CHICAGO — You can look great in a swimsuit and still be a heart attack waiting to happen. And you can also be overweight and otherwise healthy.
A new study suggests that a surprising number of overweight people — about half — have normal blood pressure and cholesterol levels, while a sizable number of trim people face some of the ills associated with obesity.
The first national estimate of its kind bolsters the argument that you can be hefty but still healthy, or at least healthier than has been believed.
The results also show that stereotypes about body size can be misleading and that even "less voluptuous" people can have risk factors commonly associated with obesity, said study author MaryFran Sowers, a University of Michigan obesity researcher.
In the study, about 51 percent of overweight adults, or roughly 36-million people nationwide, had mostly normal levels of blood pressure, cholesterol, blood fats called triglycerides and blood sugar.
Almost one-third of obese adults, or nearly 20-million people, also were in this healthy range, meaning that none or only one of those measures was abnormal.
Yet about a fourth of adults in the recommended weight range had unhealthy levels of at least two of these measures. That means about 16-million of them are at risk for heart problems.
It's no secret that thin people can develop heart-related problems and that fat people often do not. But that millions defy the stereotypes will come as a surprise to many people, Sowers said.
Even so, there's growing debate about the accuracy of the standard method of calculating whether someone is overweight. Health officials rely on the body mass index, a weight-height ratio that does not distinguish between fat and lean tissue. The limits of that method were highlighted a few years ago when it was reported that the system would put nearly half of NBA players in the overweight category.
A number of experts say waist size is a more accurate way of determining someone's health risks, and the study results support that argument.
Among people of healthy weight in the study, elevated blood pressure, cholesterol and other factors were more common for people with larger waists or potbellies. This often signals internal fat deposits surrounding abdominal organs, which previous research has shown can be especially risky.
To arrive at the new estimates, scientists analyzed nationally representative government surveys involving 5,440 people age 20 and over, and extrapolated to calculate nationwide figures.
The new study, appearing in Monday's Archives of Internal Medicine, used government surveys from 1999 to 2004 that included lab tests and height and weight measurements. Participants reported on habits including smoking and physical activity.
Dr. Robert Eckel, a former American Heart Association president and professor of medicine at the University of Colorado, said the new research may help dismiss some of the generalizations that are sometimes made about weight and health.