Credit score: Unsplash/CC0 Public Area
The well being recommendation that retains you from getting sick may truly hurt you when you’re already unwell. This counterintuitive medical actuality has a brand new title: “Cuomo’s paradox”, coined by Professor Raphael Cuomo at UC San Diego College of Drugs after analyzing findings throughout quite a few research.
The paradox describes how conduct lengthy thought of unhealthy—carrying additional weight, ingesting average quantities of alcohol, having elevated ldl cholesterol—typically correlates with higher survival in individuals who have already got most cancers or coronary heart illness. It is a phenomenon that challenges the one-size-fits-all strategy to medical recommendation.
This does not imply throwing prevention pointers out the window. Moderately, it suggests vitamin ought to be handled as stage-specific drugs. Earlier than analysis, the objective is obvious: cut back your threat of getting sick. After analysis, the priorities shift dramatically to preserving power, tolerating harsh remedies and avoiding harmful problems.
The excellence issues enormously for the thousands and thousands residing with superior most cancers or coronary heart illness. Too typically, docs apply prevention-focused recommendation—drop a few pounds, get rid of alcohol, slash levels of cholesterol—to sufferers whose speedy battle is surviving chemotherapy or managing frailty. These competing objectives can level to completely totally different dietary methods.
Cuomo argues for personalised vitamin after analysis quite than copying prevention steerage. What retains a wholesome 40-year-old disease-free might not assist a 70-year-old most cancers affected person get by way of remedy.
The sample is not completely new. Researchers have lengthy documented the weight problems paradox in cardiovascular and most cancers care, the place heavier sufferers typically survive longer as soon as they’re unwell. These observations have sparked years of debate, with critics pointing to measurement timing, unintentional weight reduction from sickness, and statistical quirks which may clarify the findings.
Though cautious research design can cut back some paradoxical alerts, they do not all the time disappear. Cuomo’s contribution is connecting these recurring reversals throughout a number of components—weight, alcohol, ldl cholesterol—and a number of illnesses, making a unified framework for stage-specific vitamin.
The findings do not negate established science. Weight problems and alcohol clearly improve most cancers threat and worsen coronary heart well being. However as soon as sickness strikes, the survival equations change, and inflexible prevention targets might not go well with each affected person present process remedy.
The paradox in observe
Why may additional weight assist most cancers survival? The reply lies within the brutal actuality of most cancers remedy. Chemotherapy, radiation and surgical procedure are bodily punishing, breaking down muscle and tissue. Sufferers with higher reserves—each fats and crucially, muscle mass—might be able to climate these assaults higher and resist the speedy weight reduction that alerts declining well being.
When an individual was final weighed issues too. An individual who’s underweight now—at analysis—might have been obese earlier than they turned unwell, however is at the next threat of loss of life in contrast with an obese particular person for the explanations said above.
Comparable patterns seem with alcohol. Though ingesting clearly will increase most cancers threat in proportion to consumption and period, some research recommend light-to-moderate drinkers present higher or equal post-diagnosis outcomes in comparison with non-drinkers. The interpretation stays murky—gentle drinkers might have totally different social or well being conduct, whereas some might stop alcohol as a consequence of sickness, skewing comparisons.
Ldl cholesterol presents one other puzzle. In superior coronary heart illness, extraordinarily low ldl cholesterol typically alerts broader well being issues: irritation, malnutrition and liver dysfunction. In these instances, low ldl cholesterol is extra prone to mirror underlying sickness quite than immediately trigger poor outcomes, which means that sicker sufferers typically present low ranges. This creates a U-shaped sample the place each very excessive and really low ldl cholesterol are linked to an elevated threat of loss of life.
Cuomo’s message is not that “high cholesterol is good” however that aggressively pursuing prevention targets in frail sufferers won’t enhance survival and will battle with sustaining power and high quality of life. Remedy selections require individualization and cautious monitoring.
For docs, this implies separating prevention from survival objectives. Earlier than analysis, commonplace steerage applies: preserve wholesome weight, restrict alcohol, handle ldl cholesterol. After analysis, targets ought to mirror illness stage, remedy plans, physique composition and different well being situations. The main target shifts to avoiding unintentional weight reduction whereas sustaining muscle and vitality throughout lively remedy.
Cuomo’s paradox would not upend well being recommendation. It emphasizes context. The conduct that stops illness is not all the time that which finest helps survival as soon as severe sickness arrives. That is not permission for unhealthy habits—it is a name for individualized care that balances survival, power and high quality of life by way of cautious medical oversight.
Offered by
The Dialog
This text is republished from The Dialog below a Artistic Commons license. Learn the unique article.
Quotation:
Why shedding pounds or reducing alcohol is not all the time finest after sickness strikes (2025, August 23)
retrieved 23 August 2025
from https://medicalxpress.com/information/2025-08-weight-alcohol-isnt-illness.html
This doc is topic to copyright. Other than any honest dealing for the aim of personal research or analysis, no
half could also be reproduced with out the written permission. The content material is supplied for data functions solely.
