Bad News: You Cannot Be Fit and Fat

You Can't Be Fit and Fat
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Even if you aced your last physical, if you’re carrying excess chub, your odds of developing heart disease are still up to 28 percent greater than a normal-weight guy’s. This comes from a new study published in European Heart Journal that tracked over a half-million people over 12 years. These findings shoot down the popular “fit but fat” myth, which gives overweight men with normal blood pressure, blood glucose, and cholesterol levels a false sense of security. 

To conduct this study, a team of European researchers zeroed in on 7,600 people in the study pool who’d experienced coronary heart disease, a precursor to heart attacks or even death. They compared those folks against a random sample of about 10,500, some of whom had heart disease while others did not, reflecting the general population.

First, the researchers classified everyone in both groups as either “healthy” or “unhealthy” based on risk factors for heart disease, such as high blood pressure, a waist circumference above 37 inches, and elevated blood sugar levels. To be deemed unhealthy, a person had to have at least three risk factors. Sure enough, no matter if they had a normal BMI (19 to 25), were overweight (BMI 25 to 30), or were obese (BMI over 30), the unhealthy adults were more than twice as likely to develop heart disease.

Next, to better assess the impact of BMI alone, the researchers looked just within the healthy group. Compared to normal-weight adults, those who were overweight but still technically healthy had a 26 percent greater chance of cardiovascular disease. Those who were metabolically healthy but obese were 28 percent more prone to heart problems.

Clearly, a flabby physique is in itself horrible for your heart. “One possible reason is that overweight people with normal blood pressure and triglycerides and no diabetes may not yet have developed the metabolic consequences of obesity,” says study co-author Ioanna Tzoulaki, an epidemiologist at Imperial College London. “In other words, they are not yet metabolically unhealthy, but they are en route to becoming unhealthy.”

But obesity may also influence heart disease risk in other ways. For example, Tzoulaki says adipose tissue (aka belly fat) releases a large number of compounds that influence blood coagulation and inflammation, which could damage blood vessels and lead to plaque buildup in the arteries.

What is certain, says Tzoulaki, is that if you’re overweight or obese, the progression from metabolically healthy to unhealthy is all but guaranteed. Therefore, she insists that “healthy obesity,” at least as it pertains to heart disease, is nothing more than a myth.