To the Editor: In his Commentary, Dr Roth1 proposed that the proinflammatory state of obesity might have provided an evolutionary advantage during tuberculosis pandemics. Although tuberculosis is likely to have played an important role in shaping human evolution, I believe the notion that obesity-associated inflammation favors protection or survival from tuberculosis is not well supported.
Fantuzzi G. Tuberculosis and the Inflammatory Processes of Obesity in Human Evolution. JAMA. 2009;302(16):1754-1755. doi:10.1001/jama.2009.1514