Being 'fat but fit' still carries health risks

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However, those were considered "metabolically unhealthy" carried a larger associated CHD risk, even if the person was of normal weight (BMI ≤18.5 to 25, HR 2.15, 95% CI 1.79-2.57, P 0.0001), they wrote in the European Heart Journal.

The researchers used data from more than half a million people in 10 European countries - taken from the European Prospective Investigation into Cancer and Nutrition (EPIC) - in the largest study of its kind to date.

Results of the study showed that normal blood pressure (BP), blood sugar levels and cholesterol were no assurance of good heart health among overweight people.

Previous studies had identified a subset of overweight people who appeared to lack the adverse effects of excess weight, leading them to be labelled "metabolically healthy obese" or "fat but fit".

New British research shows that if you're overweight but swear you're in excellent shape, you probably aren't.

They found that people that were overweight, but did not have issues with their blood pressure, blood sugar and cholesterol were not necessarily in the clear, and were actually 28% more likely to develop heart disease over the years than their non-overweight counterparts with similar metabolic health readings.

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The research group reported a positive log linear association between BMI and associated CHD risk, with the highest risk reported among individuals in the highest mean BMI quintile (32.7) when compared to the lowest mean BMI quintile (21.5, HR 1.96, 95% CI 1.66-2.32, P 0.0001).

Following adjustment for lifestyle factors, the researchers found those classed as unhealthy had more than double the risk of CHD, whether they were normal weight, overweight or obese.

The authors believe that "the excess weight itself may not be increasing the risk of heart disease directly, but rather indirectly through mechanisms such as increased blood pressure and high glucose".

But over the course of the study, one-third of them developed factors that plunked them right in the "metabolically unhealthy" group.

Lead author Dr Camille Lassale said: "Overall, our findings challenge the concept of the "healthy obese".

"It's another brick in the wall of evidence that being healthy overweight is not true".

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