Being 'healthy fat' still doesn't offset the risk of a host of conditions, new research on Brits reveals. A study of nearly half a million people shows that even if they stick to a healthy diet, being fat still leaves them at a greater risk of health problems.
Eating plenty of fruit and vegetables, taking regular exercise, drinking in moderation and not smoking protects against a wide rage of illnesses, the study shows. But benefits are modest in those with a BMI (body mass index) of 30 or above, say scientists.
The findings are based on 438,500 over-40s from the UK Biobank - a database holding detailed information about their genes and health. Corresponding author Dr Sebastien Czernichow, of the Public Assistance Hospital of Paris, said: "Adults with obesity were at a higher risk of various diseases compared with those who maintained a healthy body weight and lifestyle.
"For individuals with obesity, engaging in regular exercise, refraining from smoking, consuming alcohol in moderation or not at all and eating a healthy diet were associated with a decreased risk of cardiovascular disease, kidney failure, gout or sleep disorders. These findings suggest that although adherence to a healthy lifestyle is associated with a reduced risk of several adverse health outcomes in adults with obesity, it does not entirely eradicate the risk of obesity-related diseases."
Those who met all four healthy lifestyle factors were 16, 28, 29 and 35 per cent less likely to develop hypertension, ischaemic heart disease, irregular heartbeats and heart failure. They were also 81 percent less prone to hardening of the arteries. Cases of kidney failure, gout, sleep and mood disorders fell by 27, 49, 32 and 34 percent, respectively, compared to the general population.
Around a quarter of the particpants had obesity. During an average follow-up of almost 13 years, a third developed at least one of the studied conditions. Plant-based diets low in animal foods, sugary drinks, snacks and desserts have been shown to protect against potentially fatal conditions including cardiovascular disease and cancer.
The UK has been dubbed the 'fat man' of Europe with almost two in three adults overweight. Obesity is the most prevalent chronic disease worldwide. It is estimated more than a billion people will be living with obesity by 2030 increasing their risk of diabetes, cardiovascular disease, chronic kidney disease and several types of cancer. The international team described the figure as "staggering."
Reduced productivity and greater intensity of healthcare service use are expected to result in a major economic burden. Dr Czernichow said: "A need exists for the treatment of obesity as a chronic, progressive, and relapsing disease to improve outcomes for people living with this disease.
"A suboptimal lifestyle is a major preventable cause of obesity and its associated comorbidities. As such, interventions to improve lifestyle are an opportunity to optimise the management of obesity."
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Being physically active, avoiding smoking, and adhering to a healthy diet are associated with lower disease and mortality rates in the general population. The study in JAMA Network Open is one of the first to analyse links across the BMI (body mass index) spectrum, particularly in adults with obesity.
Dr Czernichow said: "The findings from this population-based cohort study suggest that adherence to a healthy lifestyle as a composite score is associated with a reduced risk of several health outcomes in adults with obesity but does not entirely offset the negative effects of obesity. Studies that estimate the risk of a wide range of outcomes according to adherence to lifestyle factors among adults with obesity are lacking, he said.
Most of the research has focused on cardiovascular diseases and mortality and individual lifestyle factors. Dr Czernichow added: "In this cohort study of UK Biobank participants, adherence to a healthy lifestyle as a composite score, including not smoking, exercising regularly, consuming no or moderate amounts of alcohol, and eating a healthy diet, was associated with a reduced risk of several health outcomes among adults with obesity. Although a healthy lifestyle appeared to be beneficial, it did not entirely offset the health risks associated with obesity."
