Harvard Heart Letter

Obesity raises heart disease risk despite healthy metabolic profile

Is there such a thing as metabolically healthy obesity, also known as being "fit but fat"? Not when it comes to coronary artery disease, say the authors of an article in the Journal of the American College of Cardiology.

Using computed tomography (CT), the researchers examined the coronary arteries of 14,828 middle-aged men and women for microscopic calcium deposits, an early indicator of atherosclerosis. None of the participants had known cardiovascular disease, and all were deemed to be metabolically healthy. Metabolic health was defined as having normal cholesterol, blood pressure, and blood sugar levels as well as no evidence of insulin resistance.

The subjects were then divided according to body mass index (BMI) into four categories ranging from underweight to obese. The subjects with the highest BMI numbers—the "metabolically healthy obese" individuals—had significantly more calcium deposits in their coronary arteries than those in the normal-weight group. This study further dispels the premise that obesity can be harmless. 

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