Exercise Counteracts Obesity's Impact on Heart Health in the Elderly

01 Mar 2017 --- The benefits of physical activity may outweigh the impact of overweight and obesity on cardiovascular disease in middle-aged and elderly people, according to research published today in the European Journal of Preventive Cardiology.

“Overweight and obesity is associated with a higher risk of cardiovascular disease and it is recommended to lose weight,” said author Dr. Klodian Dhana, a postdoctoral researcher in the Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands.

“But in the elderly this is slightly different because weight loss, especially unintentional, is associated with muscle loss and death.”

“Physical activity is associated with a lower risk of cardiovascular disease regardless of age,” he continued.

“We investigated the combined impact of body mass index (BMI) and physical activity on cardiovascular disease in the middle age to elderly population.”

The study included 5,344 individuals aged 55 to 97 years of age (average 70 years) who participated in the Rotterdam Study and were free of cardiovascular disease at baseline.

Information about BMI, physical activity, smoking, alcohol use, diet, education, and family history of premature heart attack was collected during the enrolment period in 1997 to 2001.

When analyzed alone, physical activity was associated with a decreased risk of cardiovascular disease regardless of BMI.

There was no association between BMI alone and cardiovascular disease.

Ukactive Public Affairs Director Huw Edwards told NutritionInsight: “There is now clear consensus on the importance of an active life as by meeting recommended levels of physical activity, your risk of heart disease, stroke and type 2 diabetes can be reduced by up to 50%."

“We need to ensure that health professionals, a trusted source of advice especially for older people, are supported and confident in recommending physical activity to people irrespective of their capacities and abilities; whether that be simply walking home with the shopping or pottering around in the garden."

“The unique benefits of physical activity, described as ‘a miracle cure’ by both The Association of Medical Royal Colleges and NHS CEO Simon Stevens, is often lost in the national obesity debate, as we tend to focus on the size of our waists rather than the health of our hearts. There’s a great opportunity to build new partnerships that support a healthy life, based around both diet and activity.”

Discussing the results of the study, Dr. Dhana said that, "In the overall population, we found that physical activity was protective for cardiovascular risk."

“Overweight and obese participants were not at increased cardiovascular risk compared to those of normal weight.”

“We do not refute the risk associated with obesity in the general population even though we did not find it in this older group. BMI may not be the best way to measure adiposity risk in the elderly.”

The researchers also analyzed the joint effect of physical activity and BMI.

Compared to normal weight people with high physical activity levels (the ideal), overweight or obese individuals with high levels of physical activity were not at increased risk of cardiovascular disease, but overweight or obese people with low levels of physical activity had 1.33 and 1.35 times higher risk for developing cardiovascular disease, respectively.

“Our results show that physical activity plays a crucial role in the health of middle age to elderly people,” said Dr. Dhana.

“Those who are overweight and obese without adequate physical activity are at higher risk of developing cardiovascular disease.”

Overweight and obesity exert harmful effects through adipose tissue, which accelerates the atherosclerotic process and increases cardiovascular risk. Physical activity lowers the harmful effects of atherosclerosis by reducing the stabilization of plaques on blood vessels and reducing the heart’s oxygen demand.

“People who engage in high levels of physical activity are protected from the harmful effects of adipose tissue on cardiovascular disease,” said Dr. Dhana.

“This may be why we found that the beneficial impact of physical activity on cardiovascular disease outweighs the negative impact of BMI.”

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, told NutritionInsight, “Research has shown that being active reduces your risk of developing heart disease, no matter how old you are."

"This study reinforces this message, although suggests in elderly people keeping fit may be even more beneficial than not gaining weight."

“This is no excuse to ignore your waistline though. The safest bet in lowering your risk of heart disease is to pay attention to a range of factors including your weight, the amount of physical activity you do and the quality of your diet.”

The Rotterdam Study was an active population, with the ‘low’ and ‘high’ groups doing two and four hours of daily activity. This included biking and walking to the shops and housework.

Dr. Dhana said the important point was that the study compared the two groups and found that more activity was better for health.

“Any physical activity is positive for cardiovascular health and in elderly people of all weights walking, biking and housework are good ways to keep moving,” said Dr. Dhana.

“European guidelines recommend 150 minutes a week of moderate-intensity physical activity to decrease the risk of cardiovascular disease.”

by Hannah Gardiner