Study debunks ‘obesity paradox’ myth; US looks at cutting nicotine levels in cigarettes
The obesity paradox – the idea that being obese offers a measure of protection against heart disease – has been proven false, say researchers. Meanwhile, the US looks at drastically reducing nicotine in cigarettes to save millions of lives
Being overweight or obese does pose a risk of heart disease, despite claims to the contrary, suggests a study of nearly 300,000 British adults.
While it is generally accepted that being overweight increases a person’s disease risk, some researchers have recently suggested that carrying extra weight does not actually boost death rates for some, particularly the elderly.
Why heart attacks are leading cause of death in women, and why many women are unaware of the higher risks they face
A number have even suggested that being overweight may protect against disease, a claim dubbed the “obesity paradox”.
But the latest study, published in the European Heart Journal, says there is no paradox.
It looked at 296,535 people aged 40 to 69 who enrolled in an ongoing health study in the UK between 2006 and 2010.
Data on the participants – all of “white European descent” – was available until 2015. All were healthy when they first enrolled.
The researchers noted the participants’ body mass index (BMI) – a ratio of weight to height squared used to determine whether a person is in a healthy weight range.
The World Health Organisation considers someone with a BMI of 25kg/m2 as overweight, and 30kg/m2 or higher as obese.
They then tracked who went on to develop cardiovascular disease (CVD) – which includes heart attack, stroke or high blood pressure. The research team found that CVD risk increased beyond a BMI of 22 to 23kg/m2.
“The risk also increases steadily the more fat a person carries around their waist,” said a press statement summarising the findings.
People with a BMI of 22 to 23kg/m2 had the lowest CVD risk, the study found.
As BMI increased above 22kg/m2, the risk of CVD increased by 13 per cent for every 5.2kg/m2 increase in women and 4.3kg/m2 in men.”
The findings present a direct challenge to the obesity paradox.
“Any public misconception of a potential ‘protective’ effect of fat against heart attack and stroke risks should be challenged,” says study co-author Stamatina Iliodromiti from the University of Glasgow.
It is possible that the effect would be different for people with pre-existing disease, the authors say.
But for healthy people, maintaining a BMI of 22 to 23kg/m2 appeared to minimise the risk of developing or dying from heart disease.
“The less fat, especially around their abdomen, the lower the risk of future heart disease,” the authors conclude.
An American study published by the journal JAMA Cardiology last month, similarly found that overweight and obesity were associated with “significantly increased risk for CVD”.
US moves to slash nicotine in cigarettes
US regulators opened the door to slashing the amount of nicotine in cigarettes to make them less addictive, a move that could drastically cut the number of smokers in the future.
The US Food and Drug Administration said it is seeking public input and will begin “to explore a product standard to lower nicotine in cigarettes to minimal or non-addictive levels”.
Despite decades of anti-smoking campaigns, nearly half a million people die in the US each year from cigarette smoking, which costs almost US$300 billion annually in direct health care and lost productivity, the FDA said.
“We’re taking a pivotal step today that could ultimately bring us closer to our vision of a world where combustible cigarettes would no longer create or sustain addiction – making it harder for future generations to become addicted in the first place and allowing more currently addicted smokers to quit or switch to potentially less harmful products,” said FDA commissioner Scott Gottlieb.
A recent study in the New England Journal of Medicine projected that cutting nicotine to a non-addictive level could mean five million fewer smokers in the first year of implementation.
Within five years, another eight million fewer people would smoke, and by 2060, the smoking rate in the US could drop to 1.4 per cent from its present level of 15 per cent, said the report.
The number of lives saved could reach 8.5 million by the end of the century, it said.
The Campaign for Tobacco-Free Kids called the FDA plan “bold” and urged the agency to act quickly and set a hard deadline.
“This is truly a once-in-a-lifetime opportunity to greatly accelerate progress in reducing tobacco use – the nation’s No. 1 cause of preventable death – and bring us closer to eliminating the death and disease it causes,” said the group’s president, Matthew Myers.