It's long been known that overweight and obese people have high heart disease risk. A new report in Archives of Internal Medicine shows that an unhealthy weight alone may be enough boost your risk. It also challenges a widely circulated idea about weight and health.
Bottom line first
Being an unhealthy weight--even if your cholesterol is under control and your blood pressure is normal--puts you at elevated risk for serious cardiovascular problems. If you're obese, the risk is far greater than if overweight.
This study in 50 words or less
Researchers analyzed data on over 300,000 people, counting cardiac events. After controlling for age, sex, smoking and physical activity--and then for cholesterol level and blood pressure--they found unhealthy weight alone may account for 45 percent of elevated heart disease risk. Obesity carried higher risk.
Yes, but. . .
This kind of report, called a meta-analyis because it pools data from many previous studies, is not as powerful as a clinical trial or even an analysis of specific individuals. The result is suggestive, not conclusive.
The authors indicate that some specific foods overweight people tend to eat, not weight itself, may explain the findings.
The group that was studied, while quite large, was mainly white and generally healthy. Results may not apply to other races or high-risk people.
Several key heart disease risk factors were not taken into account, including family history and where one's body fat is held (abdominal fat being higher risk than fat distributed at the hips or all around the body).
So what are you going to do about it?
The key implication to this study is that it challenges (but does not disprove) the idea that it's possible to have low heart risk and be overweight--the "fit but fat" phenomenon. Because the study controlled for physical activity yet still found weight to be a powerful risk factor for heart disease, it suggests that fitness may not be protective in overweight (or, particularly) obese individuals.
Still, exercise is important to weight loss--studies show that regular exercise is a key for keeping weight off long-term. It may not independly protect you from heart disease, but it helps control weight and other serious health risks such as high blood pressure, diabetes, mild depression and sleep apnea.
The takeaway, as always: To help control heart disease risk, control your weight. This study suggests that moving from the obese category (a body mass index above 30) to the overweight category (between 25 and 30) can reduce heart risk considerably.
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