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Obese and healthy? Maybe not, study says

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Can a person be simultaneously obese and healthy?

Though some obese individuals may appear otherwise healthy, a new study published in the Journal of the American College of Cardiology indicates obese people are more likely to have hidden plaque build-up in their arteries compared to normal weight people.

“The consequences [of obesity] can include elevated blood sugar, diabetes, hypertension, cholesterol and high lipid levels…it’s a very pro-inflammatory disease,” study author Dr. Eliseo Guallar, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, told FoxNews.com. “But one question was, what happens if a person is obese but doesn’t have [these] elevated risk factors? Are they still going to be at risk of cardiovascular disease?”

To analyze the potentially hidden health consequences of obesity, the researchers studied the coronary artery calcium (CAC) scores – a measure of calcium build-up in the plaque of artery walls – in a cohort of 14,828 metabolically healthy individuals. The individuals, ages 30 to 59, were all from Korea.

“CAC scores are a marker of atherosclerosis in the coronary arteries,…lesions that can result in myocardial infarction or angina or ischemic cardiomyopathy – heart disease,” Guallar said. “We have this technique, CAC scoring, which uses computed tomography, or CT scans…[and] it’s being used as screening procedure to identify people who have no symptoms, who in some cases might have no other manifestation, but who already have the disease.”

Overall, obese individuals were found to have a higher prevalence of early plaque build-up in their arteries, based on their CAC scoring, compared to normal weight individuals. According to Guallar, this indicates that even otherwise healthy obese people should consider taking action to lose weight.

In addition to improving their diet and fitness habits, Guallar noted that eliminating other cardiovascular risk factors – like smoking – may also help lessen an individual’s risk of progressing to cardiovascular disease.

“Obesity as you know is a major, major epidemic. There are many people with obesity, and sometimes there was this question of whether people who had obesity but no other risk factors, if they could just forget about it,” Guallar said. “So this study is pointing out the opposite, to this idea that if you have obesity, even if all the numbers in your health report card look good, you might have to think of doing something about it.”

The concept of ‘healthy’ obesity is controversial in the medical world, as previous studies have indicated that obesity may have some protective effects on health or that metabolically ‘healthy’ obese individuals may not have any greater risk for cardiovascular disease than normal weight individuals. However, Guallar argues that their study indicates that even outwardly healthy obese individuals may be at future risk.

“It has been controversial, but now there are studies that show even people who have metabolically ‘healthy’ obesity are more likely to develop unhealthy obesity,” Guallar said. “And what we are showing is they already have more calcium in their coronary arteries, a reflection that they have coronary heart disease.”