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Metabolically Healthy Obese People Still Have Higher Cardiovascular Risk

Metabolically healthy obese people meet the BMI requirement of obesity, but don’t have the other complications usually seen with obesity, including poor cholesterol levels, poor blood sugar, diabetes, or high blood pressure. However, a recent study suggests that even metabolically healthy obese people may be at a higher risk of cardiovascular disease events such as heart attack or stroke than people who have a normal weight.


For this study, researchers examined electronic health records from The Health Improvement Network for the years 1995 to 2015. From that data set, the researchers put together a cohort of 3.5 million people age 18 or older who were placed into categories based on BMI and did not have cardiovascular disease initially. The researchers then created a metabolic abnormalities scale from zero to three based on the presence or absence of diabetes, high blood pressure, and abnormal blood fats. In order to qualify as metabolically healthy, the participants had to have a score of zero.


The researchers then examined the risk of developing coronary heart disease, cerebrovascular disease, heart failure, and peripheral vascular disease in metabolically healthy normal weight people in comparison with metabolically healthy obese people. They found that people who were metabolically obese had a 50% increased risk of coronary heart disease, a 7% increased risk of cerebrovascular disease, and a doubled risk of heart failure when compared with metabolically healthy people of a normal weight. Initially, metabolically obese people had a 9% lower risk of peripheral vascular disease when compared with metabolically healthy people of a normal weight. However, when cigarette smokers were excluded from the sample, metabolically obese people had an 11% increased risk.


The risk of a cardiovascular event also increased when obese people had metabolic abnormalities.  Compared to a metabolically healthy person of a normal weight, an obese person with three metabolic abnormalities had a 2.6 times increased risk of coronary heart disease; a 58% increased risk of cerebrovascular disease, including stroke; a 3.8 times increased risk of heart failure, and a 2.2 times increased risk of peripheral vascular disease.


Researchers from the University of Birmingham conducted the study. It was presented at the 207 European Congress on Obesity, which took place in Porto, Portugal from May 17-20, 2017.


Obesity has a far ranging negative effect on health.  Each year, obesity causes approximately 300,000 premature deaths in the United States. The negative health effects associated with obesity include high blood pressure, diabetes, heart disease, osteoarthritis, metabolic syndrome and sleep apnea.


Improving eating habits and increasing physical activity play a vital role in preventing obesity.  It is recommended that we eat five to six servings of fruits and vegetables per day. It’s also recommended that we get at least 30 minutes of moderate intensity activity every day.

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