Obesity and Heart Health: What’s The Connection?

The World Health Organization (WHO) has declared obesity to be a public health crisis that requires imminent corrective action on a global scale.

Simply put, obesity and overweight means accumulation of excessive fat such that it can impair a person’s health.

While by definition the issue may seem simple, the on-ground reality is much complex.

Apart from genetical factors, lifestyle factors like unhealthy dietary habits and a sedentary lifestyle are pushing more and more people around the world into the bracket of obesity and overweight.

In adults, obesity also multiplies the risk of musculoskeletal disorders, diabetes, cancer, and more so, cardiovascular diseases (CVDs).

Let us explore how obesity and heart health share an intrinsic connection.

What is obesity?

A generally-accepted measure to see if one is obese or overweight, is to calculate the Body Mass Index (BMI). A BMI over 25 categorizes a person as overweight, whereas a BMI over 30 categorizes them as obese.

However, BMI is not always an accurate measure of obesity or overweight, because it cannot differentiate between weight gain due to muscle mass and weight gain due to fat deposition.

Hence, waist circumference or waist-to-hip ratio is often used to determine whether the weight gain is due to fat accumulation or not. A waist circumference of more than 102 cm in men and more than 89 cm in women is considered a marker for obesity.

A certain volume of fat is actually necessary for the human body to store energy, as well as, for shock absorption and heat insulation. But, an excessive or abnormal accumulation of fats leads to several non-communicable health problems, especially CVDs.

How does obesity affect your heart

Till recent times, it was considered that obesity increases the risk of heart diseases or CVDs, especially when accompanied by other markers like diabetes, high BP, or high cholesterol.

However, ongoing research points to obesity being capable of single-handedly increasing the risk for heart problems, even when unaccompanied by the said markers.

• That is because, increase in weight (as measured by BMI) is directly proportional to release of the hormone troponin, which is typically released by injured cells of the heart muscles.

Hence, obesity can be a strong reason for silent heart attacks.

Obesity also contributes to boosting the markers of heart disease and CVD.

• For instance, obesity causes a spike in bad LDL cholesterol and triglycerides, along with reducing the good HDL cholesterol levels. This double whammy has a debilitating effect on heart health because bad cholesterol starts building up as plaque in the arteries and restricts the supply of oxygenated blood and nutrients to the heart – thus causing heart attacks and the like.
• Obesity leads to high blood pressure because people with excessive body weight require more amount of blood to send nutrients and oxygen to the heart. Moving around this blood through the body also needs more pressure in obese people than in others. Prolonged high levels of blood pressure can start causing anginal pains that lead to microvascular disease (MVD).
• Obesity is an important contributor to developing type 2 diabetes by causing insulin resistance owing to increase in fatty acids and inflammation. High levels of blood sugar lead to damage of blood vessels and nerves controlling the heart. The sugar that does not get used by the body gets stuck to the blood cells, thus damaging them and preventing them from carrying oxygenated blood to the optimum. Lack of nutrient- and oxygen-rich blood makes a diabetic person vulnerable to heart diseases and CVDs.

Obesity, when it occurs due to deposition of excessive fat, can become directly causative to heart problems.

Distribution of fats and consequences for heart health

An important aspect of obesity leading to weakened heart health is the location of excessive fat deposition/accumulation.

There are two main types of fat distribution that can prove causative for heart problems even when a person’s BMI may be normal, or, they may not have other prominent markers of heart disease/CVDs.

One is visceral fat accumulation i.e., accumulation of fats around the belly. When fat deposits sit around the belly, they lead to higher levels of blood lipids (known as hyperlipidemia) and systemic & vascular inflammation.

Both these factors can hasten the development of plaque in the arterial walls (atherosclerosis) and restrict the supply of oxygenated blood to the heart, thus leading to strokes or heart attacks. It can also lead to the onset of CVDs.

Visceral fat distribution is associated with low HDL cholesterol, high blood pressure, high blood sugar, and excessive triglycerides – all causative factors for various heart and vascular diseases.

Visceral fat accumulation in men and pre-menopausal women happens primarily due to a high-fat diet. Men are more prone than women for this type of fat deposition.

