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Regular exercise is one way to maintain body weight. Maskot/Getty Images
  • Researchers people with body mass index measurements that fluctuate between high and low have higher risks of serious cardiovascular issues.
  • Experts say the variations in body mass index can put additional strain on the heart and other organs.
  • They add that regaining weight also tends to produce abdominal fat.
  • They say that regular exercise and a healthy diet are two ways to maintain body weight at a healthy level.

Having a high body mass index (BMI) may be linked to a wide range of health issues, which can ultimately result in serious cardiovascular conditions.

According to a new study, highly variable BMI was associated with adverse cardiovascular events. Highly variable BMI is repeated fluctuations in weight.

The findings were published in JAMA Network Open: Cardiology.

Researchers analyzed data gathered from the Million Veteran Program between 2011 and 2018 and participants in the UK Biobank enrolled between 2006 and 2010. The follow-up was an average of nearly 4 years.

Researchers reported that increased BMI fluctuation was associated with adverse cardiovascular events regardless of common cardiovascular disease risk factors and genetic risk.

They said the findings indicate that highly variable BMI could be linked to a high-risk phenotype for cardiovascular disease.

BMI is associated with increased levels of adipose (fat) in your body and, in turn, can lead to numerous chronic health conditions.

“We know that central obesity and, in turn, waist circumference are independent risk factors for the development of atherosclerotic cardiovascular disease (i.e. stroke, heart attack, coronary artery disease, and peripheral vascular disease), diabetes, and kidney disease,” Dr. Hosam Hmoud, a cardiology fellow at Northwell Lenox Hill Hospital in New York who was not involved in the study, told Healthline.

Elevated levels of adipose tissue release pro-inflammatory chemical messengers in the body that accelerates the development of high cholesterol and inflammation leading to plaque buildup in your arteries (atherosclerosis), insulin resistance which causes diabetes, and high blood pressure (hypertension), Hmoud explained.

Having a BMI in the normal range is an important marker for overall health for a number of reasons, experts say.

“Excess weight puts additional burden on the heart, the circulatory system, and the joints in the body,” said Brooke Aggarwal, an assistant professor of medical sciences and behavioral cardiology expert at Columbia University Vagelos College of Physicians and Surgeons in New York who was not involved in the study.

“Excess adipose tissue also leads to increased blood pressure, elevated triglycerides and cholesterol, and poor blood sugar control, which contributes to increased risk for developing cardiovascular disease, the leading cause of death globally,” Aggarwal told Healthline.

BMI as it relates to overall health is a U-shaped relationship.

“Very low or high BMI associated with increased morbidity and mortality,” John Higgins, a sports cardiologist with UTHealth Houston who was not involved in the study, told Healthline.

Here is a general guideline:

  • Optimal for adults is BMI between 18.5 and 25
  • BMI less than 18.5 – A person is considered underweight
  • BMI between 25 and 30 is considered overweight
  • BMI over 30 is considered obese.

Highly variable BMI may be associated with cardiovascular events in several different ways.

“It’s possible that every time the weight is regained, cardiovascular risk factors such as blood pressure, cholesterol, and glucose inch higher, above the baseline level, and this is known as the ‘repeated overshoot theory‘,” Aggarwal said.

In addition, weight that is lost is usually a mix of fat and some lean muscle tissue, whereas weight that is regained is typically all adipose tissue, he explained.

This fat may be preferentially deposited in the abdomen and abdominal fat has been strongly associated with risk for cardiovascular disease.

To improve your BMI, Hmoud recommends 30 minutes of adequate exercise at moderate intensity for at least 5 days per week.

He also suggests modifying your diet to include more Mediterranean-based foods (i.e. olive oil, fish, vegetables), and seeing your primary doctor on a regular basis to monitor your weight.

“BMI reduction decreases the rate of major adverse cardiovascular events, including stroke and heart attack, by decreasing basal levels of inflammation, lowering blood pressure and blood sugar, and improving your gut health, which also decreases inflammation,” said Hmoud. “Supplementation of a healthy lifestyle with weight loss drugs such as GLP-1 RA (semaglutide) may also be helpful in the setting of refractory weight loss efforts.”

When thinking about BMI, experts say it’s important to consider the bigger picture in terms of lifestyle and developing healthy long-term habits.

“I think the study highlights the importance of trying to achieve a healthy body weight in a sustainable way and one that can become a lifestyle rather than a short-term fix. Conventional diets that focus on eliminating entire food groups and severe calorie restriction often fail to yield sustained weight reduction and health benefits,” Aggarwal said.

Strict short-term diets can lead to a pattern of restricting and bingeing over the long-term. Intuitive and/or mindful eating is a more achievable approach to weight management that may lead to gentle weight loss long-term and improvement of other physiological parameters, such as inflammation, Aggarwal explained.

“We and others have also shown that eating a large percentage of one’s total daily calories in the evening meal is associated with greater risk of elevated BMI and blood pressure, so eating the majority of your calories earlier in the day may be a good strategy for managing weight, without severe restriction,” he added.

“You can calculate your own BMI by dividing your weight in pounds by your height in inches squared, and then multiplying by 703,” said Aggarwal.

To learn more specific information about own BMI, try this adult BMI calculator.