While it may sound like an oxymoron, there is some validity to being “fat and fit.”
For years, doctors have used body mass index (BMI), a person’s weight in kilograms divided by height in meters squared, to determine these categories:
Underweight: BMI less than 20
Normal: BMI 20 to 24.9
Overweight: BMI 25 to 29.9
Obese: BMI above 30
Extremely obese: BMI above 35
Many studies attempting to correlate BMI with heart disease risk seem to agree on these two points:
• Obese or extremely obese people have a greatly increased risk of heart disease and death.
• Underweight people also have an increased risk of death (mainly due to underlying conditions, including heart disease, lung disease or cancer, which can produce weight loss as the disease progresses).
However, the health risk for people with BMIs in the overweight category has been more difficult to assess. Some studies indicate that overweight patients have increased risks for heart disease; others do not.
Waist-to-hip ratio may be better indicator for heart disease
Waist-to-hip ratios (WHRs) may be more adequate heart disease indicators for some people. To determine yours, divide your waist measurement by your hip measurement (such as waist 28 divided by hip 38 equals WHR 74), and use this chart to determine your associated health risk:
More recent studies indicate that for people in the overweight category, waist-to-hip ratio and overall level of fitness more accurately reflect their cardiac risk. For instance, in a recent study, overweight men with reduced fitness levels had nearly twice as much abdominal fat as overweight men who were physically fit. Consequently, they had greater risks for heart disease. Even men in the “obese” category benefited by maintaining a good level of cardiovascular fitness; they had less abdominal fat than people with similar BMIs who were not physically fit. Being “fat and fit,” therefore, is much better than just being fat.
What’s the bottom line?
If your BMI classifies you as overweight, but you are physically fit and your abdominal fat is not excessive, your weight itself may not be a major contributor to your heart risk profile.
If you are merely “overweight,” measure your WHR. If it is in normal range, your weight probably is not having a significant impact on your heart disease risk. If you are not physically active and your WHR is abnormal, you are at increased risk.
If you are obese or extremely obese, you have greatly increased cardiac risk and should try to lose weight. However, even obese people improve their heart disease risks if they can remain physically active and fit.
No matter what your BMI profile, physical activity can reduce abdominal obesity and therefore cardiac risk.
How do I learn more?
To learn more about the risk factors, symptoms and treatment for heart disease, visit Western Baptist’s newly re-designed Web site at westernbaptist.com/heart. You can take a free, five-minute online heart risk survey and become eligible for reduced-cost cardiac screenings at Baptist Prime Care. You also may phone Baptist Health Line at (270) 575-2918.
Send your questions!
Do you have a cardiac question tugging at your heart? Send it to firstname.lastname@example.org or mail it to HeartBeat, 2501 Kentucky
Ave., Paducah, KY 42003. If we use it in a future HeartBeat column, you will receive a Baptist Heart Center T-shirt.
HeartCheck on Feb. 27
HeartCheck, a free screening event at Western Baptist Hospital, will be held from 9 a.m. to noon Friday, Feb. 27, in the atrium of Doctors Office Building 2. The event features free screenings, including cholesterol, blood pressure, blood sugar, EKG rhythm strips and respiratory checks.
Cardiologist Patrick Withrow, M.D., will be available to review screening results. Health information, including smoking cessation resources, also will be offered, along with a basket raffle, jewelry and bake sales. All proceeds will benefit the American Heart Association.
Advance registration and fasting are not necessary, but you may phone Baptist Health Line at (270) 575-2918 for more information.