Kowall B, et al. - Authors evaluated cross-sectional and longitudinal metabolically healthy obesity (MHO) coronary artery calcification (CAC) associations in a Caucasian population. They conducted the Heinz Nixdorf Recall Study, a population-based cohort study in Germany, and assessed CAC by electron-beam tomography at baseline and at 5-year follow-up. The evidence that MHO is not a purely benign health condition was supported by this analysis. Compared with the healthy normal weight (MHNW) persons, persons with MHO had a higher prevalence of CAC. Slightly larger odds of CAC progression were evident in the persons with MHNW.