N.C. – April 24, 2018 – People who are 30 pounds or more
overweight may want to slim down a bit even if they don’t have high blood
pressure or any other heart disease risk, according to scientists at Wake
Forest Baptist Medical Center.
In a study published in the May issue of the Journal of
the American College of Cardiology, the researchers found that slightly less
than half of the people who were considered obese – 30 pounds or more
overweight – developed metabolic syndrome within 10 years, putting them at a
much higher risk for cardiovascular disease and diabetes.
“Common medical wisdom has been that some people who are obese
seemed to be pretty healthy and free from heart disease risks, so they haven’t
been advised to lose weight or take other steps to prevent future heart
disease,” said Morgana Mongraw-Chaffin, Ph.D., assistant professor of public
health sciences at Wake Forest Baptist and lead author of the study.
“The big question has been whether these people who are
metabolically healthy will stay that way or whether they will progress to
metabolic syndrome over time.”
Metabolic syndrome includes those risk factors – high
blood pressure, high blood sugar, unhealthy cholesterol levels and
abdominal fat – which double the risk
of cardiovascular disease that can lead to heart attacks and strokes.
In addition, these risk factors increase the risk of diabetes by five
Forest Baptist study included 6,809 participants from the Multi-Ethnic Study of
Atherosclerosis who were recruited from six sites in the United States. Participants
with cardiovascular disease were excluded.
The study was conducted to determine if metabolically
healthy obesity (MHO) at baseline remained stable or led to metabolic syndrome
and increased the risk of heart and vascular disease. Participants were
followed for 12 years with clinical evaluation repeated every two years. MHO
was defined as a body mass index of more than 30 and two or fewer risk factors.
The researchers found that compared to normal weight,
baseline MHO was not significantly associated with incident cardiovascular
disease, the first occurrence of a
potentially life-threatening condition. However, almost half of the
participants developed metabolic syndrome over the course of the study and had
increased odds of cardiovascular disease compared to those with stable MHO and normal
“In this paper, we specifically looked to see whether
that progression was associated with a higher risk for heart disease and we
found that it was,” Mongraw-Chaffin said. “Metabolically healthy obesity is not
a stable or reliable indicator of future risk for cardiovascular disease. Right
now, there isn’t any way to know which 50 percent will progress and which won’t.
“Therefore we recommend that everyone with MHO work with
their doctor to lose weight or at least maintain their current weight, exercise
more and make other lifestyle changes so they don’t develop metabolic
for the research was provided by the National Heart, Lung, and Blood Institute,
N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164,
N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169 and HL088451, as well as UL1-TR-000040 and UL1-TR-001079 from NCRR.
are Gregory L. Burke, M.D., of Wake Forest Baptist; Meredith C. Foster, Sc.D.,
of Duke-NUS Medical School in Singapore; Cheryl A.M. Anderson, Ph.D., of
University of California San Diego; Nowreen Haq, M.D., of New York University;
Rita R. Kalyani, M.D., Pamela Ouyang, M.D., and Dhananjay Vaidya, Ph.D., of
Johns Hopkins University; Christopher T. Sibley, M.D., of Great Point Health in
Portland, Ore.; Russell Tracy, Ph.D., of University of Vermont; Mark Woodward,
Ph.D., of the University of Oxford, U.K.