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Challenging the Notion of “Healthy Obesity”

Back in October of 2013, the concept of “healthy obesity” made news because of a study published in the journal Diabetologia about overweight people with no metabolic problems. Now a study published on April 30th 2014 in the Journal of the American College of Cardiology challenges that assertion. A release from the publisher explains that obese people who have no signs of cardiovascular disease show a much higher prevalence of early plaque buildup in the arteries compared to healthy normal weight individuals, according to a study. The researchers recommend that all obese individuals get counseling about their risks for cardiovascular disease and receive tips for achieving a healthy weight.

Obesity can often lead to cardiovascular disease through the development of dyslipidemia (abnormal amounts of fat or cholesterol in the blood), hyperglycemia (high blood sugar) and hypertension (high blood pressure)—all common conditions in obese individuals. But, the idea of “healthy” people whose body weight puts them in the obese category but who show no signs of cardiovascular disease is controversial.

The team for the current study looked at 14, 828 metabolically healthy Korean adults aged 30 to 59 years who had no known cardiovascular disease and had undergone a health checkup including cardiac tomography estimation of coronary artery calcium scores, which is a measure of calcium build up in the plaque on artery walls. CAC scoring can determine early stage heart disease, such as atherosclerosis, before symptoms are present. Obesity or normal weight was determined using a standard Asian body mass index scale.

Based on CAC scores, obese individuals were found to have a much higher prevalence of subclinical coronary atherosclerosis, or early-stage plaque buildup in the arteries, than their normal weight counterparts. Atherosclerosis, if not managed, can lead to heart attack and sudden cardiac death, among other cardiovascular conditions.

The release quotes lead author Yoosoo Chang, MD, professor at Kangbuk Samsung Hospital Total Healthcare Center Center for Cohort Studies in Seoul, Korea, as saying, “Obese individuals who are considered ‘healthy’ because they don’t currently have heart disease risk factors, should not be assumed healthy by their doctors. 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.”

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