Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study
European Journal of Preventive Cardiology, 2022
Abstract
The study highlights the widespread issue of obesity and the associated increased risk of cardiometabolic health problems. Recent evidence suggests that having a high cardiorespiratory fitness (CRF) can offset the harmful impacts of overweight or obesity on cardiometabolic health, a notion referred to as the ‘fat but fit’ paradox.
A meta-analysis found that despite overweight/obesity and low CRF both increasing mortality risk from cardiovascular diseases (CVD), low CRF is a stronger predictor.
The study suggests that while increasing physical activity is important, weight loss should remain a primary target in health policies aimed at reducing CVD risk in people with overweight/obesity.
These insights contribute to a comprehensive understanding of the interplay between physical activity, weight, and cardiometabolic health, offering a more nuanced perspective that can guide public health initiatives and personal lifestyle choices
The study refutes the 'fat but fit' paradox, stressing the importance of weight loss in combination with physical activity to alleviate risks of cardiovascular diseases.
Where does it apply?
This study underlines the importance of weight management and physical activity for cardiovascular health, which is applicable in healthcare, public health policy formulation, health education campaigns, personal health strategies, and the fitness industry.

Why does it matters?
This study’s findings are significant as they challenge the ‘fat but fit’ paradox and highlight the enduring harmful effects of obesity on cardiovascular disease (CVD) risk, irrespective of physical activity levels.
It emphasizes that while physical activity does help mitigate some of obesity’s negative impacts, overweight or obese individuals still carry higher odds for hypercholesterolemia, hypertension, and diabetes compared to their normal-weight counterparts.
Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study
European Journal of Preventive Cardiology, 2022

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