January 22, 2021

expert reaction to being overweight and heart health

A study published in the European Journal of Preventive Cardiology suggests being fat linked with worse heart health, even in people who exercise.

Prof Keith Frayn, Emeritus Professor of Human Metabolism, University of Oxford, said:

“This paper addresses the question of whether fitness can outweigh fatness in terms of risk of cardiovascular disease and diabetes.  The findings confirm that obesity or overweight greatly increase the risk of cardiovascular disease and diabetes.  Fitness is protective for people of any weight; but these results suggest that physical activity does not completely mitigate the effects of being overweight or obese.  The authors conclude that public health attention should still focus on weight reduction rather than increasing physical activity. 

“This paper should be considered only a starting point.  Its weakness is that it based on self-reported measures of activity rather than measured fitness, and on markers in the blood to determine cardiovascular and diabetes risk.  It goes counter to earlier work suggesting that fitness, measured directly, can counteract the adverse effects of obesity on mortality, especially from cardiovascular disease.  Fitness can improve health through many means, not necessarily reflected in the blood measurements reported here, and also has benefits beyond protection against cardiovascular/metabolic disease.  Rather than focussing just on weight reduction, public health messages need to continue to stress the importance of physical activity alongside weight reduction.”

Prof Metin Avkiran, Associate Medical Director at the British Heart Foundation, said:

“This observational study adds to existing evidence that there is no such thing as ‘healthy obesity’.  It shows that being overweight or obese significantly increases a person’s chance of having high cholesterol, high blood pressure and diabetes – all of which are risk factors for developing cardiovascular disease.

“A second important message from the study is confirmation that being physically active protects against these risk factors, but only partly mitigates the detrimental effects of being overweight or obese.”

‘Being fat linked with worse heart health even in people who exercise’ by Pedro L. Valenzuela et al. is published in the European Journal of Preventive Cardiology

doi:10.1093/eurjpc/zwaa151

Declared interests

Prof Frayn: “I have no conflict of interest to declare.”

None others received.