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Increased risk of heart disease among ‘Fat but Fit’
August 20, 2017, 12:49 pm
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Carrying extra weight could raise your risk of heart attack by more than a quarter, even if you are otherwise healthy, says a new study.

Researchers have found that being overweight or obese increases a person's risk of coronary heart disease (CHD) by up to 28 percent compared to those with a healthy bodyweight, even if they have healthy blood pressure, blood sugar and cholesterol levels.

The findings add to a growing body of evidence that suggests being 'fat but fit' is a myth, and that people should aim to maintain a body weight within a healthy range. Storing too much fat in the body is associated with a number of metabolic changes, including increased blood pressure, high blood sugar and altered cholesterol levels, which can lead to disease and poor health.

Previous studies have revealed a subset of overweight people who appear to lack the adverse health effects of excess weight, leading to them being classified as 'metabolically healthy obese' in the medical literature, and 'fat but fit' in the media.

Now, a group of researchers at Imperial College London and the University of Cambridge have shown that despite an apparent clean bill of health, this overweight group is still at increased risk compared to those with a healthy weight.

In the largest study of its kind to date, scientists used data from more than half a million people in 10 European countries to show that excess weight is linked with an increased risk of heart disease, even when people have a healthy metabolic profile.

"Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors. Even if their blood pressure, blood sugar and cholesterol appear within the normal range, excess weight is still a risk factor" said lead author Dr. Camille Lassale.

In the study, researchers looked at the link between excess weight and risk of CHD, a condition where not enough blood gets through to the heart due to clogged arteries, leading to heart attacks.

After a follow-up period of more than 12 years, a total of 7,637 people in the study cohort experienced CHD events, such as death from heart attack. Researchers then selected a representative group of more than 10,000 individuals as controls, for analysis.

After adjusting for lifestyle factors such as smoking, diet, exercise and socioeconomic status, the researchers found that compared to the healthy normal weight group, those classed as unhealthy had more than double the risk of CHD, whether they were normal weight, overweight or obese.

However, analysis also revealed that within the apparently healthy group there was a significant difference in outcomes for people depending on their weight. The research found that compared to those at normal weight, people who were classified as healthy but were overweight had an increased CHD risk of 26 percent, while those who were healthy but obese had an increased risk of 28 percent).

According to the researchers, the excess weight itself may not be increasing the risk of heart disease directly, but rather indirectly through mechanisms such as increased blood pressure and high glucose. They added that what is clear from the study is that population-wide prevention and treatment of obesity is needed in order to ensure public health.
 

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