Overweight and obesity: the risks for the heart

Overweight and obesity are two extremely widespread conditions in Italy as well. National averages leave no room for doubt: 31.7% of adults are overweight and 10.7% are obese, with all the risks this entails for their heart. Excess fat represents a threat to cardiovascular health. Overweight and obesity are considered risk factors for heart attack, congestive heart failure, and hypertension, as well as for type 2 diabetes and metabolic syndrome, other conditions dangerous for the heart.

The link between excess fat and heart risks

The reasons why excess fat can be so dangerous for the heart depend on the fact that adipose tissue is not just a simple fat store, but a true endocrine organ, that is, an organ capable of producing biologically active substances that control metabolism and cardiovascular functions. In particular, adipose tissue produces so-called adipokines, molecules that can have pro-inflammatory or anti-inflammatory properties.

When the body accumulates adipose tissue, it undergoes a real transformation, starting to produce more pro-inflammatory adipokines and fewer anti-inflammatory ones. But not only that: the increase of adipose tissue also raises the production of reactive oxygen species – molecules with oxidizing properties. The results are harmful: alterations in glucose and fat metabolism, increased blood pressure, insulin resistance, inflammation, changes in blood coagulation, and dysfunction of blood vessels. Overweight and obesity are associated with increased cholesterol, triglycerides, and blood pressure, and decreased HDL (High Density Lipoproteins, the so-called “good cholesterol”); all these phenomena together contribute to the increased risks faced by the heart.

The dangers of visceral and perivascular fat

In reality, however, not all fat deposits are equal: their danger for the heart depends on their location, size, and also the balance between different types of deposits present in the body. In particular, the increased mortality associated with overweight and obesity depends on the fat accumulated in the chest and abdominal regions; the most dangerous adipose tissue is indeed visceral fat, the fat that accumulates around internal organs. Additionally, adipose tissue that accumulates around blood vessels (called perivascular fat) also seems to influence the functioning of the cardiovascular system. Like visceral fat, perivascular fat releases factors that act on blood vessels, adipokines, and other molecules associated with inflammation; for this reason, its presence can affect vascular tone, blood flow, inflammatory processes, and oxidative status.

Better to prevent

For all these reasons, it is better to avoid accumulating excess fat. Among the parameters that can tell us if we have too much are waist circumference and waist-to-hip ratio, which are more useful than the classic body mass index (BMI) calculated based on weight and height. Diet and physical activity are two tools as fundamental as they are simple to avoid gaining weight or, if necessary, to lose weight. And not only that: together they can also help keep blood fat levels under control. In particular, physical activity helps maintain healthy HDL levels, while a diet low in saturated fats and rich in Omega-3 helps keep bad cholesterol and triglycerides in check.

Omega-3s can also be taken through fish oil supplementation; the best supplements on the market can be recognized thanks to certifications (such as that issued by the Ifos program) that guarantee the high quality of the fatty acids contained and the absence of contaminants. 

Sources: American Heart Association. Obesity Information. https://goo.gl/FYSdC1, 11/05/18 Costa RM et al. Perivascular Adipose Tissue as a Relevant Fat Depot for Cardiovascular Risk in Obesity. Front Physiol. 2018 Mar 21;9:253. doi: 10.3389/fphys.2018.00253 Consiglio per la ricerca in agricoltura e l'analisi dell'economia agraria. Linee guida per una sana alimentazione italiana. Controlla il peso e mantieniti sempre attivo. https://goo.gl/iXxE9H, 11/05/18 Fantoni F. “Obesità: la mappa regionale del rischio. Campania in cima alla classifica”. Il Sole 24 Ore – Info Data – Le notizie raccontate con i numeri. https://goo.gl/8tNkNU, 11/05/18 MedlinePlus. Health risks of obesity. https://goo.gl/AwbB3X, 11/05/18 MedlinePlus. Type 2 diabetes. https://goo.gl/H6eG46, 11/05/18 Ministero della Salute. www.salute.gov. Obesità. https://goo.gl/ypHsya, 11/05/18 Image: Pixabay