The Fire in the Fat

If you follow the news you will know that Boris Johnson, the Prime Minister of Britain, had a close shave with coronavirus. He himself, now recovered, is reported as blaming his body weight. As a result, he has a new enthusiasm for public health measures that stop people getting fat.

Boris has a fair point. In the scramble for data, many researchers have found that obese people with COVID infection are more likely to die than thinner ones, or to need intense hospital treatment to survive. Which is a worry in a world, at least in the affluent parts, that is collectively much more obese than it has ever been before. We are uniquely primed to succumb to pandemic viruses, not just because there are so many people on the planet and so much air travel, but because so many of us aren’t fit to fight when it arrives. 

So why, you ask, is obesity so bad? Obesity is inflammatory. Fat tissue secretes the molecules that stir up inflammation and obese people walk around with a long-term low-grade inflammation throughout their tissues as a result. This is why heart disease and cancer (also diseases of inflammation) are higher in obese people and we are now discovering, on a global scale, fatal reactions to viral infections are as well. Inflammation comes from an unbalanced immune system, the same system that has to fight off viruses. When it is not in good working order, then the fight doesn’t go very well.

Most of us will get through this crisis with our health intact but one interesting way of looking at the experience is the insights it has delivered. It has exposed the failings of population health goals. Too many people are too flabby and unfit to fight. If that operates as a shock for policy makers and couch potatoes, all to the good. Measures that reduce body weight actually reduce inflammation in multiple ways: regular exercise, coloured vegetables, spices and multiple forms of natural goodness all have their immune balancing health payoffs.

As always, so many health messages come down in the end to have a properly balanced immune system, which is a consequence of lifestyle choices.