Did Harvard make me fat?
There has been a long-running, delicious food fight pitting a University of Colorado law professor and the Atlanta-based Centers for Disease Control against the Harvard School of Public Health on the subject of fatitude.
Most recently, law professor Paul Campos published an article in The New Republic titled "Why Harvard Wants You to Be Unhealthily Thin." Amid a heady mix of accusations, such as book-cooking and intellectual dishonesty, Campos indicts high-profile Harvard School of Public Health nutritionists Walter Willet and Meir Stampfer for relentlessly hyping the so-called Body Mass Index, or BMI.
"They've played a crucial role in promoting the BMI," Campos told me. "They lobbied to get the definition of overweight lowered from a BMI of 27.3 to 25. That turned 31 million Americans overweight overnight. They don't use science. If they weren't Harvard people, they could never get away with this."
What is the BMI? It is an old-fashioned biometric indicator, dating back to the 19th century. Your BMI is your body weight divided by the square of your height. It measures your adiposity, or fatness. (You can easily find a BMI calculator on the Internet.) A common perception is that the BMI "determines the degree of healthiness one enjoys," as one health website claims. Stampfer and Willett have written that having a BMI of over 25 is "a major contributor to morbidity and mortality."
I have a dog in this hunt. My BMI is 27.1. But most people don't think I'm fat. Let's say I am full figured, more like the Britney Spears who performed at last week's Video Music Awards than the former, pre-K-Fed, too-thin Britney. Here's the rub. My doctor has gently hinted that I might lose 7 or 8 pounds. But even if I did, my BMI would be 26 - overweight. If I were 15 pounds thinner, I would look terrific. But I would still have a BMI of over 25, and the Harvard docs would call me fat.
Perhaps too gleefully, Campos cites a Harvard Alumni Study that found the lowest mortality rates among those graduates who gained the most weight since graduating, while also exercising vigorously. "Such work suggests strongly that [obesity researchers have been] using fat as a proxy - and a poor one at that - for a factor that actually does have a significant effect on health and mortality: cardiovascular and metabolic fitness," he writes.
Campos isn't Harvard's only critic. Two years ago, CDC researcher Katherine M. Flegal released a study that "came to a startling conclusion," according to Scientific American. "Mildly overweight adults had a lower risk of dying than those at so-called healthy weights."
The World's Greatest Public Health School kicked into overdrive to trash the CDC findings. Harvard convened a fat symposium shortly after Flegal's work appeared in the Journal of the American Medical Association, to critique the CDC work. Around the same time, Willett wrote a letter to JAMA, calling Flegal's work "flawed and misleading." In an interview, Willett called the CDC study "complete rubbish," which seems a little strong. "The work got CDC's highest science award in 2006," Flegal told me. "I wouldn't call it rubbish."
Willett is not in the mood to compromise on the BMI indicator. (Easy for him to say; he's a 23 1/2.) "The data are clear. If you put on that extra weight, there are increased risks of diabetes, heart disease, gallstones, and various cancers," he says. As self-appointed tribune of the over-25 crowd, I ask: What about the "cycling paradox," described in The
As for Campos, who has been spitballing HSPH fat work since at least 2001, Willett says: "It's unfortunate that he's gotten into an issue that's complex, because it leads to confusion in the minds of many people on an issue that is very important to their health. It is important to remember that he is a lawyer with no scientific qualifications."
"Yes, that's Willett's position," Campos retorts. " 'I am the Mighty Oz and this is a law professor with no medical training.' It's like - here he affects a deep, authoritative voice - 'Ask your doctor if Cialis is right for you.' Their obesity standards are insane. You couldn't have a BMI of 21 unless you were in a concentration camp."
Alex Beam is a Globe columnist. His e-dress is firstname.lastname@example.org.