Cardiometabolic risk & body size

Overweight and obese individuals have an increased risk of developing metabolic and cardiovascular diseases when compared to normal weight individuals. However, recent studies indicated that an individual’s cardiovascular disease (CVD) risk may depend on the body size and metabolic profile. Among obese individuals, there is a subgroup who are metabolically healthy and appear resistant to the development of the adiposity-associated cardiometabolic abnormalities that increase the CVD risk. Similarly, a subset of normal weight individuals also showed cardiometabolic abnormalities often associated with being overweight and obese. So what percentage of normal weight individuals has increased CVD risk?

The prevalence and correlates of body mass index (BMI) and cardiometabolic groups were assessed in 5,440 participants of the National Health and Nutrition Examination Surveys (NHANES) 1999 – 2004 (Arch Intern Med 2008; 168: 1617 – 1624). The definition of normal weight, overweight and obese individuals was BMI < 25.0, 25.0 – 29.9 and > 30.0, respectively. Metabolically healthy individuals have 0 or 1 cardiometabolic abnormalities and metabolically abnormal individuals have ≥ 2 cardiometabolic abnormalities. Cardiometabolic abnormalities included raised blood pressure; elevated levels of triglycerides, fasting plasma glucose and C-reactive protein; raised homeostasis model assessment of insulin resistance value and low level of high-density lipoprotein (HDL) cholesterol level. The study found that among US adults, 30.1% of normal weight men and 21.1% of normal weight women were metabolically abnormal. In the overweight group, 51.2% of men and 43.0% of women were metabolically abnormal. Seventy point eight percent of obese men and 64.6 % of obese women were metabolically abnormal. The independent correlates of cardiometabolic abnormalities among normal weight individuals were older age, lower physical activity levels and larger waist circumference. If you were overweight or obese, the correlates for metabolically healthy individuals were younger age, non-Hispanic black race, higher physical activity levels and smaller waist circumference.

Even if you are normal weight, you can still have an increased CVD risk. Irrespective of whether you are normal weight, overweight or obese, physical activity levels do play an important role in determining your health risk. If you have a good level of physical activity, you are less likely to become overweight or obese. If you exercise regularly, you reduce your CVD risk. If you want to be healthy, you have to exercise and watch those waist lines!