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.
Obesity Wars: Coca-Cola, McDonald’s, and 7-Eleven See the Lite
While they suffer from even more ignominy under a new glare induced by the HBO documentary series The Weight of the Nation, the roundly condemned purveyors of “junk” salt, sugar and calories aren’t exactly lying low and saying their mea culpas. McDonald’s, Coca-Cola and 7-Eleven are each fighting back in their own way.
Coca-Cola has launched a test of its own new “mid-calorie” sodas to join PepsiCo in trying once again the concept of a “hybrid” diet/non-diet drink even though other attempts by both companies to mine a moderately-minded market have failed. Coke plans to test Sprite Select and Fanta Select products this summer - with only half the calories, 70 of regular drinks per 12-ounce can - in test markets in Atlanta, Detroit, Louisville and Memphis.
Interestingly, Coke’s new toe in the mid-calorie water will depend on a blend of sugar: Cargill’s Truvia brand of natural sweetener stevia plus erythritol, a “sugar alcohol” (unlike the ingredients in PepsiCo’s new, nationally available mid-cal, Pepsi Next, which includes sucralose and high-fructose corn syrup). That gives Coke a leg up on an “more natural” claim it might want to make for select beverages against Next.
Meanwhile, McDonald’s keeps fighting public perceptions that it is a willing enabler of the rampant global obesity problem. In Australia, for example, a local effort is afoot in Melbourne to hit McDonald’s, KFC and other fast-food outlets with a so-called “fat tax” of higher rates.
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.