In menopausal women, visceral fat accumulation happens because menopause causes redistribution of adipose tissue to direct it towards to middle section, thus increasing the risk of diabetes and heart disease in this bracket of women.

The other type of fat distribution is ectopic fat accumulation i.e., fat accumulation in various parts or organs of the body. These could include muscles, pancreas, liver, kidney, heart, blood vessels and even the neck. Excessive ectopic fat can lead to several CVDs.

Muscles or the liver affected by fat accumulation can adversely affect the glucose and lipid metabolism.

Ectopic fat around the heart can be segregated into four types viz., myocardial fat, pericardial fat, pericoronary fat, and perivascular fat. These lead to lipotoxicity (accumulation of lipids in non-adipose tissues) and cytokine secretion, thus harming the heart and blood vessels, both.

Fat accumulation in the renal arteries is known as renal sinus fat and can lead to high blood pressure and other cardiovascular risks, apart from chronic kidney disease (CKD), which again puts excess stress on the heart and leads to heart diseases.

Fat accumulation in the pancreas can cause negative changes in insulin resistance and glucose metabolism – thus increasing various cardiovascular risks.

Comparatively, subcutaneous fat deposits (fats stored under the skin) are not so much of a risk for heart disease unless there’s too much of it.

Symptoms of obesity-induced heart problems

Let us look at some factors that can signal an impending heart problem that is induced by excessive weight.

• Shortness of breath: Your breathing gets labored after even a bit of exertion
• Fatigue: You feel tired even after a bit of activity, or even without
• Difficulty in sleeping: When fat deposits in the upper respiratory tract cause the airway to narrow, it leads to a sleep disorder called Obstructive Sleep Apnea.
• Snoring: Accumulation of ectopic fat in the neck area can lead to compression of the upper airway, thus making a person snore constantly and loudly
• Excessive sweating: Sweating more than normal, especially at night, can be due to fat deposits.

If you notice any such symptoms, it’s time to stand on that weighing scale and then visit a doctor to see if your weight is becoming a weak link for your heart health. 

How to tackle obesity-induced heart problems?

The first step to tackle obesity-induced heart problems is to tackle obesity before it starts leading to heart problems.

For a better part, obesity and overweight can be tackled through lifestyle changes. The key to prevent them from becoming fatal in terms of heart problems, is to start making lifestyle changes well in time.

• Get moving: A sedentary lifestyle leads to hastening of a probable heart problem. It can also contribute to adding to your weight and lead to other problems. Hence, make it a point to go for a brisk walk, or, start swimming. Wherever possible, climb stairs instead of taking an elevator. Small measures like these can go a long way to control your weight.
• Change your dietary habits: Cut down or stop your intake of unhealthy processed foods with high artificial sugars and saturated fats. They not only give just temporary satiation, but also contribute to harming your health in multiple ways. Instead, opt for fiber-rich foods, whole foods, raw fruit, and such other healthy options which will control your weight and also increase the body’s overall health quotient.
• Get proper sleep and cut down on stress: A peaceful, undisturbed sleep can go a long way in maintaining one’s weight by rectifying the imbalance of leptin and ghrelin hormones that happens during sleep loss. So also, freeing oneself from the shackles of stress by venting it via positive means such as meditation, yoga, or some hobby can dramatically cut down on stress-induced obesity, while also reducing cortisol-induced inflammation that directly causes heart ailments.
• Surgical options: If your level of obesity is too high to get cut down by the aforesaid factors, or, it has already started causing anginal or cardiac discomfort, there are surgical options to reduce and control excessive weight gain. These are known as bariatric surgeries, and are seen to reduce the probability of cardiovascular mortality by 65%.

Most medical experts will encourage people to lose weight first by lifestyle and dietary changes. Surgical procedures are resorted to only if no other option works.

Conclusion

Obesity can have several ill-effects on your heart health.

While genetic factors are not in your hands, it is certainly possible to not pile on weight, or, cut down on excessive weight by carrying out simple modifications to one’s way of life.

Heart and vascular diseases develop over time (unless congenital in nature), even if they’re obesity-induced. Shrug off complacency and work towards maintaining your weight and consequent heart health in an organic way.