Being Active May Counter Effects of Obesity on Cardiovascular Disease

US and European guidelines recommend 150 minutes per week of moderate physical activity.

Physical activity offers benefits that may offset how being overweight puts a person at risk for cardiovascular disease, especially for those who are middle-aged or elderly, according to a new study.

The findings, published in the European Journal of Preventive Cardiology, examined 5344 adults aged 55 to 97 years who were enrolled in the Rotterdam Study. None had cardiovascular disease when they entered the study. Data on physical activity, body mass index (BMI), smoking habits, alcohol use, diet, education, and family history of heart attacks were collected.

Over 15 years of follow-up, 16% of the study subjects had a cardiovascular event, such as a heart attack or stroke. An analysis showed that physical activity was linked to decreased risk of cardiovascular disease, regardless of BMI. There was no association of BMI alone and cardiovascular disease.

The study also examined the joint effect of physical activity and BMI. Among those with high levels of physical activity, those at normal weight (18.5 kg/m2 to 24.9 kg/m2) had no advantage over those who were overweight (25 kg/m2 to 29.9 kg/m2) or obese (30 kg/m2 or higher). But among those with low levels of physical activity, the overweight and obese patients had 1.33 and 1.35 times greater risk of developing cardiovascular disease, respectively.

Study author Klodian Dhana, MD, PhD, DSc, noted that while overweight persons are always advised to lose weight, “People who engage in high levels of physical activity are protected from the harmful effects of adipose tissue on cardiovascular disease,” he said in a statement.

Of note, the Rotterdam Study group were all comparatively active, as the “low activity” group had 2 hours of activity a day while the “high activity” group had 4 hours. Physical activity guidelines in both the United States and Europe recommend at least 150 minutes per week of moderate activity, and US guidelines say 70 minutes of intense activity can achieve the same benefits.

The US Surgeon General has warned about the need for Americans to increase physical activity levels, recommending that just walking 22 minutes a day could bring health benefits. And the American Diabetes Association recommended last fall that persons with diabetes should interrupt long periods of sitting every 30 minutes with steps or stretching.


Koolhaus CM, Dhana K, Schoufour JD, et al. Impact of physical activity on the association of overweight and obesity with cardiovascular disease: The Rotterdam Study [published online March 1, 2017]. Eur J Prev Cardiol. 2017. DOI: 10.1177/2047487317693952