Overweight and Healthy

Some obese people show little evidence of diseases linked to unhealthy diets

We know that excess weight, and especially obesity, can lead to heart disease and diabetes. But not all obese people have the same risk factors for disease. In fact, some extremely overweight people are actually “metabolically healthy,” meaning that they exhibit few symptoms of metabolic syndrome, such as high blood pressure, high blood sugar and high cholesterol.

A recent study published in Preventive Medicine sought to determine whether there is something special about the dietary patterns and nutrient intakes of metabolically healthy obese people.

The researchers found that overall, the obese people studied had pretty low dietary quality. Photo: Scott Bauer/USDAThe researchers found that overall, the obese people studied had pretty low dietary quality. Photo: Scott Bauer/USDA
The study, a collaboration among researchers at the University of Massachusetts, Brown Medical School, Tufts University School of Medicine and the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts, used dietary and health data from the National Health and Nutrition Examination Survey to examine the diets of more than 1,200 obese adolescents and adults.

The researchers gave every individual’s diet a score on the Healthy Eating Index (HEI), which awards points for healthy food behaviors, like eating more vegetables, fruits and whole grains. Points are also given for low intakes of solid fats, alcohol and added sugars. Each diet can receive a score of up to 100; the higher the score, the healthier the diet.

They found that compared to their metabolically unhealthy peers, the metabolically healthy adolescents and adult women under age 45 had higher HEI scores, indicating relatively healthy diets.

However, HEI scores were not linked to metabolic health in adult men or in women age 45 and older. The researchers also found that overall, the obese people in the study had pretty low dietary quality; in fact, the group with the highest HEI score, the metabolically healthy adults ages 45 to 85, averaged only a lackluster 56 out of a possible 100 points.

The findings could be useful for future interventions to reduce disease risk in obese people, especially if started early in life.

This article first appeared in the Winter 2016 issue of Tufts Nutrition magazine.

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