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"Fit but Overweight" Raises Heart Disease Risk


What to Know

Being overweight or obese puts your health at risk. It increases your odds of high blood pressure as well as heart and kidney disease, already great concerns if you have diabetes. Excess weight also has been tied to certain cancers, as well as to sleep apnea, osteoarthritis, and more. However, some overweight and obese people appear perfectly fit. They have normal blood pressure and cholesterol levels, for example. That may seem to suggest that such people don’t need to pay close attention to their weight. This study challenges that conclusion.

The Study

European researchers analyzed health information from 7,637 people who had developed heart disease. The participants’ average age was 54, and nearly two-thirds were women. To identify the factors that may have contributed to their heart disease, the researchers recorded the participants’ body mass index (BMI, a ratio of weight to height used to estimate how close a person is to a healthy weight) and waist circumference. They also reviewed other health measures, including cholesterol, blood glucose levels, triglycerides, and blood pressure. The researchers then compared the people with heart disease with healthy, normal-weight people.

The Results

Obese people with high blood pressure, elevated blood glucose, and high levels of triglycerides and cholesterol were 2½ times more likely to develop heart disease than normal-weight people without those conditions. Unhealthy people who were normal weight or overweight had just over twice the risk. Those results were not surprising. However, the researchers found that the otherwise healthy overweight and obese participants also had a heightened risk of heart disease. Obesity increased the chances of heart disease by 28 percent, while being overweight raised the risk by 26 percent compared with healthy, normal-weight people.


Don’t let a clean bill of health persuade you to ignore your scale. If you are overweight or obese, weight loss will help reduce your risk of heart problems over the long term no matter how healthy you are now. Also, the researchers point out, obese people who have healthy levels of cholesterol, blood glucose, and blood pressure now are more likely than healthy, normal-weight people to see those levels change for the worse. Your best protection: Work off whatever extra weight you carry.

Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis.” Camille Lassale, Ioanna Tzoulaki, Karel G.M. Moons, Michael Sweeting, Jolanda Boer, Laura Johnson, José Marıa Huerta, Claudia Agnoli, Heinz Freisling, Elisabete Weiderpass, Patrik Wennberg, Daphne L. van der A, Larraitz Arriola, Vassiliki Benetou, Heiner Boeing, Fabrice Bonnet, Sandra M. Colorado-Yohar, Gunnar Engstrom, Anne K. Eriksen, Pietro Ferrari, Sara Grioni, Matthias Johansson, Rudolf Kaaks, Michail Katsoulis, Verena Katzke, Timothy J. Key, Giuseppe Matullo, Olle Melander, Elena Molina-Portillo, Concepcion Moreno-Iribas, Margareta Norberg, Kim Overvad, Salvatore Panico, J. Ramon Quiros, Calogero Saieva, Guri Skeie, Annika Steffen, Magdalena Stepien, Anne Tjønneland, Antonia Trichopoulou, Rosario Tumino, Yvonne T. van der Schouw, W.M. Monique Verschuren, Claudia Langenberg, Emanuele Di Angelantonio, Elio Riboli1, Nicholas J.Wareham, John Danesh, and Adam S. Butterworth. European Heart Journal, published online August 14, 2017.

The information on this screen does not take the place of care from your doctor or other health care provider. If you have general questions about diabetes or diabetes-related research, e-mail askada@diabetes.org or call 1-800-DIABETES (800-342-2382).