New research suggests we are what we eat, not what we weigh.

A Swedish study has found that overweight people who eat healthily have a lower risk of dying from cardiovascular disease compared to those with unhealthy diets.

The researchers measured how closely people kept to a Mediterranean-like diet rich in wholegrains, fruits and vegetables, and found that those who ate a healthier diet were at lower risk of dying, regardless of their BMI.

The authors suggest that we shift our focus onto healthy eating, but caution that being overweight still carries health risks.

Higher body mass (BMI) accounted for 4.0 million deaths globally in 2015 and more than two-thirds of those deaths were due to cardiovascular disease (CVD).

In the new study, researchers studied BMI, diet and mortality among 79,003 adults, measuring their adherence to a Mediterranean-like diet (mMED) on a scale of 0 to 8.

They were able to integrate information on intake of fruits and vegetables, legumes, nuts, unrefined or high-fibre grains, fish, red and processed meat, and olive oil. Information was also available on age, physical activity, smoking and socioeconomics of the cohort participants.

Over 21 years of follow-up, 38 per cent of participants died.

Among overweight individuals, the group with the lowest hazard ratio of all-cause mortality were those with high mMED.

Obese individuals who also had high mMED did not have a significantly higher mortality compared with those with normal weight and high mMED. Conversely, individuals with a normal BMI but low mMED had a higher mortality than those with normal weight and high mMED.

For CVD mortality, which represented 12,064 of the deaths, the findings were broadly similar.

However, while CVD morality associated with high BMI was reduced by adherence to a Mediterranean diet, it was not fully countered. Moreover, lower BMI did not counter the elevated CVD mortality associated with a low mMED.

“These results indicate that adherence to healthy diets such as a Mediterranean-like diet may be a more appropriate focus that avoidance of obesity for the prevention of overall mortality,” the authors say.

“Nonetheless, a healthy diet may not completely counter higher CVD mortality related with obesity.”

The study is accessible here.