Naturally-thin people who don’t have to watch what they eat or exercise to stay in shape are putting their health to risk. Cardiologists say thinness is not always an indication of good health because levels of artery-clogging ‘bad’ cholesterol — or low density lipoprotein (LDL) — in the blood are higher in thin inactive people than in overweight people who exercise.
“Most thin people think they don’t need to exercise because they don’t have to watch their weight, but they are wrong. They need as much exercise to stay healthy because exercise pushes down LDL cholesterol, increases heart-protecting good cholesterol (high density lipoprotein or HDL) and keeps blood pressure in check,” says Dr Ashok Seth, chairman and chief cardiologist, Max Heart and vascular institute.
30 per cent of all deaths are caused by CVD
5 million will die of CVD by 2020
50 per cent of these deaths are under 70 years
10 per cent people aged 20 in urban India have CVD
India lost USD 9.2 million potentially productive years of life to CVD in 2000
India will lose USD 18 million potentially productive years of life to CVD by 2030
32 million people have diabetes
70 million will have diabetes by 2025
118 million have hypertension (high blood pressure)
213 million people will have high blood pressure by 2025
When too much LDL cholesterol circulates in the blood, it slowly deposits on the inside walls of the arteries as a thick, hard deposit called plaque. If the block is big enough to stop blood flow, it can cause a heart attack or stroke. LDL cholesterol of less than 2.59 mmol/l is the optimal level, and more than 4.14 mmol/l shows heightened risk of heart disease.
“Naturally thin people do not enjoy protection from heart disease as people with any type of body shape can have high cholesterol. Overweight people are more likely to have high cholesterol, but thin people should also get their cholesterol checked regularly,” says Dr KK Agarwal, chief cardiologist, Moolcand Medcity. A study published in International Journal of Obesity in 2007 reported that lean people who exercise have near-optimal levels of LDL-cholesterol, while lean non-exercisers had high levels of bad cholesterol.
“The term for people with normal weight with high levels of body fat and cholesterol is normal weight obesity. Most of my thin patients are stunned when they are diagnosed with heart disease because they think it is a disease that afflicts only the overweight and obese,” he explains.
Often, people who don’t gain weight easily tend to eat more fatty food laden with heart-damaging saturated and transfat. “More than your weight, it’s your lifestyle that defines your heart risk. Naturally thin people do not enjoy protection from heart disease, so nobody can say they can eat anything they want without worrying about heart disease,” says Dr Seth.
Exercise alone can lower the risk of heart disease by 20 per cent. “We have found that thin people who are hypertensive have worse coronary artery disease and more complications associated with peripheral vascular disease because their artery walls are thinner and more prone to damage,” says Dr Seth.
This, of course, does not mean you can put on as much weight as you like. “A retrospective survey of 90 people at Moolchand showed most of them gained about 10 kg in 10 years after the age of 18 years. The normal weight gain after adolescence should not exceed 5 kg. People who gain 10 kg more are at risk of diabetes, and if the weight gain is over 30 kg, they have probably developed heart disease and diabetes,” says Dr Agarwal. The study included people from all cross-sections — 30 resident doctors, 30 nurses and 30 patients — 95 per cent of who had gained weight.
“The bottomline is that everyone needs to eat healthy and get physically active regardless of their weight,” says Dr Agarwal.