December 29, 2009

No Such Thing as "Healthy Obese"

I've been doing a lot of thinking about Science Writing.

Here is an example of great Scientific Journalism from Forbes.com (via Dr. Ves)
Study Debunks Notion of 'Healthy Obese' Man

The report concisely analyzes a new study in the journal Circulation, including the patient size and population (1800 Swedish men) and most importantly, context: ("starting at age 50 for an unusually long time, 30 years, recording those who have died of a heart attack or stroke.") Problems with previous studies did not track patients over an adequate period of time (in which patients were only followed for 15 years or less.)

The results:
the study found that over the 30-year period, the risk of cardiovascular disease was 63 percent higher in men of normal weight who had metabolic syndrome, compared to normal-weight men who did not have metabolic syndrome. It was 52 percent higher in overweight men without metabolic syndrome, 74 percent higher in overweight men with metabolic syndrome, 95 percent higher in obese men without metabolic syndrome and 155 percent higher in obese men with metabolic syndrome.


The only thing that this report fails to do is cite the original article, which I will do (along with an older one that is readily available on PubMed.)

Circulation. 2008 Jun 17;117(24):3057-9.
Healthy lifestyle: even if you are doing everything right, extra weight carries an excess risk of acute coronary events
.
Johan Ärnlöv, Erik Ingelsson, Johan Sundström, and Lars Lind
Impact of Body Mass Index and the Metabolic Syndrome on the Risk of Cardiovascular Disease and Death in Middle-Aged Men
Circulation, Dec 2009
Poirier P.

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It's topical and relevant, especially in this holiday season :)

So what will I tell my patients?
If you are a middle-aged Swedish male with a pot-belly, high cholesterol, elevated blood sugars, and high blood pressure, you are doubling your risk for a cardiovascular event (1.74x for overweight, 2.55x for obese.) If you only have a pot-belly you ALSO increase your risk (1.52x for overweight, 1.95x for obese.)

This is likely even higher for other more at-risk populations.

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