Obesity: Silent Risk for Heart Disease?

August 2, 2023

The link between heart disease and obesity is multifaceted. Overweight and obesity are complex, chronic and relapsing diseases causing an estimated 3.4M deaths per year. Currently, more than 73% of US adults have overweight or obesity. Cardiovascular disease (CVD) is the leading global cause of death and includes conditions affecting the heart and blood vessels. In the US, according to the American Heart Association (AHA), someone dies from CVD every 38 seconds. Around 18.2 million adults age 20 and older have CVD and, 1 in 5 heart attacks is silent, meaning the person is unaware of it. Obesity increases the risk for developing conditions such as diabetes, high blood pressure, and high cholesterol, which are also risk factors for heart disease.

Obesity is the 2nd leading cause of preventable death, after smoking
Obesity is an independent risk factor for CVD
18.2M adults aged 20 and older have CVD
1 in 5 heart attacks is silent
Moderate weight loss of 5-10% improves obesity-related risk factors for CVD

Obesity is categorized by body mass index (BMI), which is a ratio between height and weight. A BMI between 25-29.9 defines overweight and a BMI greater than 30 defines obesity. Understand however that BMI, although a quick easy categorization tool we can all use, does not consider body composition, waist circumference, metabolic laboratory analysis nor presence of obesity-related co-morbidities. Its solo use to define the disease of obesity is clinically incomplete.

Modifiable Risk Factors for CVD:

Non-Modifiable Risk Factors for CVD:

Obesity is an independent risk factor for CVD and can negatively affect function, structure, and blood vessels. Obesity also triggers inflammatory processes that can harm the cardiovascular system and lead to structural and/or functional changes of the heart. Overweight also increases the risk of metabolic syndrome, a cluster of heart-disease risk factors that include hypertension, high levels of triglycerides, low levels of HDL (the “good” cholesterol), high blood sugar and a large waist circumference (greater than 35 inches in women and greater than 40 inches in men). Obesity can contribute to heart failure, coronary heart disease, stroke, venous thromboembolism, obstructive sleep apnea, and atrial fibrillation.

Obesity triggers inflammatory processes that can harm the cardiovascular system and lead to structural and/or functional changes of the heart

Where the excess weight deposits also impacts the risk of developing heart disease. In other words, when the adipose tissue (our body’s fat) deposits in the belly area, known as central adiposity or visceral adiposity, it is associated with greater inflammation, it contributes to plaque rupture, and it even increase triglyceride levels. Inflammation associated with obesity causes the release of bioactive markers that increase atherosclerosis and buildup of plaque in the walls of the arteries. According to the AHA, obesity can increase the risk of atrial fibrillation, an irregular heartbeat of the upper chambers of the heart which promotes the formation of blood clots and can lead to stroke, heart failure or other heart related complications. Obesity can cause blood pressure to rise and it can lead to abnormal cholesterol and diabetes, all of which are modifiable risk factors for CVD.

In 2013, The American Heart Association, American College of Cardiology and The Obesity Society published Management Guidelines for Overweight and Obesity

Moderate weight reduction of up to 10% of excess weight can improve obesity-related risk factors. Weight loss decreases the stress on the heart and leads to improvements in its structure and function. The AHA/ACC/TOS obesity guideline recommends that all adults with overweight or obesity achieve the realistic and meaningful goal of 5-10% weight loss within 6 months. Losing weight is one thing, keeping it off is another, and most people that have tried a new commercial, and likely restrictive, diet know that the pounds quickly return. And so begins the yo-yo dieting cycle.

So how do you lose weight safely and sustainably? Clinically, we often discuss with patients that 5-10% total body weight reduction within a 3-6 month period also means reaching a lower body weight that is sustainable.

You can start making small changes with great health benefit:

Follow a wholesome diet.
Include vegetables, fruit, whole grains, low-fat dairy, fatty fish such as salmon, lean protein, nuts and legumes and healthy oils and nuts such as olive, walnut, sesame, or grapeseed oils.
Avoid added sugars, highly processed foods such as chips, cookies.
Avoid fried foods.
Pick a routine you can maintain and know that one size does not fit all.
Understand the importance of movement and physical activity, reducing stress, and getting enough sleep.

Evexia Medical is a doctor founded and operated nutrition and weight management practice specializing in weight loss, prevention of weight regain and optimal health. Our board-certified medical specialists focus on individualizing treatment to achieve a lifetime of sustainable changes. The healthcare provider team includes board-certified medical specialist, registered dietitian and wellness coach. The first step is an Initial Health Assessment with the medical doctor for an in-depth evaluation and treatment plan recommendation. Appointments can be scheduled online or by calling 561-621-1096. Be sure to download our Ebook on Heart Disease & Nutrition.