An important aspect about being heart-healthy is the balance between the energy you bring into your body (calories) and how many calories you burn during physical activity. If you end up consuming more calories than you burn, you are likely to gain weight. This is because your body stores the extra calories as fat. Indulging in a few extra calories at times is alright. But if this is frequent, and you also don’t engage in regular exercise, it can lead to you becoming overweight or obese. This can pose significant threats to your heart health.

Being overweight/obese is generally defined as having an excess of body-fat mass. In addition to lifestyle-related factors like excess calorie consumption, you may also be vulnerable to becoming overweight/obese due to various genetic and environmental factors. If you're wondering how to tell if you are overweight/obese, it’s by calculating the ‘body mass index’ (BMI). Below are the generally accepted classifications for overweight/obesity based on the BMI:

There is a catch with the overweight/obesity classifications above — South Asians are at higher risks of heart disease at even lower BMIs. A BMI between 23 and 24.9 kg/m2 is considered overweight for South Asians, while a BMI greater than 25 kg/m2 is considered obese.

Obesity/overweight has become a serious public health problem. In 2016, the World Health Organization estimated that around a whopping 40% of the world’s adult population was overweight, while around 13% was obese. As India has transitioned to a largely sedentary lifestyle with calorie-dense diets, the burden of overweight/obesity has also risen. Between 2010 and 2040, the number of obese Indians is projected to triple.

Being overweight/obese is linked with a range of adverse health effects, including heart diseases. If you are overweight/obese, you are more susceptible to serious heart diseases like atherosclerosis, ischemic heart disease, and heart failure. Hence, it’s more important than ever to be vigilant about maintaining or reducing your body weight to lower your risk of life-threatening heart diseases.

How Does Being Overweight/Obese Affect My Heart and Blood Vessels?

Your body weight and appetite is not only dictated by what you eat, but also by special tissues, hormones, the digestive system, and the nervous system. Excess body fat can affect the functioning of these components, which in turn can harm parts of your cardiovascular system.

Adipose tissue is a special type of tissue which stores energy in the form of fats. Simply put, this is the fat that you feel under your skin (subcutaneous fat) and surrounds your organs (visceral fat). You can read more about these types of fats and their impact on heart health in our previous blog about the hidden dangers of belly fat.

Adipose tissue produces a hormone (adiponectin) in high amounts in healthy and lean people. But in obese people, this hormone does not get produced as much. This, in combination with high fat/adipose tissue levels, can increase inflammation in the body. Inflammation can damage the blood vessels and lead to atherosclerosis, and can also contribute to metabolic syndrome.

Overweight/obesity can also damage the endothelial cells, which are special cells that line the inner walls of the blood vessels. Usually, the hormone adiponectin ensures that the endothelial cells can relax the blood vessels and regulate fatty plaque deposition in the walls of the blood vessels. But lower levels of adiponectin can lead to the improper functioning of the endothelial cells. Damage to the endothelial cells can increase the risk of atherosclerosis, hypertension (high blood pressure), and high ‘bad’ cholesterol levels in the blood vessels.

Being overweight/obese can also cause your body to not respond properly to the action of insulin, an important hormone in regulating blood sugar levels. This state of insulin resistance can make you more vulnerable to type 2 diabetes, a major risk factor for heart disease.

Hence, the biological processes linked with obesity can heighten your risk of atherosclerosis, diabetes, high blood pressure, and structural changes in the heart. All of these can in turn make you more vulnerable to heart diseases like ischemic heart disease and heart failure.

So How Do I Manage My Weight?

This is the burning question that most of you have. Majority of you are well-aware of the various ways to maintain a healthy weight, but putting your knowledge into practice may be the hard part. When trying to maintain or lose weight, consider this a golden rule – spend more calories than you consume. You can follow this rule with simple lifestyle changes. Below are a few basic tips to help you keep track of your weight and heart health:

• Calculate your BMI to get an idea about whether you are overweight/obese or borderline overweight/obese. All you need is a weighing scale, measuring tape, and calculator. Measure your weight using the weighing scale, and your height from head to toe using the measuring tape. Use this formula to then calculate your BMI:

BMI = (Weight in kilograms) / [ (height in meters) x (height in meters) ]

For example, if your weight is 65 kg and your height is 1.63 meters:

BMI = (65 kg) / (1.63 m x 1.63 m)

= 65 / 2.6569

= 24.5 kg/m<sup>2</sup>

It is important to remember that the BMI has some limitations — it does not account for age, gender, or muscle mass, and you cannot tell whether the excess weight comes from fat, muscle, or bone. Another important thing to note is that waist size also matters. Excess belly fat raises your risk of heart attacks and strokes and is essential to consider when talking about weight loss. Read more about how to measure your waist here.

• Avoid foods high in saturated fats, trans fats, refined carbohydrates, and refined sugar. These are major culprits behind excess weight gain. Control your food portions and load up on fibre-rich foods as they keep you fuller for longer. Read more about a heart-healthy diet and heart-healthy food swaps in our previous blogs.

• Regular physical activity can do wonders during your weight loss or maintenance journey. Read more about the impacts of exercise on heart health and how you can incorporate more physical activity into your daily routine here.

Remember, your weight may not always be under your control. You may become or be overweight/obese because of another underlying health condition. But this should not discourage you from taking the first step of pledging to shed some kilos and lead a heart-healthy lifestyle. Given the higher risk of overweight/obesity and heart disease in South Asians, it is essential for you to be proactive about maintaining or reducing your weight. If you have any doubts about ways to lose weight, it is best to consult your doctor for possible interventions. So, don’t take it easy with your and your family’s heart health!

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