Though obesity can have an impact on the risk of an individual developing cardiovascular disease, a sedentary lifestyle could be even more harmful to middle-aged and elderly people, according to new research from the Netherlands.

The observational study followed more than 5,000 people 55 years and older for up to 15 years. The work follows on the heels of a similar study from the United Kingdom on individuals working primarily desk jobs.

At the beginning of the study, published in the European Journal of Preventive Cardiology, all participants were free of cardiovascular disease. From 1997 to 2001, the researchers collected information about participants’ body mass index (BMI), physical activity, smoking, alcohol use, diet, education and family history. Up to 2012, the researchers followed participants for cardiovascular events, such as stroke and heart attack.

"Overweight and obesity is associated with a higher risk of cardiovascular disease and it is recommended to lose weight," said Klodian Dhana, MD, the author on the study and a postdoctoral researcher at Erasmus University Medical Centre in the Netherlands, in a statement. "But in the elderly this is slightly different because weight loss, especially unintentional, is associated with muscle loss and death."

Results showed 16 percent of participants had a cardiovascular event and that there was no association between BMI alone and cardiovascular disease. Furthermore, physical activity was associated with a decreased risk of developing heart disease, regardless of a participant’s BMI, suggesting it is more beneficial to be active regularly than to lose weight.

"In the overall population we found that physical activity was protective for cardiovascular risk," Dhana said. "Overweight and obese participants were not at increased cardiovascular risk compared to those of normal weight. We do not refute the risk associated with obesity in the general population even though we did not find it in this older group. BMI may not be the best way to measure adiposity risk in the elderly."

To explain this, Dhana wrote in the study that obesity harms adipose tissues, which accelerate the atherosclerotic process and increase cardiovascular risk. However, physical activity lowers those harmful effects and reduces the heart’s oxygen demand.

"People who engage in high levels of physical activity are protected from the harmful effects of adipose tissue on cardiovascular disease," Dhana said. "This may be why we found that the beneficial impact of physical activity on cardiovascular disease outweighs the negative impact of BMI."