Long-term health outcomes for heart attack survivors are better if the patient is overweight or mildly obese, compared to people who are a normal weight. Wait, what? A series of eyebrow-raising results from UT Southwestern Medical Center require explanation and interpretation.
The Obesity Paradox
“The finding does not suggest that heart attack patients should try to gain weight if they are of normal weight," clarified first author of the new study Dr. Ian Neeland, cardiologist at UT Southwestern Medical Center. Rather, Neeland explains, the results suggest that people who are overweight or mildly obese should not actively try to lose weight in the immediate aftermath of a heart attack.
Neeland and a team of researchers examined survival rates in the years following an individual experiencing heart attack in a study with nearly 20,000 participants. Mildly obese people were 30 percent more likely to survive and spent less days in hospital compared to people with a normal weight.
For the purposes of the study, mildly obese is defined as having a body mass index (BMI) between 30 and 34.9, and normal weight is a BMI between 18.5 and 24.9.
The difference in long-term health outcomes between mildly obese people and extremely obese people (BMI greater than 40) is important to point out; extremely obese people and normal-weight people had similar health outcomes post-heart attack.
“Doctors should focus more on heart attack patients who are normal weight and not assume that just because they're normal weight that they're probably going to be better off,” Neeland suggested.
Other studies have found similar - and strange - connections between mildly obese people and health outcomes following illness. "One theory is that you have more energy reserves to combat the illness. You're able to weather the storm better," Neeland offered. Nonetheless, the scientific and medical community isn’t yet convinced that there’s something they’re missing that could explain the recent findings.
“It's important to remember that adults who are obese or overweight are at greater risk of developing diabetes, high blood pressure, and high cholesterol in the first place,” Neeland pointed out.
Maybe BMI isn’t as important for reflecting cardiovascular health as other factors yet to be revealed. Maybe there is something missing in the explanation for this phenomena. Here’s one scientist’s opinion on the connection between obesity, inflammation, and heart disease:
The present study was published in the European Heart Journal: Quality of Care and Clinical Outcomes.
Source: UT Southwestern Medical Center