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Recent research findings report the critical role of fat distribution in assessing cardiovascular risk among individuals categorized as metabolically healthy obese (MHO).

Led by DZD researchers Matthias Schulze and Norbert Stefan, the review challenges conventional wisdom by emphasizing that not all obesity carries equal risk.

Traditional health metrics like high blood pressure, elevated fasting blood glucose, and abnormal lipid levels typically define metabolic health. However, the study, published in Nature Reviews Endocrinology, found that individuals deemed metabolically healthy-those with fewer than two risk factors and no medication-are not uniformly protected.

Distinct subgroups, such as metabolically unhealthy normal weight (MUHNW) and MHO, exhibit significant variations in cardiovascular disease susceptibility.

Contrary to earlier assumptions, MHO individuals with favorable fat distribution do not face significantly increased mortality risk from cardiovascular disease compared to their metabolically healthy, normal-weight counterparts.

According to Mirage News, meta-analyses consistently showed that MHO individuals face a roughly 50% higher cardiovascular disease risk compared to metabolically healthy normal-weight (MHNW) individuals.

This risk pales in comparison to the much higher risk seen in MUHNW individuals, whose cardiovascular risk can be twice that of MHNW counterparts.

"These data support that body fat distribution should be taken into account when defining metabolic health," said Matthias Schulze, head of the Department of Molecular Epidemiology at the German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE).

Schulze and his team advocate for a nuanced approach that considers waist-to-hip ratios alongside traditional risk factors.

Norbert Stefan, Professor of Clinical Experimental Diabetology at the University Hospital of Tübingen, added, "BMI does not adequately reflect the metabolic abnormalities associated with the accumulation of internal abdominal fat and fat in the liver in both people with obesity and those of normal weight."

The review underscored that genetic predispositions affecting fat storage patterns-such as reduced capacity in the lower body-can independently elevate cardiovascular risk.

While MHO individuals exhibit lower cardiovascular risk compared to metabolically unhealthy obese individuals, they are more prone to developing type 2 diabetes over time. This showed the importance of proactive lifestyle interventions for all metabolic health categories.

Schulze and Stefan emphasized that lifestyle modifications involving weight management, physical activity, and dietary improvements can significantly enhance or maintain metabolic health.

Understanding metabolic health beyond BMI and embracing tailored interventions can mitigate cardiovascular risks associated with different body compositions. This approach not only aids in patient communication but also informs personalized treatment strategies in clinical practice.