Myocardial infarction, diabetes or hypertension Is there a metabolically healthy overweight?

Study examines the risk factors of common diseases in terms of body weight

Overweight and obesity have been potential risk factors for metabolic disorders such as diabetes, high blood pressure and high cholesterol in the blood (hypercholesterolemia), has been widely reported recently. On the other hand there are reports of "sickly slender ones" who despite normal weight have a similar increased risk for cardiovascular diseases, such as obese people. Likewise, there seems to be the phenomenon of "healthy thicknesses" which, despite massive excess weight, do not develop metabolic disorders. A recent study looked at how metabolic risk factors are affected by body weight and the actual risks of heart attack and stroke.

Scientists from the German Institute of Human Nutrition (DIfE), Harvard University and the University Hospital Tübingen examined about 90,000 data sets of a large US cohort study. The data are all from women. According to the analysis, women with severe obesity or obesity are at an increased risk for heart disease, even if they have a healthy metabolism. It has also been shown that normal weight women are at an increased risk of having a heart attack or stroke if they have a metabolic disorder such as diabetes or high blood pressure. The results were recently published in the journal "The Lancet Diabetes & Endocrinology".

Study confirms obesity as an independent risk factor for heart attack and stroke. But also slim have to be aware, because high blood pressure, diabetes and high cholesterol are considered weight-independent risk factors. (Image: llhedgehogll / fotolia.com)

Data collected over 30 years

The research team led by Matthias Schulze and Nathalie Eckel from the DIfE evaluated the data from a large US long-term study (Nurses' Health Study). The women were medically monitored for up to 30 years. The focus was on body weight, metabolic health and the incidence of heart attacks or strokes. Women who did not have high blood pressure, diabetes or hypercholesterolemia were considered metabolically healthy regardless of body weight.

Overweight as an independent risk factor

In the group of metabolically healthy women, it was shown that subjects with obesity or obesity had an increased risk of cardiovascular disease compared to normal weight patients. The study also showed that as soon as a risk factor such as high blood pressure, diabetes or high blood lipid levels in cholesterol was added, the risk of heart attack and stroke increased regardless of body weight.

Diabetes and high blood pressure as the biggest risk factors

Over the course of 20 years, more than 80 percent of at least one of these risk factors developed among the metabolically healthy women with obesity. Even in normal-weight women, at least two-thirds experienced at least one risk factor over the same period. In particular, diabetes and high blood pressure are associated with a two to three times higher risk of heart attack and stroke, according to the study results.

Healthy obesity does not exist

"We observed that obese women also had an increased risk of cardiovascular disease, even if they remained metabolically healthy for 10 or even 20 years," says first author Nathalie Eckel in a press release on the study results. Obesity is therefore a serious disease risk, regardless of whether you have for years no abnormalities in the metabolism. Thus, there is still no clear evidence that a subgroup exists in people with obesity who do not have an increased risk, said Eckel. The scientists emphasize that the results are consistent with a previous study that attempted to find a suitable definition of healthy obesity.

Even lean should be on guard

"We were also surprised that among the metabolically healthy normal-weight women such a high proportion of either high blood pressure, diabetes or a lipid metabolism disorder over the course of 20 years," sums up study lead Matthias Schulze, who heads the Department of Molecular Epidemiology at DIfE. Since these diseases significantly affect the risk of heart attack and stroke, it is important to maintain long-term metabolic health through a healthy lifestyle and a healthy diet. This is true for normal weight or overweight persons alike. (Vb)