medwireNews: Another two large studies have demonstrated that people who appear to be in good health despite being obese do not remain so for long.
For the first, Matthias Schulze (German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal) and colleagues looked at data from 90,257 women from the Nurses’ Health Study. In line with previous research they found a graded increase in cardiovascular risk, with obesity per se significantly increasing it but not to the same extent as poor metabolic health did. Obesity status was updated every second year, rather than being based on measurements at study entry.
Having poor metabolic health (one or more of diabetes, hypertension, and hypercholesterolemia) more than doubled women’s risk for experiencing a myocardial infarction or stroke during the median 24 years of follow-up. Even women of a healthy weight had a 2.43-fold increased cardiovascular risk if they were metabolically unhealthy, and the risk increased further for those who were overweight or obese.
Of note, only a minority of women retained good metabolic health, the team reports in The Lancet Diabetes & Endocrinology. Among those in this category at baseline, only 6.1% of initially obese women remained metabolically healthy after 20 years, along with 7.9% of overweight women and 15.4% of normal-weight women.
Complementing these findings are those of a Clinical Practice Research Datalink analysis, published in the International Journal of Obesity.
Within this database, Osama Moussa (Imperial College, London, UK) and team identified 128,191 people with obesity but good metabolic health, which they defined as having no record of any comorbidities or medications relating to the metabolic syndrome; vascular, renal, or liver disease; or sleep apnea.
After an average 9.4 years of follow-up, the proportion of individuals still with good metabolic health had fallen to 55.8%. The highest rate of conversion to unhealthy obesity occurred near the beginning of follow-up, with the risk decreasing over time.
In a commentary accompanying the Nurses’ Health Study analysis, Carl Lavie (The University of Queensland School of Medicine, New Orleans, Louisiana, USA) and co-authors call for “drastic efforts […] to prevent obesity in the first place and, especially, to prevent conversion to more severe degrees of obesity and the metabolic syndrome.”
They say: “It is prudent to remind ourselves that an ounce of prevention is better than a pound of cure.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group
See also:
- Further evidence challenges obesity paradox
- Surrogate BMI approach supports overweight mortality risk
- Metabolically healthy obese do not remain so for long
- Metabolically healthy obese concept overturned
- EPIC findings refute metabolically healthy obesity concept
- Unstable control groups may create ‘healthy obesity’ impression