Big but Fit? Don’t Count on It

Heart disease risk was greater in the healthy but obese compared to healthy normal weight people

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Although obesity is linked to heart disease, high blood pressure and diabetes, some heavy people seem immune. Those considered “healthy” obese, however, may face health troubles down the line.

As many as a third of obese adults may be considered healthy obese, according to some scientists. Some research suggests that this healthiness may be a transitional stage, and if the fat stays on, the health problems will come.

A new investigation has added support to this notion, finding that people who were significantly overweight with no heart disease were more likely to get heart disease in the future compared to those of normal weight.

"Maintain a healthy weight to lower your risk of heart disease."

Yoosoo Chang, MD, professor at Kangbuk Samsung Hospital Total Healthcare Center for Cohort Studies in Seoul, Korea, and colleagues examined data on 14,828 Korean adults between the ages of 30 and 59.

The subjects were all considered metabolically healthy, meaning they did not have high blood pressure, high cholesterol or signs of developing diabetes.

Obesity was determined using body mass index (BMI) — a ratio of a person's height to weight that is used to determine if that person is a healthy weight.

As part of a health examination, the participants underwent cardiac computed tomography, or a CT scan of the heart, aorta, pulmonary veins and arteries. State-of-the-art CT equipment can detect early coronary artery calcification. The amount of calcium buildup is a predictor of future atherosclerosis (narrowing and hardening of the arteries).

Dr. Chang and his team observed that the healthy obese patients had a greater prevalence of coronary calcification than those of normal weight, meaning they had a higher prevalence of early-stage plaque buildup in their arteries.

The study measured calcification according to coronary artery calcium (CAC) scores and showed the results according to percentile rank. The lower the CAC score and percentile rank, the less likely a person was to have heart disease.

In this study, the average CAC score for normal weight people was 5.4 percent, compared with 9.2 percent in obese participants.

If left untreated, atherosclerosis can lead to heart attack, stroke or sudden cardiac death.

"Obese individuals who are considered 'healthy' because they don't currently have heart disease risk factors, should not be assumed healthy by their doctors," Dr. Chang said in a press statement. "Our research shows that the presence of obesity is enough to increase a person's risk of future heart disease and that the disease may already be starting to form in their body. It's important that these people learn this while they still have time to change their diet and exercise habits to prevent a future cardiovascular event."

This study was published recently in the Journal of the American College of Cardiology.

Review Date: 
May 2, 2014
Last Updated:
June 2, 2014