An abstract presented in Madrid at the annual meeting of the European Association for the Study of Diabetes (EASD) suggests that when obese people lose weight, they may be less likely to develop a serious infection. That is particularly true for individuals with diabetes. The abstract was presented by Rhian Hopkins at Exeter Medical School in the UK and involved data from the ongoing UK Biobank, a database that includes health info on almost 500,000 Britons. No manuscript has been published yet, so these findings should be considered preliminary. However, if additional studies confirm their findings, it could be a big deal since as many as 1 in 3 hospitalizations among people with diabetes are for infection. The press report about the abstract did not specify whether the investigators specifically looked at wound infections.
According to the data analyzed, about 64,000 individuals in Britain were hospitalized for a bacterial infection (such as a urinary tract infection or pneumonia); almost 15,000 were hospitalized with a viral infection (such as the flu), and about 408,000 had never been hospitalized for infection. The team found that obesity appeared to be linked to a higher risk of severe infection. Every 5-point increase in Body Mass Index (BMI)– for example, from a BMI of 30 (the threshold for obesity) to 35 — incurred a 30% rise in the risk of a serious bacterial infection. These associations were for all people, regardless of whether or not they had diabetes.
There’s a patient that I can’t get off my mind. She had metastatic breast cancer and a fungating tumor on her chest wall. She knew that her life would not be prolonged by chemotherapy and and didn’t want to spend her last months sick from chemo. She stopped chemo and went on a ketogenic diet. I posted her photos on my blog in 2019. Like most fungating breast tumors, the lesion on her chest wall smelled terrible and was highly colonized. That is, until she went on a nearly zero carb diet. The odor disappeared, and she epithelizlized over the tumor. In a long career, I have never seen skin grow over a tumor. Yes, she eventually died of her cancer metastasis. But her bacterial colonization just went away on a low carb diet.
If it turns out to be true that losing weight decreases the risk of serious infection among obese people, the next step will be to identify the mechanism. Whether it is because it reduces the average blood glucose level will be one of the questions that has to be answered. In the mean time, it’s possible that weight loss could keep some of our patients from develping severe infections. And that’s a big deal because most of our patients are obese. And, as an aside, a ketogenic diet might help a lot of our patients. I went on a strict ketogenic diet with my husband to help him get his cholesterol under control. I admit that as someone for whom bread is a reason to live, I found it very difficult. When I asked my sweet breast cancer patient how she was managing a strict ketogenic diet and she said, “It’s amazing what you can do when your life depends on it.”
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
What an interesting article!!!