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(CNN) -
The negative effects of excess body fat on heart health cannot be reversed by maintaining an active lifestyle, according to new research.
Previous studies had suggested that being physically fit could mitigate the negative effects of being overweight on heart health, but this is not the case, according to a new study in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology. (ESC), published this Thursday.
«One cannot be 'fat but healthy'.
This was the first national analysis to show that physical activity is unlikely to eliminate the detrimental health effects of excess body fat, "said study author Alejandro Lucía, professor of exercise physiology at the European University of Madrid.
"Our findings refute the notion that a physically active lifestyle can completely negate the harmful effects of being overweight and obese," said Lucia.
Previous research provided some evidence that people who were "fat but fit" might have cardiovascular health similar to those who were "thin but not fit," but Lucia said this has had unintended consequences.
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"This has led to controversial health policy proposals to prioritize physical activity and fitness over weight loss," he said.
"Our study sought to clarify the links between activity, body weight, and heart health."
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The consequences of being overweight and high in body fat
The researchers used data from 527,662 working adults in Spain insured by an occupational risk prevention company, with a mean age of 42 years.
They were grouped according to activity level and groups by body weight: 42% of the participants were of normal weight, with a body mass index (BMI) between 20 and 24.9.
41% were overweight and had a BMI 25-29.9;
and 18% were obese, with a BMI of 30 or more.
The researchers then analyzed their cardiovascular health classifying them by diabetes, high cholesterol, and high blood pressure, all of which are major risk factors for stroke and heart attack.
After investigating the associations between BMI, activity level, and risk factors, the researchers concluded that any activity level meant that an individual was less likely to have any of the three risk factors compared to not exercising, with the risk of hypertension and diabetes decreases with increasing activity levels.
"This tells us that everyone, regardless of body weight, must be physically active to safeguard their health," said Lucia.
However, the study showed an increased cardiovascular risk for overweight and obese participants compared to normal weight participants, regardless of how much exercise they did.
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Participants who were obese and active were twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure than those who were of normal weight but were inactive.
"Exercise does not seem to offset the negative effects of excess weight," said Lucia.
"This finding was also generally seen in both men and women when analyzed separately."
Lucia stressed that it is "equally important" to combat obesity and sedentary lifestyle.
"Weight loss should remain a primary goal of health policies along with promoting active lifestyles," he said.
"We don't know which came first"
However, questions remain about the circumstances of the people involved in the study.
«This is a cross-sectional study;
all we can talk about is associations, we can't talk about causality, "Michael Pencina, vice dean of data science and information technology at Duke University School of Medicine, told CNN.
“Because it is a cross-sectional study, we don't know which came first;
What this study does not tell us is whether the person who is obese and active became active when they realized they were obese and if the risk factors were high?
Or were they active, and despite that, they became obese and their risk factors increased? ”Said Pencina, who was not involved in the study.
“What we see is that the burden of risk factors increases by weight category.
Obese people have the highest burden of associated risk factors.
That remains true depending on the level of activity, "he added.
The study adds to an extensive body of research on the subject.
Scientists at the University of Oxford published the results of a large study on January 12.
Physical exercise may be even more important in preventing cardiovascular disease than previously known, and the more activity the better, the report found.
And researchers from the Cleveland Clinic published a study in January 2019 showing that a sedentary lifestyle is worse for health than smoking, diabetes or heart disease.
“While controversy about the precise contribution of weight versus exercise to cardiovascular health is likely to continue, to optimize health and minimize risk of cardiovascular disease, patients should pay attention to both: maintaining a healthy weight and being physically active, ”said Dr. Anthony Rosenzweig, chief of the division of cardiology at Massachusetts General Hospital in Boston and professor of medicine at Harvard Medical School.
Obesity