id=”inContext_disabled”> 2013-09-08 15:41
id=”inContext_disabled”> [Photo: shapecharge / iStockphoto]
may be obese, but less prone to death than people of normal weight who has a belly and metabolic disorders – confirmed by research presented at this year’s European Society of Cardiology Congress in Amsterdam.
In the last decade there have been many works that showed that people who are overweight and mild obesity may be less likely to die than those very thin and weighing properly. In January 2013, the journal the Journal of the American Medical Association was published meta-analysis of 97 studies, involving nearly 3 million people. It meant that people who are overweight are less likely to die from different causes than people weighed properly, and for the first stage of obesity, there was no increased risk of death. Mortality was higher only in the most obese group (ie, obesity grade 2 and 3).
– Obesity is considered a risk factor for cardiovascular disease, but few studies have shown that people with a low body mass index (BMI) have a higher risk of dying from the disease than those with higher BMI, or overweight or obesity first degree – recalled at the press conference, Dr. Takanori nagahiro from Nagoya City University in Japan. This phenomenon is known as obesity paradox has been reported include among patients with heart failure, coronary artery disease, diabetes and stroke.
studies presented at the congress of the European Society of Cardiology (ESC) confirmed the existence of obesity paradox .
One of them included more than 260 thousand. Danish women of childbearing age (mean age 30.5 years) who gave birth in 2004-2009 and did not have a history of problems with the cardiovascular system. Because BMI was divided into two groups: women with a BMI of 18.5 to 25 kg/m2, or weigh properly and ladies with a BMI of 25 kg/m2 or more, or who are overweight and obese. In each of these groups additionally distinguished subgroup who had no metabolic disorders such as hypertension, abnormal glucose metabolism, or the blood cholesterol level and the group that have at least one such disorder. For even more analysis takes into account the detailed metabolic disorders in pregnancy, such as pre-eclampsia, associated with high blood pressure and gestational diabetes.
health status of women followed for an average of 5.5 years after the birth of a child. During this period, collected data on heart attacks, strokes and deaths because of them in all groups. After adjusting for age and smoking.
found that overweight or obese women without metabolic syndrome was not associated with a higher risk of heart attacks and strokes, compared with the control group, ie women weighing correctly and without metabolic disorders. But the ladies who are overweight or obese have metabolic disorders that were seven times more likely to have a heart attack, and four times more of a stroke. While females weigh properly, but having at least one metabolic disorder were about twice as likely to encounter these events.
assess presenting the results of Dr. Miechelle Schmiegelow Gentofte Hospital in Hellerup, Denmark, this means that health is a metabolic link between obesity and the risk of cardiovascular disease.
– Our research shows that obesity itself is not the worst thing if a young woman has no metabolic disorder. However, since these observations were carried out in a relatively short period, and obesity over time increases the risk of metabolic problems, have put forward the hypothesis that there may be a window in which the metabolically healthy but obese women can try to lose weight and change your lifestyle, and the way to improve your health predictions – said the researcher.
Dr. Schmiegelow stressed that if the ladies of overweight and obesity will not do anything to prevent metabolic disorders is a long time for their risk of heart attack and stroke may increase.
also admitted that the relationship of obesity with the risk of heart attack may depend on genetic and epigenetic factors (ie, modifying the activity of genes, rather than their sequence). ,, However, lifestyle significantly shapes the risk of metabolic syndrome and the risk of cardiovascular diseases “- she noted.
Another study, which confirmed that metabolic health is more important than the extra weight presented prof. Tabassome Hospital of St. Simon. Anthony in Paris. Her team analyzed data collected (in the registry FAST-MI 2005) of more than 3,400 French patients who left the hospital after acute myocardial infarction in late 2005 in the case of more than 3100 patients, researchers had information on their BMI, including more than 1,600 Also on the waist. Waist is considered to be the easiest indicator so. abdominal obesity, which is associated with fatness organs in the abdomen. Studies have shown that adipose tissue is stored there hormonally active and secretes compounds that negatively affect human health.
health status of patients followed for 5 years. Analysis was carried out taking into account the BMI and waist circumference. Patients were divided into five groups according to BMI – less than 22 kg/m2 (the ratio is lower than 18.5 underweight), from 22 to 25 (normal weight), 25-30 (overweight), from 30 to 35 (first-degree obesity) and 35 or more (severe obesity). Also distinguished three groups according to waist circumference. Women less than 88 cm in waist, meant no abdominal obesity, another group were ladies first degree of abdominal obesity, with a waist of 88 to 100 cm, and three women who had a waist of 100 cm or more. If men were as follows: a group with less than 102 cm (without abdominal obesity), from 102 cm to 115 cm and 115 cm or more. Importantly, in accordance with European guidelines, which are even more restrictive abdominal obesity is found if the waist circumference for men is more than 80 cm, and for men over 94 cm.
Within five years, the highest mortality was found in the most meager group (increased risk of death by 31 percent.), and in the most obese group revealed it after 3 years of follow-up (increased risk by 39 percent.). The least vulnerable to death were people with mild obesity and overweight, and a BMI of 22 to 25, or a weight properly.
When were taken into account waist circumference, the greatest risk of death were those widest at the waist – above 100 cm for women and above 115 cm among men. However, when the analysis included both indicators turned out that regardless of BMI patients with the largest waist circumference in their group (not more than 100 cm or 115 cm) had the highest risk of death within five years. Compared with people whose waist was the smallest that is higher by an average of 44 per cent., But about 41 per cent. among the most meager and by 65 per cent. among the most obese.
– This means that the highest risk of death in survivors of myocardial infarction is associated with low and very high body weight and high waist circumference. It is not good to be too thin, too obese, but even worse is when we have a big belly – assessed by Dr. Simon. Also added that in the case of the thickest patients were high risk of death, regardless of the waist.
her opinion, education campaigns and prevention for people after a heart attack should focus more on fighting obesity, and most of abdominal obesity (as well as other risk factors, such as sedentary lifestyle and smoking) and not overweight and mild obesity.
– This study raises the question of why in the risk of death and cardiovascular disease still use BMI as many other studies have shown that this is not good enough parameter for this purpose – said Dr. Heinz Drexel University of Innsbruck in Austria. In his view, instead, should rather be measured waist circumference to assess abdominal obesity, which is a better indicator of the prevalence of metabolic syndrome. It is also the easiest method. BMI is calculated by dividing weight in kilograms by height in meters squared, to measure waist circumference need only centimeter.
She agreed with the professor. Simon. BMI is not a good indicator, we should evaluate the content of fat and muscle in the body. You can have a high BMI but high physical performance, such as the sport grows, which makes it have a large muscle mass. Therefore, waist circumference is a better indicator of risk – pointed out.
evaluated by Dr. Schmigielow, BMI can be only a starting point for the assessment of overweight and obesity, but then you need to assess the risk of metabolic patient.
Congress in Amsterdam Dr nagahiro also presented evidence of the paradox of obesity among Japanese patients with hypertension and diabetes. The greatest risk of myocardial cheese, stroke, hospitalization for heart failure or death from cardiac causes were those with the lowest BMI – less than 23 kg/m2, and the smallest people with the highest BMI, ie equal to or greater than 27 k/m2 (up to 30 talking about overweight, 30 for obesity).
his opinion, can be explained by the fact that the people most meager were the most serious form of type 2 diabetes – even though they suffered as long as patients from other groups already have started to use insulin.
Dr. nagahiro noted that these results do not change the fact that obesity is a major risk factor for cardiovascular disease.
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