Lorna PapeObesity, metabolic risk and adherence to healthy lifestyle behaviours: prospective cohort study in the UK BiobankLaura Heath, Susan A. Jebb, Paul Aveyard & Carmen Piernas15 February 2022https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02236-0
Contested evidence suggests that obesity confers no risk to health in people who have a healthy lifestyle, particularly if there are no metabolic complications of obesity. The aim was to examine the association between adherence to lifestyle recommendations and the absence of metabolic complications on the incident or fatal cardiovascular disease and all-cause mortality across different categories of body mass index (BMI).
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The study found that meeting all 4 healthy lifestyle recommendations, offsets some, but not all, of the risk of subsequent CVD, and premature mortality in people who are obese. With each additional recommendation which was met, the risk of CVD and death was lowered, with adherence to guidelines on not smoking showing the most impact. However, it also found that those with a healthy BMI who did not follow any of the recommendations were actually most at risk of death.
This study supports the BALM protocol approach, and confirms that increasing fibre in the diet by eating a range of fruit and vegetables, and incorporating functional movement / exercise are important factors to protect against the risk of CVD and death. It also demonstrates that relying on a healthy BMI alone will not be sufficient to protect against those risks, and even those who are not overweight should be incorporating these factors into their diet and lifestyle.