A recent study published in Neurology examined the relationship between obesity, metabolic dysfunction (e.g. glucose sensitivity, insulin resistance, blood lipids) and cognitive function and decline.
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Method
The researchers asked 6,401 adults (aged 39?63 years in 1991?1993) to provide information on:
1) BMI: people were classified as ?normal weight?, ?overweight? or ?obese?;
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2) Metabolic status: people were classified as having a ?normal? or an ?abnormal? metabolic status, where metabolic abnormality was defined as having 2 or more of the following:
- High Blood triglycerides (?1.69 mmol/L or taking blood lipid-lowering drugs);
- High Systolic blood pressure (?130 mm Hg, diastolic blood pressure ?85 mm Hg or taking antihypertensive drugs);
- High Blood glucose (?5.6 mmol/L or taking medications for diabetes); and
- Low HDL cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women).
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3) Cognitive Ability: The researchers also measured participants? mental abilities using four cognitive tests which assesed memory, reasoning, semantic knowledge (i.e. word meanings), and phonemic fluency (e.g. coming up with words that begin with a certain letter, or belong to a certain category such as ?animals?). The results of the four tests were averaged to give a global score of cognitive ability, and the tests were taken at three different time points: (i) 1997?1999; (ii) 2002?2004; and (iii) 2007?2009.
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Results
- 69% of people were classified as? metabolically ?normal? and in this group, the decline in cognitive ability over the 10-years of measurement was similar? in those who were? normal weight, overweight and obese (i.e. BMI did not have an impact on cognitive ability.
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- However, in the 31% of people who were classified as? metabolically ?abnormal?, the decline in cognitive abilitywas significantly faster in the obese people than in the normal weight people. In other words, metabolically abnormal people?s performance on the cognitive tasks got worse quicker if they were obese than if they were normal weight.
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Author?s Conclusions
?In these analyses the fastest cognitive decline was observed in those with both obesity and metabolic abnormality?
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So What?
This study has a number of limitations -?for example, the people in this study were all British civil service workers and so the results might not extend to other populations; and the study only measured a correlation between metabolic abnormaility, BMI and cognitive ability (i.e. it didn?t show that metabolic abnormalities and obesity caused an increased rate of cognitive decline).
However, the key take-home message from this research is that it is the combination of obesity and metabolic abnormalities that was correlated with a faster cognitive decline. Adimittedly the two often go hand in hand, but this research serves as a reminder that although excess body fat might look unsightly, it?s actually often the internal physiology that we should be focusing on as much as external appearance ? something the health and fitness industry can often forget.
Although many people might want to change their exercise and diet habits in order to look better, changes in physique can be painfully slow (especially for someone with a lot of weight to lose), and this can be very demotivating. It?s therefore important to remember that we should not only be concerned with physical appearance, and to remind our clients (and ourselves) that the benefits of diet and exercise changes are internal as well as external. Improvements in metabolic measurements (such as blood glucose, blood pressure and blood triglycerdies) can happen very quickly compared to changes in weight, and even a small improvement in these markers can significantly lower a person?s risk of developing health problems such as cardiovascular disease and diabetes, and, as indicated by this study, may also have a significant positive impact on? cognitive function.
Personally, I?d like to live a long life, free of disease, and exit with all my mental faculties fully intact ? and that?s something I?m much more motivated to work for than 6 pack abs!
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