Mixed
Obesity (BMI ≥30 kg/m²) is associated with a significantly higher risk of coronary heart disease (CHD) even in individuals who are metabolically healthy (no metabolic syndrome criteria), challenging the concept of 'metabolically healthy obesity' as a benign condition.
If you are obese, your heart disease risk is higher than if you were normal weight, even if your blood pressure, cholesterol, and blood sugar are normal. You should still pursue weight loss strategies (diet, exercise, or medical therapy) to reduce this risk, as metabolic health alone does not negate the dangers of excess adiposity.
Compared to the reference group, HRs were 1.26 (1.17; 1.36) and 1.28 (1.05; 1.56) for metabolically healthy overweight and obese people, respectively. These findings challenge the concept of 'metabolically healthy obesity', encouraging population-wide strategies to tackle obesity.
Why this rating
Large pan-European case-cohort study (EPIC-CVD) with 7,637 incident CHD cases, median follow-up 12.2 years, robust sensitivity analyses.
Source
Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis
Camille Lassale et al. · European Heart Journal · 2017
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