Contrary to previous results
Researchers who reviewed past studies found that even heavy people who didn't have high blood pressure or diabetes, for instance, had more heart attacks and strokes over time than healthy normal-weight people. That runs contrary to the results of some recent shorter-term reports, which suggested people could be obese but heart-healthy.
"It made perfect sense to say there might be a group that have extra body fat but aren't necessarily at risk," James O. Hill said. "I think what this study says is, they are. It's just that the risk may be lower (than among obese people who also have other problems) and it might take a little longer to see it."
Studies over 10 years or more
Hill, executive director of the Anschutz Health and Wellness Center at the University of Colorado in Aurora, co-wrote a commentary published with the new analysis. Canadian researchers pooled the results of eight studies that followed normal-weight, overweight and obese people over time. Some of those participants were metabolically healthy. Others had a mix of heart-related risk factors like a large waist circumference, high blood pressure, high triglycerides, low "good" cholesterol and diabetes.
The studies included just over 61,000 people. Over a period of three to 30 years, depending on the study, about 4,000 of them died or developed heart problems. At first, obese people without metabolic problems didn't seem to be any more at-risk than slimmer participants who were also metabolically healthy. Then, however, the researchers looked only at studies that followed people for 10 years or more. They found that over time, heavy but healthy people in those studies were 24 percent more likely to die, have a heart attack or stroke or develop heart failure.