The press release [1] for the paper Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sec

The press release [1] for the paper Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study [2]: > We retrieved information from medical examinations on the prevalence of diabetes (medicated or glycaemia > 125 mg/dL), hypercholesterolaemia (medicated or total blood cholesterol ≥ 240 mg/dL), and hypertension (medicated or systolic/diastolic blood pressure ≥ 140/90 mmHg). > Data from 527 662 participants [32% female; age (mean ± SD): 42.3 ± 9.4 years; BMI: 26.2 ± 4.3 kg/m2] were analysed. About 42%, 41%, and 18% of the participants had normal weight, overweight, or obesity, respectively; 63.5%, 12.3%, and 24.2% were inactive, insufficiently active, and regularly active; and 30%, 15%, and 3% had hypercholesterolaemia, hypertension, and diabetes. Being either regularly or insufficiently active conferred protection compared to inactivity against all the studied risk factors within each BMI category, which was evident in a PA dose-response manner for diabetes and hypertension (Figure 1). However, regular/insufficient PA did not compensate for the negative effects of overweight/obesity, as individuals with overweight/obesity were at greater CVD risk than their peers with normal weight, irrespective of PA levels. The headline is inappropriate and I'm not convinced the study is as useful as it could be. Though large, the study only demonstrates that being overweight or obese is linked to high cholesterol, diabetes, and high blood pressure; all risks for cardio vascular disease (CVD). I'd prefer more direct measures of CVD like the Ankle-Brachial Index (ABI). Regardless, the data has to explain the U-Shaped BMI mortality curve [4] and it does not. There are also well established mortality tables [5] for blood pressure based on age and gender; 140/90 is not reflective of risk. [1] https://www.escardio.org/The-ESC/Press-Office/Press-releases/Being-fat-linked-with-worse-heart-health-even-in-people-who-exercise https://www.escardio.org/The-ESC/Press-Office/Press-releases... [2] https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaa151/6105192 https://academic.oup.com/eurjpc/advance-article/doi/10.1093/... [3] https://en.wikipedia.org/wiki/Ankle–brachial_pressure_index https://en.wikipedia.org/wiki/Ankle–brachial_pressure_index [4] https://en.wikipedia.org/wiki/Obesity#Mortality https://en.wikipedia.org/wiki/Obesity#Mortality [5] https://www.sciencedirect.com/science/article/pii/S0140673699070518?casa_token=lSR4TCGfhE4AAAAA:DTw9D3o5i4WHkWpiVlJEPpJISfTrcGqFGdmtbWcVhF8kJHCMEejDTJdvCIetm9otE864hVsMbJM https://www.sciencedirect.com/science/article/pii/S014067369...