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Be Well: Study challenges concept of ‘health and obese’

Study challenges concept of ‘healthy and obese’

Obese people with no history of heart problems are more likely to have plaque buildup in their arteries compared with people with a normal weight, according to a study that challenges the idea that people can be both heavy and healthy.

Researchers in South Korea looked at the coronary artery calcium scores — which measure calcium buildup in artery walls — of more than 14,000 Korean adults ages 30 to 59 who had no history of heart disease. The researchers divided the group based on weight, defining obese as anyone with a body mass index greater than 25. (In the United States, obesity is defined as a body mass index over 35.)

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Participants with a BMI over 25 were more likely to have calcium scores that indicated early plaque buildup in their arteries, compared with those who had normal weights.

The findings suggest that it may be inaccurate to classify some obese individuals as “metabolically healthy,” Dr. Rishi Puri of the Cleveland Clinic wrote in an editorial accompanying the study.

BOTTOM LINE: Obese people with no history of heart problems are more likely to have plaque buildup in their arteries compared with people with a normal weight.

CAUTIONS: The study did not show that obese participants with early plaque buildup went on to develop heart disease. The results may not apply to non-Koreans.

WHERE TO FIND IT: Journal of the American College of Cardiology, April 30

Antidepressants in high doses linked to self-harmful behavior in young people

Young people who take higher than average doses of antidepressants for their age group may face double the risk for self-injurious behavior, according to a study by researchers at the Harvard School of Public Health.

Led by Dr. Matthew Miller, the team looked at data from 1998 to 2010 for 162,625 people ages 10 to 64 with depression who were started on antidepressants at either an average or higher-than-average dose of three different medications — citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft).

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After one year, people age 24 and younger who were started on an above-average dose were twice as likely to have harmed themselves than similar patients in the same age group who were started on an average amount. Self-harming was most common within the first three months of starting the medication. There was no significantly higher risk of self-harm among adults older than age 24 who took high-dose antidepressants.

The findings support current guidelines that physicians start antidepressants at lower doses, Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, wrote in an accompanying editorial.

BOTTOM LINE: Young people who start with higher-than-average doses of antidepressants have double the risk of self-injurious behavior.

CAUTIONS: The study did not prove a cause-and-effect relationship between high doses of antidepressants and self-harm, nor did it assess the effects of increasing the dose over time.

WHERE TO FIND IT: JAMA Internal Medicine, online April 28

Lara Salahi