DR. WEIL: Paradox mounts over obesity

By Dr. Weil

Published November 17, 2008 at 6 p.m.

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I've just read that obese men with heart disease do better overall than men of normal weight. If so, what's the point of all this emphasis on weight control?

Results of a study published in the June 2007 issue of the American Journal of Medicine do suggest that obese men with heart-disease symptoms tend to live longer than men of normal weight.

It isn't the first study to yield such perplexing results. Obesity has also been linked to longer survival among patients with congestive heart failure, and there's evidence that obese patients do better after heart bypass surgery.

In addition, a study published in the June 20, 2007, issue of the European Heart Journal found that obese patients treated for one type of heart attack (with minimal damage to the heart muscle) were less than half as likely to die during the following three years as those with a normal body-mass index who had the same procedure.

Some evidence suggests that doctors may treat obese patients more aggressively, thus accounting for the so-called "obesity paradox," but clearly we need more research to see what's going on here. In the meantime, if you're trying to lose weight to improve your heart health, I would encourage you to keep at it. Mystifying as the results of these studies are, keeping your weight under control is still the key to avoiding a heart attack in the first place.

I know you recommend echinacea for colds, but I've read that it really doesn't help. Now a new study says it does work. What do you make of the contradictory findings?

The latest word on echinacea, from a review of 14 earlier studies, concluded that the herbal remedy reduces the risk of catching a cold by 58 percent and shortens the dura- tion of colds by 1.4 days. Re- searchers at the University of Connecticut and Hartford Hos- pital found that adults who took echinacea contracted only one to two colds a year instead of the usual two to four.

Most of the research on echinacea has been done in Germany and has confirmed the herb's antiviral, antibacterial and immunity-enhancing properties. However, until the publication of the Connecticut study, much of the U.S. research yielded mixed results, especially on its use as a preventive measure. The last well-publicized study, from the University of Virginia School of Medicine, found that echinacea neither prevented colds nor eased symptoms.

I doubt that either the Virginia or Connecticut findings will be the last word on the subject.

drweil.com

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