A new study in the Archives of Internal Medicine (2008;168:928-35) paints a rather bleak picture of the future health of obese Americans. Dr. G.L. Burke and colleagues confirmed earlier studies that found a high prevalence of overweight and obesity in most American ethnic groups. But of even more concern was their finding that many obese people who were apparently healthy with respect to current symptoms of cardiovascular disease (CVD) had signs portending future heart problems.
The researchers examined 6,814 men and women ages forty-five to eighty-four. Four ethnic groups were represented: Caucasian, African-American, Hispanic, and Chinese-American. In all but the Chinese-American group, on average, participants were overweight or frankly obese, as measured by a body mass index (BMI) of over 25 (overweight) or 30 (obese).
As expected, a higher BMI was associated with more adverse levels of traditional risk factors -- blood pressure, blood lipids (e.g., cholesterol), and blood sugar. But what was not previously known was that such individuals also tended to have increased thickness of carotid artery walls, increased heart size, and increased levels of coronary artery calcium. None of these would be apparent in a normal clinical examination, but all portend an increased risk of future CVD. The elevated prevalence in the obese group compared to people of normal weight persisted even after statistical adjustment for traditional CVD risk factors -- that is, high blood pressure and blood lipids and sugar levels.
The authors concluded that we must "redouble our efforts to assist in increasing healthy behaviors and to remove environmental barriers to maintaining a healthy weight."