A normal number on the weighing scale or a Body Mass Index (BMI) under 25 might give you a false sense of security about your heart health. Cardiologists are increasingly highlighting a dangerous paradox, particularly prevalent in certain populations like Indians, where individuals can be “metabolically challenged” despite not being overweight. This means a serious cholesterol problem could be lurking beneath a healthy-looking exterior.
This condition, often referred to as “lean but metabolically unhealthy,” means that your body’s internal processes for handling fats and sugars are not working efficiently. You may have a higher percentage of visceral fat (fat around your organs) and a specific lipid profile known as atherogenic dyslipidaemia—high triglycerides, low “good” HDL, and high levels of small, dense “bad” LDL particles.
This specific lipid combination is a potent driver of atherosclerosis, the process of plaque buildup in the arteries. The small, dense LDL particles are particularly harmful as they more easily penetrate the artery walls, accelerating plaque formation. This puts you at a high risk for early coronary disease, even if your total cholesterol or standard LDL number isn’t in the red zone.
The major takeaway is that BMI can be a deceptive measure of cardiovascular risk. For this reason, even modest weight loss of 5-10% in individuals with a normal BMI can yield disproportionately large benefits for heart health. This small change can significantly improve lipid markers and reduce the hidden metabolic risks.
Ultimately, you cannot judge your heart health by your appearance or weight alone. Regular and comprehensive blood screenings that look at your entire lipid profile are essential for everyone, regardless of their BMI. Uncovering this hidden risk is the first step to taking corrective action through diet, exercise, and medical guidance.