Some folks can get away with smoking or drinking too much, but others can’t. They have hell to pay. There’s one sure-fire way to eliminate smoking-related disease risk.
Some studies suggest you can be healthy and long-lived while obese as long as you’re “metabolically healthy.” That is, if you have normal blood pressure, LDL cholesterol, triglycerides, blood sugar, and waist circumference. (You can be obese with a “normal” waist circumference, but it’s not easy.) A new meta-analysis finds the “metabolically healthy” label is a misnomer: you’re still at higher risk for death or cardiovascular events if you’re obese and free of metabolic syndrome features.
“Our results do not support this concept of ‘benign obesity’ and demonstrate that there is no ‘healthy’ pattern of obesity,” Kramer and colleagues wrote. “Even within the same category of metabolic status (healthy or unhealthy) we show that certain cardiovascular risk factors (blood pressure, waist circumference, low high-density lipoprotein cholesterol level, insulin resistance) progressively increase from normal weight to overweight to obese.”
This report does not directly address the “fat but fit” concept, whereby you can counteract some of the adverse health effects of obesity by being fit. By fit, I mean regularly exercising and achieving a decent level of capacity and tolerance for physical activity. Fat but fit still holds.
Steve Parker, M.D.