Is fat always bad?

Research presented at the British Cardiovascular Society (BCS) Conference in Manchester has revealed how the fat surrounding our blood vessels can help fight heart disease to reduce the risk of a heart attack.

The studies, led by a British Heart Foundation (BHF) Research Fellow Professor Charalambos Antoniades at the University of Oxford, may help explain why the paradox exists that people with a Body Mass Index (BMI) that signifies obesity are actually more likely to live longer after a heart attack than someone with a healthy BMI.

By analysing tissue collected from patients undergoing heart surgery, Professor Antoniades and colleagues have revealed how the heart, and the arteries supplying blood to it, send out an SOS to the fat surrounding these tissues in order to stimulate a defence mechanism against the early stages of coronary heart disease.

The research, funded largely by the BHF, has revealed that during oxidative stress (a process that leads to the furring of the arteries known as atherosclerosis), the fat surrounding the vessels and heart releases chemicals that minimise this oxidative stress and help to prevent the development of coronary heart disease. These chemicals are anti-inflammatory to minimise the inflammation triggered by oxidative stress and anti-oxidant to target the damaging process itself.

Professor Charalambos Antoniades, Associate Professor of Cardiovascular Medicine at the University of Oxford, said: “Fat has a bad reputation but we’re learning more and more about how and why certain types of fat in the body are actually essential for good heart health. These findings are an important step towards a treatment that ensures this fat stays on-side throughout our lives to help prevent heart disease.”

The team are now looking at how these healthy processes can be weakened if the fat is unhealthy, as can be the case if a person has type 2 diabetes. They are developing treatments to reverse this so this fat has a positive impact all the time.

By using a newly developed technology based on high resolution computerized tomography (CT), they are also trying to monitor the behaviour of fat in the human body, and guide future therapeutic interventions to prevent cardiovascular diseases. This could allow doctors to detect the earliest stages of heart disease and urgently direct treatment to prevent the development of the disease which can ultimately lead to a heart attack.

Professor Jeremy Pearson, Associate Medical Director at the BHF, which helped fund the research, said: “There’s still a huge amount we don’t know about how heart disease develops and what processes in the body can help prevent it from happening.

“This high quality research carried out in people and using human tissue has provided new perspectives on the roles of fat in heart disease and has implications for future treatment.”

At the Annual BCS conference, the British Heart Foundation is calling on the UK Government to maintain the current ringfenced science budget and commit to future increases. Without this commitment, the BHF’s ability to support world class research will be significantly reduced as funds will have to be diverted from vital science to infrastructure costs like heating and lighting.