Researchers Say Fat But Fit Is A Myth In Heart Health, Weight Must Be Maintained

Sports illustration. (Unsplash/@fitmasu)

JAKARTA - The negative effects of excess body fat on heart health cannot be eliminated, despite maintaining an active lifestyle according to research.

Previous studies have shown that being physically fit can reduce the negative effects of being overweight on heart health. But this is entirely true, according to a European Society of Cardiology study published in the 'Journal of Preventive Cardiology' on January 21.

"One cannot be 'fat but healthy.' This is the first national analysis to show that being active regularly does not eliminate the detrimental health effects of excess body fat," said study author Alejandro Lucia, a professor of exercise physiology at the European University of Madrid, citing CNN January 22.

"Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of being overweight and obese."

Previous research has provided some evidence that people who are 'fat but fit' can have similar cardiovascular health to those who are 'thin but not fit'. However, Lucia said this had unintended consequences.

Sports illustration. (Unsplash/bruce mars)

"This has led to controversial proposals for health policies that prioritize physical activity and fitness over weight loss."

"Our study seeks to clarify the relationship between activity, body weight and heart health," said Lucia.

The researchers used data from 527,662 working adults from Spain who were insured by an occupational risk prevention company, with a median age of 42.

They were stratified by activity level and by weight group: 42 percent of participants were of normal weight, with a body mass index (BMI) of 20-24.9; 41 percent overweight, BMI 25-29.9; and 18 percent were obese, a BMI of 30 or more.

Then researchers looked at their cardiovascular health by categorizing them for diabetes, high cholesterol and high blood pressure, all of which are major risk factors for stroke and heart attack.

After investigating the relationship between BMI, activity level and risk factors, the researchers concluded, each level of activity means a person is less likely to have any of the three risk factors than without exercise, with the risk of high blood pressure and diabetes decreasing with increasing activity level.

Sports illustration. (Unsplash/@gabinvallet)

"This tells us that everyone, regardless of their weight, must be physically active to maintain their health," says Lucia.

However, the study demonstrated a greater cardiovascular risk for overweight and obese participants, compared to those of normal weight, regardless of how much exercise they did.

Obese and active participants were twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure than those who were normal weight but inactive.

"Exercise doesn't seem to offset the negative effects of being overweight," explains Lucia.

"These findings were also observed overall in men and women when they were analyzed separately," he continued.

At the same time Lucia underlined, 'is equally important' to fight obesity and inactivity.

"Weight loss should remain the main target of health policy together with promoting an active lifestyle. We don't know what came first," said Lucia.

Sports illustration. (Unsplash/Jonathan Borba)

Questions remain, however, about the circumstances of those involved in the study.

"This is a cross-sectional study, all we can talk about is association, we can't talk about causality," Michael Pencina, vice dean of data science and information technology at Duke University School of Medicine, told CNN.

"Because this is a cross sectional study, we don't know what comes first, what this study doesn't tell us, are people obese and active, do they become active when they realize they are obese, and their risk factors are high? Or are they active, and even then, do they become obese and their risk factors increase?" said Pencina, who was not involved in the study.

"What we saw was that the burden of risk factors increased by weight category. Obese people had the highest burden of associated risk factors. That was true according to activity level," he added. This study adds to a lot of research on the topic.

Separately, scientists at the University of Oxford released the results of a major study on January 12. Physical exercise may be more important for cardiovascular disease prevention than previously known and the more activity the better, the report said.

Meanwhile, researchers at the Cleveland Clinic published a study in January 2019 showing that a sedentary lifestyle is worse for your health than smoking, diabetes, or heart disease.

"Controversy about the appropriate contribution of body weight versus exercise to cardiovascular health is likely to continue, to optimize health and minimize cardiovascular disease risk, patients should pay attention to both, maintain a healthy weight and be physically active," Dr. Anthony Rosenzweig, chief of the division of cardiology at Massachusetts General Hospital in Boston and professor of medicine at Harvard Medical School.