Overweight and obesity: the risks to the heart

Overweight and obesity are two conditions that are also extremely prevalent in Italy. National averages leave no room for doubt: 31.7 percent of adults are overweight and 10.7 percent are obese, with all the risks this poses to their hearts. In fact, excess fat poses a threat to cardiovascular health. Overweight and obesity are considered risk factors for heart attack, congestive heart failure, and hypertension, and also for type 2 diabetes and metabolic syndrome, other heart-threatening conditions.

The link between excess fat and heart risks

The reasons why excess fat can be so dangerous to 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 function. In particular, adipose tissue produces so-called adipokines, molecules that may have proinflammatory or anti-inflammatory properties.

When the body accumulates adipose tissue the latter undergoes a real transformation, starting to produce more proinflammatory adipokines and less anti-inflammatory adipokines. But that's not all: increased adipose tissue also increases the production of reactive oxygen species-molecules with oxidizing properties. The results are deleterious: alterations in glucose and fat metabolism, increased blood pressure, insulin resistance, inflammation, and alterations in blood clotting and blood vessel function. 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,taken together, contribute to the increased risks run by the heart.

The dangers of visceral and perivascular fat

In reality, however, not all fat deposits are equivalent: their danger to the heart depends on where they are located, their size, and also the balance between the different types of deposits in the body. In particular, the increased mortality associated with overweight and obesity depends on the fat that accumulates in the chest and abdominal regions; in fact, the most dangerous fat tissue is visceral fat, the fat that accumulates around the internal organs. In addition, adipose tissue that accumulates around blood vessels (called perivascular fat) also appears to be able to affect the functioning of the cardiovascular system. Like visceral fat, perivascular fat also releases factors that exert an action on blood vessels, adipokines, and other molecules associated with inflammation; therefore, its presence may influence vascular tone, blood flow, inflammatory processes, and oxidation status.

Better to prevent

For all these reasons, it is best to avoid accumulating excess fat. Parameters that can tell us whether we have too much of it include waist circumference and waist to hip ratio, which are more useful than the classic body mass index (the so-called BMI, from the English Body Mass Index) calculated from weight and height. Nutrition and physical activity are two tools that are as basic as they are simple to succeed in not gaining weight or, if necessary, losing weight. And not only that: together they can also help keep blood fat levels under control. In particular, physical activity helps maintain healthy levels of HDL, while a diet low in saturated fat and rich in Omega 3 helps keep bad cholesterol and triglycerides at bay.

Omega 3s can also be taken through fish oil supplementation; the best supplements among those on the market can be recognized through certifications (such as that issued by the Ifos program) that guarantee the high quality of the fatty acids they contain 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 Council for Agricultural Research and Agricultural Economics Analysis. Italian healthy eating guidelines. Control your weight and keep active. https://goo.gl/iXxE9H, 11/05/18 Fantoni F. "Obesity: the regional map of risk. Campania tops the list." Il Sole 24 Ore - Info Data - News told by numbers. 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 Ministry of Health. www.salute.gov. Obesity. https://goo.gl/ypHsya, 11/05/18 Image: Pixabay