別再幻想了——胖的健康這種事是不存在的！

Back in the 1980s, the term "metabolically healthy obesity" began popping up in medical circles. It referred to obese people who displayed no other signs of related health complications, like hypertension or diabetes. The phrase evolved into the societally popular term "healthy obesity."

20世紀(jì)80年代，在醫(yī)學(xué)圈突然出現(xiàn)了“代謝健康型肥胖”，這個(gè)詞指的是那些肥胖患者并沒有出現(xiàn)其他相關(guān)的并發(fā)癥，例如高血壓和糖尿病。這個(gè)詞后來進(jìn)化成社會(huì)上很流行的“健康肥胖”。

But a researcher from the U.K.'s Loughborough University has called for people to stop using the term. William Johnson calls the idea of healthy obesity "crude and problematic" in a commentary published in the April 11, 2018, issue of the journal Annals of Human Biology. He writes that the concept of zero complications despite obese status is attractive, especially to those people with a body mass index (BMI) of 30 or greater, who'd rather not think of themselves as unhealthy. Johnson authored the commentary and holds a doctorate in human biology and epidemiology.

但是英國(guó)拉夫堡大學(xué)的研究人員呼吁人們不要再繼續(xù)用這個(gè)詞了。在今年4月11日出版的《人類生物學(xué)刊》上，William Johnson發(fā)表的評(píng)論文稱健康肥胖的概念“粗糙且存在疑問”。在文中他還寫道除了肥胖以外沒有其他并發(fā)癥這個(gè)概念十分誘人，尤其是對(duì)于那些身體質(zhì)量指數(shù)(BMI)超過30的人來說，他們死都不肯承認(rèn)自己不健康。作為這篇評(píng)論文的作者，Johnson有人類生物學(xué)和流行病學(xué)的雙博士學(xué)位。

However, Johnson points out that many studies have declared such people to be rare and more likely to eventually become unhealthy compared with non-obese people. Even without current health problems, healthy obese people are still at a higher risk of developing diseases like Type 2 diabetes and chronic kidneydisease, not to mention having a higher mortality rate when compared with others of normal weight.

但是Johnson也指出很多研究表明胖的健康的人非常稀少，而且與體重正常的人相比，很有可能他們最終都會(huì)變得不健康。即使目前他們的身體沒有健康問題，健康肥胖者也是易患II型糖尿病和慢性腎病的高危人群，更不用說他們的死亡率比正常人要高很多。

This is unfortunate news for people who look up to athletes who appear overweight but who likely engage in far more exercise, boast more muscle and eat more nutritiously than the average Joe. In fact, current BMI measurements are calculated using only use height and weight. So, the person who has more muscle mass but weighs the same as another person with more fat actually would sport the same BMI. As a result, a clear picture of comparative health is lacking.

這個(gè)消息對(duì)于那些以運(yùn)動(dòng)員為榜樣的人來說則不是個(gè)好消息，雖然他們外表看起來超重，但是比起普通人來說，他們的運(yùn)動(dòng)量更大，擁有更多的肌肉，攝入更多的營(yíng)養(yǎng)。而事實(shí)上目前的BMI指數(shù)是以體重和身高來計(jì)算的。所以有更多肌肉的人的BMI指數(shù)會(huì)和同樣體重的胖子一樣。因此，清晰準(zhǔn)確的健康比對(duì)還是缺失的。

"As one might expect, individuals who are obese yet healthy are more likely to be younger, of European ancestry, lead a healthier lifestyle in terms of physical activity and diet, etc., have less central and visceral adiposity [body fat stored within the abdominal cavity] and be of higher socio-economic position than obese individuals who have already developed complications," Johnson explains in the paper.

Johnson在文章中解釋說：“和人們預(yù)料的一樣，比起有并發(fā)癥的肥胖個(gè)體來說，肥胖但是健康的那些個(gè)體很可能比較年輕，有歐洲血統(tǒng)，在運(yùn)動(dòng)和飲食等方面上更健康，他們的內(nèi)臟脂肪較少，有著較高的社會(huì)經(jīng)濟(jì)地位。”

He notes that the opposite is true when compared with a healthy group of normal weight participants.

他還指出如果把比照雙方換成健康的胖子和體重正常的人也是成立的。

Here's Johnson again:

他在文中寫到如下內(nèi)容：

Thus, it probably comes as no surprise that levels of cardio-metabolic disease risk factors (e.g. systolic blood pressure and fasting glucose) are worse among healthy obese than healthy normal weight individuals, despite both groups having the same label of 'healthy.'

因此，健康肥胖的人群比起正常體重人群，毫無懸念的擁有更高水平的代謝性心血管疾病的危險(xiǎn)因素(比如說心臟收縮壓和空腹血糖)，盡管這兩組人都被貼上了“健康”這個(gè)標(biāo)簽。

Johnson isn't the first scholar to call for the idea of healthy obesity to be retired. He's interested less in research that determines whether healthy obesity exists and more interested in rerouting research dollars to figure out why two people with similar BMIs can wind up with such different outcomes, with one dying of disease and the other completely fine.

Johnson并不是第一個(gè)呼吁停用健康肥胖這個(gè)概念的學(xué)者。比起花心思研究是否存在真的健康肥胖，他更愿意把研究資金投入研究為什么BMI相同的兩個(gè)人結(jié)局會(huì)如此不同，一人因肥胖死亡而另一人卻完全沒事。

"It is undeniable that obesity is bad for health, but there are clearly differences between individuals in the extent to which it is bad," he says in the accompanying press release. "While the concept of healthy obesity is crude and problematic and may best be laid to rest, there is great opportunity for human biological investigation of the levels, causes, and consequences of heterogeneity in health among people with the same BMI."

“肥胖影響健康是不可否認(rèn)的，但是很明顯不同的個(gè)體間差異也很大，”他在隨文新聞稿中說。“由于健康肥胖這個(gè)概念粗糙且存在疑問，我們最好把它放一放。人類生物學(xué)還存在更好的機(jī)會(huì)去研究調(diào)查BMI相同的人群的健康水平、原因以及異質(zhì)性對(duì)健康的影響。”