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Previous studies had suggested that being in good physical shape could lessen the negative effects of being overweight on heart health, but this is not the case, according to a new study published in the European Journal of Preventive Cardiology, a journal of the Society. European Cardiology (ESC), released Thursday.
“You can’t be ‘fat but healthy.’ This was the first nationwide analysis to show that being regularly active is not likely to eliminate the harmful health effects of being overweight. body fat, ”said study author Alejandro Lucia, professor of exercise physiology at the European University of Madrid.
“Our results refute the idea that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity.”
Previous research has provided evidence that people “fat but fit” may have similar cardiovascular health to those who are “thin but unfit”, but Lucia said this has had unintended consequences.
“This has led to controversial health policy proposals to prioritize physical activity and fitness over weight loss,” he said. “Our study aimed to clarify the links between activity, body weight and heart health.”
The researchers used data from 527,662 Spanish adult workers insured by a company for the prevention of occupational risks, with an average age of 42 years.
They were grouped according to activity level and groups according to body weight: 42% of the participants were of normal weight, with a body mass index (BMI) of 20 to 24.9; 41% were overweight, BMI 25-29.9; and 18% were obese, BMI 30 or greater.
Next, the researchers looked at their cardiovascular health by categorizing them as diabetes, high cholesterol, and high blood pressure, all of which are major risk factors for stroke and heart attack.
After studying the associations between BMI, activity level, and risk factors, the researchers concluded that any level of activity meant that an individual was less likely to have one of the three risk factors. risk versus no exercise, with the risk of high blood pressure and diabetes. decreasing with increasing activity levels.
“This tells us that everyone, regardless of their body weight, needs to be physically active to protect their health,” Lucia said.
However, the study showed a higher cardiovascular risk for overweight and obese participants compared to those of normal weight, regardless of how much exercise they did.
Obese and active participants were twice as likely to have high cholesterol, four times as likely to have diabetes, and five times as likely to have high blood pressure than those who were normal weight but were inactive .
“Exercise doesn’t seem to offset the negative effects of being overweight,” Lucia said. “This finding was also observed overall in men and women when analyzed separately.”
Lucie stressed that it is “just as important” to fight against obesity and inactivity.
“Weight loss must remain a primary target of health policies and promote active lifestyles,” he said.
‘We don’t know what happened first’
Questions remain, however, around the situation of those involved in the study.
“This is a cross-sectional study – all we can talk about is associations, we can’t talk about causation,” Michael Pencina, associate dean for data science and technology, told CNN. information at Duke University School of Medicine.
“Because this is a cross-sectional study, we don’t know what happened first – what this study doesn’t tell us is that the obese and active person became active when she realized she was obese, and her risk or were they active, and despite this, they became obese and their risk factors increased? Pencina, who was not involved in the study, added.
“What we are finding is that the burden of risk factors increases with weight category. Obese people have the highest burden of associated risk factors. This remains true depending on activity level,” at -he adds.
The study adds to a large body of research on the subject.
“Although controversy over the precise contribution of weight versus exercise to cardiovascular health is likely to continue, to optimize health and minimize the risk of cardiovascular disease, patients should pay attention to both: maintain a healthy weight and be physically active, ”said Dr. Anthony Rosenzweig, chief of the cardiology division at Massachusetts General Hospital in Boston and professor of medicine at Harvard Medical School.
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