or greater is obese.

Urlacher - 6'4" 258lbs - BMI = 31.4

[/ QUOTE ]

BMI doesnt apply to people with a lot of muscle mass. why do people pretend to debunk some complex principle when they inevitably state some example like this?

[siccjay]

Obese is worse. I would rather bang a girl that smokes than an obese woman.

[daryn]

[ QUOTE ]
Obese is worse. I would rather bang a girl that smokes than an obese woman.

[/ QUOTE ]

yeah but you'd rather take food recommendations from an obese woman i bet. in other words, who cares who you would rather bang?

[siccjay]

Well for one I do. I didn't thin you were obese daryn, please forgive me.

[daryn]

[ QUOTE ]
Well for one I do. I didn't thin you were obese daryn, please forgive me.

[/ QUOTE ]

you've misunderstood my point i guess. i'm just saying the thread wasn't about who you'd like to bang.


it's like a thread, what's healthier, a carrot or a cheeseburger. well, i'd rather eat the cheeseburger, so it must be better!