Apple shaped obesity as bad for heart as other obesity

March 11, 2011
Apple shaped obesity as bad for heart as other obesity

( -- An international study of 220,000 people has challenged the idea that obese people who have an “apple shape” (fat deposits on the middle section of the body) are at higher risk of heart attacks and strokes than obese people with other types of fat distribution.

These are the conclusions of an Article published Online First and in an upcoming Lancet, from the Emerging Risk Factors Collaboration, a consortium of 200 scientists from 17 countries led from the University of Cambridge, UK.

Some earlier studies had claimed that people with "central " (as assessed by the ratio of the waist to hip circumference, or "waist-to-hip" ratio) have 3 times greater risk of heart attack than people with general obesity (as assessed by the body-mass index (BMI), or the weight divided by the height squared). However, these earlier studies had major design limitations.

The current study involved over 220,000 adults, each monitored for almost a decade, of whom over 14,000 developed a heart attack or stroke during monitoring. The researchers confirmed that obesity is a major determinant of , but that body mass index (BMI), waist circumference, and waist-to-hip ratio each had a similar impact on the risk of subsequent heart attack and strokes.

A further finding of this study is that BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

This result highlights the value of GPs continuing to measure blood cholesterol and blood pressure levels. The findings should also help guide medical practice worldwide because national and international guidelines have provided differing recommendations about the value of clinical measures of obesity for prediction of cardiovascular disease risk in primary prevention.

The authors conclude: "Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures… This finding applies to a wide range of circumstances and clinically relevant subgroups."

But they add: "The main finding of this study does not, of course, diminish the importance of adiposity as a major modifiable determinant of cardiovascular disease."

In a linked Comment, Dr. Rachel R Huxley and Dr. David R Jacobs Jr, School of Public Health, University of Minnesota, conclude: "BMI used with good clinical judgment is highly appropriate in adults because it is so strongly associated with chronic disease risk, although we caution that it is correlated with height in children. Many overweight or obese adolescent, young adult, and middle-aged individuals with few risk factors for cardiovascular disease will develop that risk relatively soon, so BMI should serve as an early warning, both to them and their general practitioners. But discriminating which overweight individuals without current risk factors for cardiovascular disease will go on to develop those risk factors, and ultimately clinical cardiovascular disease, remains a challenge-here, blood tests continue to be helpful."

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not rated yet Mar 11, 2011
Evidently nobody is going to think twice in relation to the obesity paradox. One just jumps brightly from conclusion to conclusion to reach the desired end result: Fat is bad.

Obviously one doesn't think of the painfully obvious:
Their diet is unhealthy which puts them at greater risk, and that diet as a secondary effect makes them fat.

Would make much more sense, since it explains the obesity paradox well: Not everyone gets fat because of a poor diet.

But there's no money to be made there, because diet is mostly a function of money. Unhealthy food is cheaper.

Much more money is in medications, preventive treatments, surgery what have you. So, Fat must be bad

not rated yet Mar 11, 2011
I don't know why people say unhealthy food is cheaper. I can by a bag of store brand lentils for $0.90 and a bag of store brand rice for $1.20. That can feed me for a day or so and is still cheaper then most fast food meals.
not rated yet Mar 12, 2011
I'd call that a very unhealthy, unbalanced diet. Granted you won't get fat fast, but you starve yourself of essential nutrients. Unhealthy comes in many forms. Fastfood, vegan food, unisource food. They all are unhealthy.

Oliveoil for example isn't unhealthy, but can make you quite fat. Were i live people still eat the medaterranian diet. The larger part are quite obese according to the BMI norm.
1 / 5 (4) Mar 13, 2011
Evidently nobody is going to think twice in relation to the obesity paradox.
Fat people live longer physically, and in quality of life, 'cause they don't waste half their lives mindlessly running on treadmills!

Couch potatoes unite!


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