In Europe, 51.6% of adults are overweight (1). Being obese not only increases your risk of high blood pressure, heart disease and diabetes, but also makes you more likely to have a stroke, particularly if you are carrying extra weight around your stomach (2). Fortunately, this is yet another risk factor that can be potentially altered through a healthy diet, exercise and other lifestyle changes.

How do I know if I’m overweight or obese?

You probably already know if you’re carrying extra weight, but it’s worth checking your body mass index (BMI) to find out exactly where you sit on the scale. The World Health Organization (WHO) defines being overweight or obese as: “the disease in which excess body fat has accumulated to such an extent that health may be adversely affected” (3). You can easily find out if you are heavier than you should be for your height by working out your BMI.

What your BMI says about you

Body Mass Index (BMI) is calculated by dividing your weight in kilograms by the square of your height in metres. This result helps to determine the difference between being a little overweight or being morbidly obese.

Overweight
BMI: 25 to 29.9

Obese
BMI: Over 30

Morbidly obese
BMI: Over 40 (4)

How is obesity linked to stroke?

The relationship between abdominal obesity and stroke is long established, particularly where other conditions are also present, such as diabetes, high blood pressure and high cholesterol. But there are different opinions as to why the risk is increased in overweight people.

Some studies suggest BMI alone is not a good indicator for stroke risk. Instead, researchers claim excess stomach weight may be a stronger predictor (2). A waist measurement of over 40 inches in men and over 35 inches in women is classed as abdominal obesity (5).

Why is waist-to-hip ratio (WHR) important?

Your waist-to-hip ratio (WHR) essentially tells you if you are carrying excess weight around your stomach – and this directly relates to your stroke risk. Start by measuring your waist and the widest part of your hips; then divide the waist measurement by the hip measurement. Abdominal obesity is defined as a waist-to-hip ratio above 0.90 for men; and over 0.85 for women (3). For every 0.01 increase in WHR, your stroke risk increases by 5% (6).

How can I reduce my risk of stroke?

Obesity is linked to stroke, regardless of age or other cardiovascular risk factors (7). Therefore, it makes sense that reducing your weight will reduce your chance of having a stroke.

There are several ways you can reduce body fat, including introducing more exercise, lowering your salt intake, cutting down on alcohol and eating a healthy diet that’s low in saturated fat, and high in fruit and vegetables. A Swedish study showed a significant reduction in diabetes, heart attack and stroke when patients met more than 3 healthy lifestyle goals (8).

References:

1. Eurostat. Overweight and obesity – BMI statistics. 2014. Accessed June 7th. https://ec.europa.eu/eurostat/statistics-explained/index.php/Overweight_and_obesity – BMI_statistics.

2. (Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration et al, 2014). Suk et al (2003).

3. World Health Organization (WHO). Obesity: preventing and managing the global epidemic. WHO Technical Report Series 894, World Health Organization, Geneva, Switzerland, 2000.

4. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report: National Institutes of Health. Obes Res 1998;6 (suppl 2):51S-209S.

5. Wildman RP et al. Cardiovascular disease risk of abdominal obesity vs. metabolic abnormalities. Obesity (Silver Spring).2011;19:853-860.

6. De Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J. 2007;28:850-856.

7. Prospective Studies Collaboration; Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083-1096.

8. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial: a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219-234.

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