Obesity fit and fat?

Is it possible to be fat and fit

Yes — but not forever, according to Prakash Deedwania, MD, of the University of California at San Francisco School of     Medicine.

“Obesity is never healthy; it’s just a question of time,” Deedwania said. “You can be fat and fit, and you will probably be okay for a little while. But to remain fat and fit is difficult. Most obese people will convert to a metabolically unhealthy state.

Nearly 38% of U.S. adults are obese and another 33% are overweight. And about 35% of American adults including nearly 50%of those age 60 years or older — are estimated to have metabolic syndrome. “Metabolic syndrome is worse than obesity,” said Carl Lavie, MD, “Although abdominal obesity is one of the components of metabolic syndrome, some people without abdominal obesity have metabolic syndrome and some obese people do not.” Metabolic syndrome is associated with high cardiovascular risk and risk of increased mortality. More obese people have metabolic syndrome than non-obese people, but regardless of weight, higher physical activity and a diet lower in simple sweets and carbs may help prevent metabolic syndrome, as will having a higher level of fitness.”

Though definitions vary slightly around the world, the American Heart Associationclassifies metabolic syndrome as a clustering of three or more of the following characteristics:

  • Abdominal obesity (a waist circumference of greater than 40 inches in men, or greaterthan 35 inches in women
  • Serum triglycerides of 150 mg/dL or greater
  • High-density lipoprotein (HDL) cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure of 130 mm Hg or greater, or diastolic blood pressure of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater”

Metabolic syndrome is a conglomeration of risk factors,” said Deedwania. “Individually,

these factors are unhealthy, but when three or more of them come together, it gives you good information about potential problems ahead.”

Obesity and Heart Health

Recent studies have examined the links between obesity, metabolic syndrome, and cardiovascular disease. Earlier this year, an analysis of 6,809 Multi-Ethnic Study of Atherosclerosis (MESA) participants suggested that metabolically healthy obesity may be transient. Followed for a median of 12.2 years, almost half of the people who had metabolically healthy obesity developed metabolic syndrome, which was associated with cardiovascular risks that progressively increased with time.

“Metabolically healthy obesity is not a stable condition and also not necessarily an indicator of low cardiovascular disease risk”Instead, metabolically healthy obesity appears to be a transient condition on the pathway between obesity and the development of cardiovascular events.”

Staving Off Metabolic Syndrome at the Clinical Level

While obesity in general is associated with metabolic syndrome, visceral adiposity poses a particular concern, explained Deedwania. Ask the patient to take off their shirt. Even a thin person can have visceral obesity; these people have very high risk of diabetes and subsequent cardiovascular disease.”