'Fat but fit' people still risk heart disease, experts say

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However, there is also a type of obesity known as "metabolically healthy obesity", which is usually taken to refer to people with a higher-than-normal body mass index (BMI) but no identifiable health issues.

Note that this observational study found that those who were overweight and obese, even if they didn't have other metabolic risk factors, were at increased risk of heart disease.

Drawing from the European Prospective Investigation into Cancer and Nutrition study (EPIC-CVD) cohort (n=10,474 after exclusions), the researchers identified 7,637 incident cases of CHD during a 12.2-year follow-up, defined as initial fatal or non-fatal events, including MI, acute ischemic heart disease, chronic ischemic heart disease, or angina pectoris.

"I think there is no longer this concept of healthy obese".

People who are overweight or obese are at increased risk of heart disease even if they appear medically healthy, experts are warning.

Myth-buster? A new study finds that people who are considered "fat, but fit" are at a greater risk of suffering from coronary heart disease. In fact, the study authors classify the "fat but fit" group at intermediate heart risk-above that of fit, normal weight people, but below that of metabolically-unhealthy overweight or obese people.

This marked the largest study of its kind to date.

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Participants classed as overweight but metabolically healthy had a 26 percent higher risk of coronary heart disease than their normal weight counterparts, and metabolically healthy obese participants had a 28 percent higher risk of coronary heart disease.

More than 10,000 people served as a control group for the study and factors such as exercise level, smoking history, and socio-economic status were taken into account for the research. "That comes later in the timeline, then they have an event, such as a heart attack", says Dr. Tzoulaki.

And that might be the important factor: Even though some overweight or obese people can be metabolically healthy now, they might be less likely to stay that way.

She said that these findings "challenge the concept of the healthy obese".

"Even if you are classified as metabolically healthy, (excess weight) was associated with an increased risk of heart disease", Camille said.

According to the researchers, the excess weight itself may not be increasing the risk of heart disease directly, but rather over time through mechanisms such as increased blood pressure and high glucose.

Alarming results of the new study were detailed in the most recent edition of the European Heart journal.