Recent research released in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) discloses that having a normal metabolic profile does not mean that a person with obesity is healthy, referred to as metabolically healthy obesity because they are at an increased risk of diabetes, heart disease, stroke, and respiratory disease.
Individuals With Obesity Are More Prone To Heart Attacks
Dr. Frederick Ho and colleagues from the Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK, undertook the study to see if people with obesity and a normal metabolic profile are healthy, or if they are at a higher risk of developing obesity-related health problems.
Obesity is predicted to affect approximately 300 million individuals worldwide, and if present trends continue, this figure would likely approach 1 billion people by 2030, accounting for 20% of the world’s adult population. Obesity is connected to the ongoing global epidemics of type-2 diabetes (T2D), hypertension, cardiovascular disease (CVD), and a variety of other major health concerns.
Obesity is often associated with metabolic issues such as raised blood sugar, increased blood pressure (BP), insulin resistance, and other negative metabolic alterations. These effects are not universal, and some obese persons have normal blood pressure, good blood lipids, little or no systemic inflammation, and a normal insulin level. This is frequently referred to as metabolically healthy obesity (MHO), and its prevalence is believed to range from 3% to 22% of the general population.
This research examined the relationship between MHO and all-cause mortality, type 2 diabetes, heart attack and stroke, heart failure (HF), and respiratory illnesses, including chronic obstructive pulmonary disease (COPD). MHO was defined as having a BMI of 30 kg/m2 or more and satisfying at least four of the six metabolically healthy criteria. Blood pressure is one of them, as are five blood-based biomarkers: C-reactive protein (CRP, an inflammatory marker), triglycerides (fats), low-density lipoprotein (LDL/’bad’ cholesterol), high-density lipoprotein (HDL/’good’ cholesterol), and glycated hemoglobin (HbA1c, a measure of average blood glucose over the previous 2-3 months).
Participants were classified into four groups based on their metabolic and obesity status: metabolically healthy non-obese (MHN), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUN), and metabolically unhealthy obese (MUO).
The researchers examined the data of 381,363 people, excluding those classified as ‘underweight,’ during a median follow-up time of 11.2 years. They were a part of the UK Biobank project, which was large-scale prospective cohort research that enrolled people from the general community in England, Scotland, and Wales between 2007 and 2010.
The authors discovered that MHO participants were usually younger, watched less television, exercised more, had a better education level, a lower deprivation index, a greater intake of red and processed meat, and were not likely to be male and non-white than MUO participants.
Participants with MHO were 4.3 times more likely to have T2D, 18% more likely to have a heart attack or stroke, 76% more likely to have heart failure, 28% more likely to have respiratory disease, and 19% more likely to have COPD when compared to metabolically healthy participants without obesity (MHN). When compared to
persons who were metabolically unwell but did not have obesity (MUN), those classified as MHO were 28 percent more likely to suffer heart failure.
According to the authors, MUO had the greatest rates of cardiovascular and respiratory outcomes, followed by MUN and MHO, except for incident and fatal heart failure and incident respiratory disorders. People with MHO had greater rates of these outcomes than those with MUN.
They go on to say that those with metabolically healthy obesity had a significantly increased risk of diabetes, heart attack and stroke, heart failure, respiratory illnesses, and all-cause mortality when compared to persons who were not fat and had a healthy metabolic profile. It’s worth mentioning that persons with metabolically healthy obesity had a higher risk of heart failure and respiratory illness than persons with metabolically unhealthy obesity who didn’t have obesity.
Furthermore, among a group of people having follow-up metabolic and obesity data, the researchers discovered that one-third of individuals with metabolically healthy obesity at the start of the study period became metabolically unhealthy within 3 to 5 years.
Individuals with metabolically healthy obesity are not ‘healthy,’ according to the researchers because they are at a greater risk of heart attack and stroke, heart failure, and respiratory disorders than people without obesity who have normal metabolic features.