There's no such thing as "fat but fit"

An overweight man
15th August 2017

Carrying extra pounds does raise your risk of heart disease, however healthy you seem to be, a new study has said. We look behind the headlines.

Being overweight increases your risk of heart disease, even if you otherwise have a clean bill of health, according to a new study.

Compared to those of normal weight, people who were classified as healthy but overweight had a 26 per cent increased risk of heart disease, while those who were healthy but obese had a 28 per cent higher risk.

Usually, being overweight is linked to a number of effects on your body, including:

  • more fat around the waist,
  • increased blood pressure
  • high levels of triglycerides (a type of fat in the blood)
  • high blood sugar
  • lower ‘good’ cholesterol levels.

These changes are called metabolic syndrome and are linked to heart and circulatory disease and type 2 diabetes. But there have been some suggestions that if you are overweight but don’t have these changes, then your risk of heart disease is no higher than a person of healthy weight – in other words, you can be ‘fat but fit’. The study tried to find out whether this is the case – and found that it wasn’t.

People with metabolic syndrome were at higher risk of heart disease, even if they were not overweight

Unsurprisingly, it also found that people with metabolic syndrome were at higher risk of heart disease, even if they were not overweight.

The research was published in the European Heart Journal. The story was covered widely, by The Sun, The Daily Mail, The Independent and the BBC, amongst others, and accurately represented the research.

The research

A strength of the research was that it made adjustments for age, sex, smoking, diet and physical activity. It was also based on large numbers of people – the researchers described it as “the largest to address this question in terms of the number of CHD events”.

Moreover, as no follow up measurements were taken, we don’t know whether people’s weight, or other measurements such as blood pressure and blood sugar, changed after the initial measurements, during the period in which they were followed up (12 years on average).

The BHF view

Professor Metin Avkiran, Associate Medical Director at the BHF, says: “Coronary heart disease – the cause of heart attacks and angina – is the UK’s single biggest killer.

This study provides robust evidence that there is no such thing as ‘healthy obesity’

“This study provides robust evidence that there is no such thing as ‘healthy obesity’.  It shows that being obese increases a person’s risk of developing heart disease, even if they are otherwise healthy. The take-home message here is that maintaining a healthy body weight is a key step towards maintaining a healthy heart.

“BHF-funded researchers are now looking to understand exactly how obesity leads to heart attacks,” he says.

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