Being obese doesn't necessarily increase a person's chances of having a heart attack, researchers say. Based on the results of a study which is surely to create a stir in health and medical science circles, British scientists assert that obese people whom are metabolically healthy are not at increased risk for cardiovascular disease.
Mark Hamer and Emmanuel Stamatakis of the University College of London studied the link between cardiovascular disease risk and mortality and metabolically healthy obesity. To this end, they recruited 22,203 middle aged Scottish and British men and women and collected waist circumference, blood pressure and other vital metabolic data.
The participants, whom were followed for a total of seven years, provided Hamer and Stamatakis with a wealth of information which they used to understand the relationship between obesity and mortality.
According to Hamer and Stamatakis's results, which were published in the Journal of Clinical Endocrinology & Metabolism, metabolically healthy obese people are not in jeopardy of developing heart disease.
During the course of the experiment, 2472 people died. Of that number, 604 were attributed to cardiovascular disease. However, when British researchers compared cardiovascular risk for metabolically healthy obese and nonobese participants, they found little difference between the two groups.
On the other hand, obese people with two or more cardiovascular disease risk factors e.g. elevated blood pressure, bad cholesterol were at risk for future heart disease. The data also showed that nonobese people who were metabolically unhealthy were also at risk for developing cardiovascular disease at some point in the future.
Based on these results, Hamer and Stamatakis concluded that obesity in and of itself doesn't necessarily place people at risk for developing heart disease.
Is it Possible to be Obese and Metabolically Healthy?
To be honest, I don't agree with Hamer and Stamatakis's conclusion. Although a subset of obese people may have normal blood pressure and higher ratio of good cholesterol to bad cholesterol, etc. the majority do not. Moreover, there is no generally accepted consensus on how to define metabolically healthy obese.
In October 2010, I wrote about the problems surrounding the issue of metabolically healthy obese. I cited a number of scientific studies to establish my doubts about the qualifications of the healthy obese individuals.
Since that time, the scientific community has continued to wrestle with it. For example, researchers from the University of Montreal sought to establish a set of clinical markers for identification of metabolically healthy obese individuals. They studied 154 obese postmenopausal middle-aged women, whom had to meet four out of five specific criteria in order to qualify as metabolically healthy obese.
Contrary to Hamer and Stamatakis, who used waist circumference in their evaluation of metabolically healthy obese, the Canadian researchers excluded this as a potential marker because in their words "most obese individuals have large waist circumferences".
It's also important to note that in the Canadian study, only 19 women met the criteria for metabolically healthy obese.
Moreover, a report published in the European Journal of Clinical Nutrition, concluded the prevalence of metabolically healthy obese varies according to the criteria used. Those researchers went on to say that although physical activity may increase the prevalence of metabolically healthy obese, the scientific community needs to agree on a definition of metabolically healthy obese.
The bottom line is that obesity is associated with diabetes, hypertension, atherosclerosis and a host of other cardiovascular disease risk factors. The lack of consensus about the definition of metabolically healthy obese can't change that.
35 As Jesus approached Jericho, a blind man was sitting by the roadside begging. 36 When he heard the crowd going by, he asked what was happening. 37 They told him, "Jesus of Nazareth is passing by." 38 He called out, "Jesus, Son of David, have mercy on me!" 39 Those who led the way rebuked him and told him to be quiet, but he shouted all the more, "Son of David, have mercy on me!" 40 Jesus stopped and ordered the man to be brought to him. When he came near, Jesus asked him, 41 "What do you want me to do for you?" "Lord, I want to see," he replied. 42 Jesus said to him, "Receive your sight; your faith has healed you." 43 Immediately he received his sight and followed Jesus, praising God. When all the people saw it, they also praised God. Luke 18:35-43
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Hamer M, & Stamatakis E (2012). Metabolically Healthy Obesity and Risk of All-Cause and Cardiovascular Disease Mortality. The Journal of clinical endocrinology and metabolism PMID: 22508708
Karelis AD, Brochu M, & Rabasa-Lhoret R (2004). Can we identify metabolically healthy but obese individuals (MHO)? Diabetes & metabolism, 30 (6), 569-72 PMID: 15671927
Velho, S., Paccaud, F., Waeber, G., Vollenweider, P., & Marques-Vidal, P. (2010). Metabolically healthy obesity: different prevalences using different criteria European Journal of Clinical Nutrition, 64 (10), 1043-1051 DOI: 10.1038/ejcn.2010.114
"Obesity Doesn't Always Lead To Heart Attacks, Study" copyright © 2012 Living Fit, Healthy and Happy(SM). All Rights Reserved.