# For the Heart, Metabolic Health Often Outweighs Body Weight

_Evidence Level: Moderate · Ghorbani Z et al., International journal of obesity (2005), DOI 10.1038/s41366-026-02237-6_

*Metabolic health is a stronger determinant than obesity for cardiovascular disease incidence: a meta-analysis of longitudinal cohort studies.*

- **Evidence Level**: Moderate
- **Why this grade**: Pooled data from 44 studies that followed people for years; observational data show links but cannot prove cause and effect.
- **Facts**: Design: Meta-analysis
- **Publication Types**: Journal Article, Review
- **Journal**: International journal of obesity (2005)
- **Sample Size**: 44 cohort studies
- **Authors**: Ghorbani Z, Soltani S, Aune D, Khandouzi N, Noormohammadi M, Kazemi A
- **Graded and published**: 2026-10-17
- **Last edited**: 2026-10-21
- **Topics**: Heart Health, Metabolic Health
- **DOI**: https://doi.org/10.1038/s41366-026-02237-6
- **Original Source**: https://pubmed.ncbi.nlm.nih.gov/42892649/

## Summary

People of normal weight with unhealthy metabolism often had a higher risk of heart and blood vessel disease than people with obesity whose metabolism was healthy. That is the picture from an analysis that pooled 44 long-term studies. The risk was highest when both came together.

The researchers searched two large medical databases up to January 2025. They found 44 studies that had followed people over years. They sorted participants by weight and by whether their metabolism was healthy. Compared with normal-weight people with healthy metabolism, people with obesity and unhealthy metabolism had about twice the risk of heart and blood vessel disease. Heart attacks and heart failure showed a similar pattern. For stroke, risk depended mainly on metabolic health.

Weight and metabolism were each linked to risk on their own. But the studies only observed people; they did not treat them. So they cannot show whether improving metabolism actually lowers heart risk.

## Practical Takeaway

Normal weight with unhealthy metabolism was often linked to more heart risk than obesity with healthy metabolism.

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_Canonical: https://longevity-germany.com/en/research/for-the-heart-metabolic-health-often-outweighs-body-weight · Part of Longevity Cities · Updated 2026-10-21_