Brought to you by the letter U


The u- or j-shaped curve is a feature of a lot of research studies on health-related topics. “Moderation in all things,” is as true now as it was when Hesiod and/or Aristotle doled out the advice thousands of years ago. It’s also a key to some of the trickiness of health advice – you can get too little or too much of a thing. People like to latch onto particular foods or behaviors as being healthy or unhealthy, but none of them exists in isolation. I mean, sure, kale is packed with all kinds of minerals, but if you only eat kale, the results aren’t going to be pretty.

Here’s another maxim from the ancients: “The dose makes the poison,” attributed to Paracelus, a Swiss alchemist (b. 1494-ish, d. 1541). That can apply to everything from Tylenol to red wine, both of which will, in sufficient quantities, utterly destroy your liver, but which are pretty okay in small doses. Fish, likewise, is good for you (Omega 3 fatty acids are important), but because it also often contains some heavy metals (not so good for you) you should go easy on it. Then there’s exercise. None is very bad, and any amount more is better, until you start to get to the point where you’re utterly wearing yourself out.

One of the first places I ran across this relationship was when I was wondering about optimal weight. According to the stock advice these days, normal weight is defined by the 18.5 to 24.9 range of BMI (Body Mass Index, more on this in another post). However, “Normal” does not match the range of the BMIs with the lowest all-cause mortality. “… many epidemiological studies show an inverse relationship between mortality and BMI inside the normal BMI range. Other studies show that the lowest mortality in the entire range of BMI is obtained in the overweight range (25–29.9).” This paper has a long title: “How Much Should We Weigh for a Long and Healthy Life Span? The Need to Reconcile Caloric Restriction versus Longevity with Body Mass Index versus Mortality Data.” It also has a nice little chart which shows lowest mortality at a BMI of 23.4, but no significant difference from 20.8 to 27.7. 

The u- or j-shaped curve also shows up when you look at the results of exercise, eating red meat or protein, drinking alcohol, or eating sugar, though in those later two cases it’s unclear that any amount is really good for people. Sleep is another problematic example, which merits a blog post of its own. 

For almost everything, there’s going to be a balance. Fortunately, we’re adaptable creatures, and that balance point is very broad without a gigantic drop-off for most things. Don’t get too stressed out if you’re not hitting the bullseye. Being more or less on target really is good enough. Still, it helps to have some idea of what the targets are, and that's what I'll get into in a little while. 

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