Physical activity, weight and heart health
Physical activity does not cancel out the negative effects of excess body weight on heart health. This is the finding of an extensive study published in January 2021 in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
“You can’t be fat, but healthy,” said the study’s author, Dr. Alejandro Lucia of the European University, Madrid, Spain. “This was the first national analysis to show that being active regularly does not eliminate the harmful effects of excess body fat. Our findings reject the notion that an active lifestyle can completely nullify the harmful effects of being overweight and obesity.”
There is some evidence that fitness could alleviate the negative effects of excess body weight on heart health, which has led to controversial health policy proposals to prioritize physical activity and fitness over weight loss. This study sought to clarify the links between activity, body weight and heart health.
The study used data from 527,662 working adults, provided by a large occupational risk prevention company in Spain. The average age of the participants was 42 years and 32% were women. Participants were placed in three categories: normal weight (body mass index [BMI] 20.0-24.9 kg / m2), overweight (BMI 25.0-29.9 kg / m2) or obese (BMI 30, 0 kg / m2 or more). In addition, they were grouped according to the level of activity as follows:
- Regularly active, defined as achieving the minimum recommended for adults by the World Health Organization (WHO);
- Insufficiently active (some moderate to vigorous physical activity each week, but less than the WHO minimum);
- Inactive (not exercising at all).
Cardiovascular health was determined by three major risk factors for heart attack and stroke, which are: diabetes, high cholesterol and high blood pressure.
The researchers investigated the associations between each BMI and activity group and the three risk factors. At all BMI levels, any activity (whether or not it reached the WHO minimum level) was associated with a lower likelihood of diabetes, high blood pressure or high cholesterol, compared to a lack of exercise. Dr. Lucia said: “This tells us that everyone, regardless of body weight, should be physically active to protect their health.”
For all body weights, the chances of diabetes and hypertension decreased when there was more physical activity involved. “More activity is better, so walking 30 minutes a day is better than walking 15 minutes a day,” he said.
However, overweight and obese participants had a higher cardiovascular risk than their peers with normal weight, regardless of activity levels. For example, compared with inactive normal-weight individuals, active obese people were about twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. Dr. Lucia said: “Exercise does not seem to compensate for the negative effects of being overweight. This finding was also observed in men and women when analyzed separately.”
He concluded: “Combating obesity and inactivity is just as important; it should be a common struggle. Weight loss should remain a major goal of health policies, along with the promotion of active lifestyles.”
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