A major British study has challenged the idea that it is possible to be obese but healthy.
The researchers say today that their findings show a steady increase in risk of cardiovascular disease with increases in body mass index.
The Glasgow University researchers studied outcomes for nearly 300,000 adults of European descent, who joined the UK Biobank study from 2006.
Their findings are reported in the European Heart Journal.
The researchers say that factors such as smoking may have confounded other studies – as smokers may be lean and unhealthy.
Researcher Dr Stamatina Iliodromiti said: “Any public misconception of a potential protective effect of fat on heart and stroke risks should be challenged.
“This is the largest study that provides evidence against the obesity paradox in healthy people. It is possible that the story may be different for those with pre-existing disease because there is evidence that in cancer patients, for instance, being slightly overweight is associated with lower risk, especially as cancer and its treatments can lead to unhealthy weight loss.
“By maintaining a healthy BMI of around 22-23 kg/m2, healthy people can minimise their risk of developing or dying from heart disease.”
She added: “In terms of other adiposity measures, the less fat, especially around their abdomen, they have, the lower the risk of future heart disease.
“Even within the normal BMI category of between 18.5-25 kg/m2, the risk of cardiovascular disease increases beyond a BMI of 22-23 kg/m2. The other adiposity measures show that the leaner the person the lower the risk of cardiovascular disease, and this must be a public message, that healthy individuals should maintain a lean physique to minimise their risk of cardiovascular disease.”
The findings were welcomed by the British Heart Foundation.
Medical director Professor Sir Nilesh Samani said: “The findings from this study contribute to the overwhelming 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.”
Stamatina Iliodromiti et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. European Heart Journal. doi:10.1093/eurheartj/ehy057
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