Obesity NOT Always Tied To Heart Risk

Umeboshi

http://www.foxnews.com/health/2012/05/25/obesity-not-always-tied-to-higher-heart-risk-study/

An obese person isn't inevitably at increased risk of cardiovascular disease and death, a new U.K. study finds.

"The people really at risk are the ones who have obesity in combination with other metabolic health risk factors," said Mark Hamer, a principal research associate at University College London who worked on the study.

The results are in line with most previous research that defined metabolic health as having normal levels of markers like blood pressure, blood sugar, HDL, or "good" cholesterol, and C-reactive protein, which is a measure of inflammation in the body.

"People with good metabolic health are not at risk of future heart disease -- even if they are obese," Hamer told Reuters Health.

On the flip side, the non-obese in poor metabolic shape face as much risk as the unhealthy obese, the researchers concluded.

The findings, published in the Journal of Clinical Endocrinology & Metabolism, are based on more than 22,000 middle-aged participants in national health studies conducted in England and Scotland.

According to the researchers, the results suggest that metabolic factors may be more important in predicting a person's risk of cardiovascular disease than excess body weight in itself.

From a clinical perspective, stratifying individuals based upon their metabolic profile may help to identify those -- both obese and non-obese -- who should be treated with drugs or changes in diet and exercise, the study authors noted.

"We encourage obese people to lose weight for their health, but (some) provision should be made in how we screen people for metabolic risk," Hamer told Reuters Health.

An adult who has a body mass index -- a height-to-weight ratio -- of 30 or higher is considered obese. A normal BMI is between 18.5 and 24.9, and a BMI between 25 and 29.9 is considered overweight.

During the past 20 years, obesity has increased significantly in the United States. More than a third of American adults are obese, according to the Centers for Disease Control and Prevention.

Poor metabolic health?

For the new report, Hamer and a colleague collected data on participants' BMI and metabolic profiles and followed individuals, on average, for seven years. Then they looked at how many participants had died during the study period, and from what causes.

None of the participants had heart disease at the start of the study.

Almost a quarter were obese, and just under a quarter of those were considered "metabolically healthy obese" -- meaning they had no abnormal blood pressure, cholesterol, blood sugar or inflammation readings.

During the study period, more than 600 participants died from heart-related causes and 1,800 from other causes.

The obese individuals in good metabolic health were not at greater risk of dying from cardiovascular disease than the metabolically healthy non-obese, the researchers found.

But both non-obese and obese participants in poor metabolic health had a 59 percent and 64 percent increased risk of dying from heart disease, respectively, compared to the healthy non-obese.

Among the metabolically unhealthy participants, the non-obese had high levels of hypertension and inflammation -- comparable to those in the unhealthy obese group.

The metabolically unhealthy obese also had a 72 percent higher risk of dying from non-heart-related causes than those in good health.

That was after taking into account study participants' age, sex, smoking, physical activity and socioeconomic status.

Researchers found the results to be largely unchanged when they used waist circumference to define obesity instead of BMI.

'Think more broadly'

Hamer and his colleague note in their report that a strength of their study was having a large study population. But because the researchers only measured participants' metabolic risk factors at the beginning of the study, it's possible that some of the metabolically healthy obese went on to develop unhealthy readings.

The study shows the need "to think more broadly about obesity" rather than to focus on body weight alone, said Dr. Cora Lewis, a professor of preventive medicine and an epidemiologist at the University of Alabama, Birmingham, who was not involved in the research.

"If you are obese and you struggle with weight, but your (metabolic) risk factors are fine, that may not be such a bad place to be," Lewis told Reuters Health -- adding that only "a minority of people" fit the description of "metabolically-healthy obese."

Equally important, the study shows that people may be at increased metabolic risk no matter what they weigh, she noted.

Excess body fat may be carried not only under the skin, but also inside the abdomen, heart, liver and muscles -- making it hard to tell -- she added.

"BMI doesn't always tell you everything. If you are non-obese, but you have high cholesterol or hypertension, you have some work to do," Lewis said.

Read more: http://www.foxnews.com/health/2012/05/25/obesity-not-always-tied-to-higher-heart-risk-study/#ixzz1vszfaXuO

TheFunBun

That's an interesting article.

It makes sense that quality food and frequent activity would lead to good health since our bodies are designed to store the surplus anyways. Still, it's pretty taxing on the weightbearing joints, especially if you're leading an active life while being obese. I know my body performs better at lower weights in all of the measurable activities I take part in.

I wonder what the average BMI in the obesity group was, though.

bm99

I absolutely think that we do smaller people a disservice by focusing on obesity all the time. Instead of weight alone we should be focused on good food and exercise AND weight. As it stands we tend to think thin people are fine just because they are thin and they may not be.


However, articles like these are often held up by the "fat acceptance" community as reasons why they shouldn't lose weight. Carrying around a lot of extra weight is not healthy in any way, even if you do manage to avoid the most obvious health risks (diabetes, heart disease etc). It's dangerous to think that it's physically ok to be fat (and I mean 50+ extra pounds. Not everyone has to be "skinny", but no one should be fat, either. There is a range of normal weights that are not necessarily thin).

selfishshellfish

Yes, my understanding is that it's a much more subtle issue than is generally presented. This is why I'm relaxed about my BMI as long as I feel well and am eating good food.

I have also read that mortality and morbidity is only really affected at very high and very low BMI values (sorry, don't have the sources right here, so please treat this as anecdote).

And if you're an older person, well, having some surplus fat actually correlates with better life expectancy.

Umeboshi

I absolutely think that we do smaller people a disservice by focusing on obesity all the time. Instead of weight alone we should be focused on good food and exercise AND weight. As it stands we tend to think thin people are fine just because they are thin and they may not be.


However, articles like these are often held up by the "fat acceptance" community as reasons why they shouldn't lose weight. Carrying around a lot of extra weight is not healthy in any way, even if you do manage to avoid the most obvious health risks (diabetes, heart disease etc). It's dangerous to think that it's physically ok to be fat (and I mean 50+ extra pounds. Not everyone has to be "skinny", but no one should be fat, either. There is a range of normal weights that are not necessarily thin).

What are these other major health risks that make it such a big deal to be fat?
Saying no one 'should' be fat is not the best wording, considering there are many illnesses that cause weight gain that is entirely out of a person's control. Even if a person is fat without these illnesses, AND have health issues, it is not anyone else's business what that person does with their own body.

selfishshellfish

I absolutely think that we do smaller people a disservice by focusing on obesity all the time. Instead of weight alone we should be focused on good food and exercise AND weight. As it stands we tend to think thin people are fine just because they are thin and they may not be.


However, articles like these are often held up by the "fat acceptance" community as reasons why they shouldn't lose weight. Carrying around a lot of extra weight is not healthy in any way, even if you do manage to avoid the most obvious health risks (diabetes, heart disease etc). It's dangerous to think that it's physically ok to be fat (and I mean 50+ extra pounds. Not everyone has to be "skinny", but no one should be fat, either. There is a range of normal weights that are not necessarily thin).

You know, the link between health and fatness is actually not particularly well understood. For example, fatness itself is not an unhealthy thing in species such as seals (hence my profile picture, ahem), and any causal relationship between fatness and poor health in humans is the subject of a ongoing research.

My point, though, is that the health argument can be a spurious one. It is often used as justification to stigmatise fatter people. And I find it incredibly illiberal when shame and humiliation are used as tools of social engineering. It's something I object to on principle.

Fat acceptance is about personal freedom, in my view. I don't fancy living in a society where I am not granted the freedom to manage my health as I see fit.