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[Aug. 12th, 2008|11:46 am] |
Extra Pounds Don't Always Translate Into Heart Risk, Study Says
By Michelle Fay Cortez
Aug. 11 (Bloomberg) -- One in three obese Americans appears to be heart healthy, according to a study that contradicts conventional wisdom and suggests standard tests can identify which fat people face higher risk for cardiac disease.
Though obesity puts people at risk for a host of medical problems, a study in the Archives of Internal Medicine showed not all fat is created equal. A large number of overweight people have ``benign obesity,'' a condition marked by normal reactions to insulin in their blood and no early signs of heart disease. The low-risk patients can be identified with insulin tests, the researchers said today.
The findings suggest doctors should dig deeper for early signs of damage that identify people most likely to benefit from weight loss and increased activity, said Judith Wylie-Rosett, a professor of population health at Yeshiva University's Albert Einstein College of Medicine in New York.
``What we have to do is look beyond weight,'' Wylie-Rosett said in a telephone interview. ``We really need to know what the risk is. Being lean doesn't mean you aren't at risk, and we are now starting to understand obesity a whole lot better.''
The researchers examined medical records from 5,440 people who took part in the National Health and Nutrition Examination Surveys from 1999 through 2004. They found 31.7 percent of obese volunteers were ``metabolically healthy,'' meaning they showed no signs of complications in tests for blood pressure, cholesterol, triglycerides, blood sugar, inflammation and insulin resistance.
19.5 Million Americans
That translates into 19.5 million Americans, the researchers calculated. Two-thirds of Americans are considered overweight or obese, according to the U.S. Centers for Disease Control and Prevention, in Atlanta.
At the same time, 23.5 percent of those with a ``healthy'' weight didn't have the same beneficial scores on tests for metabolism and cardiovascular disease, the researchers said. About half of those aged 20 and older who were overweight also were deemed metabolically healthy, the researchers found.
A second study, from researchers at University of Tubingen in Germany, involved advanced medical imaging on 314 volunteers, analyzing the amount of total fat, as well as its buildup in their livers and other organs.
Obese people with a normal reaction to insulin, used to convert blood sugar to energy, had less fatty plaque buildup in the carotid artery leading to the brain than those with insulin resistance, a harbinger of diabetes. Unexpectedly, the researchers found obese people with insulin sensitivity had nearly identical test scores compared with those who weren't obese, indicating no increased risk, the researchers said.
`Possible to Identify'
``It may be possible to identify a metabolically benign fat distribution'' in obese people, said the researchers led by Norbert Stefan, from the department of internal medicine. ``Such individuals may be protected from type 2 diabetes mellitus and cardiovascular disease.''
The findings aren't a reason to forgo exercise and weight control, said Lewis Landsberg, director of the Northwestern University Comprehensive Center on Obesity, in Chicago, in a telephone interview. While extra pounds don't always mean extra heart risks, they can cause other medical problems, he said.
``Certainly it may not predispose you to heart disease, but all things being equal, you're healthier if you are thinner,'' he said. ``There is stress on the joints, the possibility of pulmonary disease, arthritis and cancer. There are a whole slew of diseases related to obesity that make it healthier to be thin.''
To contact the reporter on this story: Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net
http://www.bloomberg.com/apps/news?pid=20601124&sid=a892HASUU_4w&refer=home |
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