Reverse epidemiology of obesity paradox: Fact or fiction?
Abstract Obesity paradox refers to the clinical observation that when acute cardiovascular decompensation occurs, patients with obesity may have a survival benefit. This apparently runs counter to the epidemiology of obesity, which may increase the risk for non‐communicable diseases (NCDs). The scie...
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Wiley
2024-11-01
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| Series: | Physiological Reports |
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| Online Access: | https://doi.org/10.14814/phy2.70107 |
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| author | Bellamkonda K. Kishore |
| author_facet | Bellamkonda K. Kishore |
| author_sort | Bellamkonda K. Kishore |
| collection | DOAJ |
| description | Abstract Obesity paradox refers to the clinical observation that when acute cardiovascular decompensation occurs, patients with obesity may have a survival benefit. This apparently runs counter to the epidemiology of obesity, which may increase the risk for non‐communicable diseases (NCDs). The scientific community is split on obesity paradox, with some supporting it, while others call it BMI paradox. This review: (a) defines the obesity paradox, and its proposed role in overall mortality in NCDs; (b) delineates evidence for and against obesity paradox; (c) presents the importance of using different indices of body mass to assess the risk in NCDs; (d) examines the role of metabolically healthy obesity in obesity paradox, and emerging importance of cardio‐respiratory fitness (CRF) as an independent predictor of CVD risk and all‐cause mortality in patients with/without obesity. Evidence suggests that the development of obesity and insulin resistance are influenced by genetic (or ethnic) make up and dietary habits (culture) of the individuals. Hence, this review presents lean diabetes, which has higher total CVD and non‐CVD mortality as compared to diabetics with obesity and the possibility of maternal factors programming cardiometabolic risk during fetal development, which may lead to a paradigm shift in our understanding of obesity. |
| format | Article |
| id | doaj-art-2d7f626a51b64ab99bc4c387a085fefc |
| institution | Kabale University |
| issn | 2051-817X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Physiological Reports |
| spelling | doaj-art-2d7f626a51b64ab99bc4c387a085fefc2025-01-25T06:41:00ZengWileyPhysiological Reports2051-817X2024-11-011221n/an/a10.14814/phy2.70107Reverse epidemiology of obesity paradox: Fact or fiction?Bellamkonda K. Kishore0Division of Nephrology and Hypertension, Department of Internal Medicine University of Utah Health Salt Lake City Utah USAAbstract Obesity paradox refers to the clinical observation that when acute cardiovascular decompensation occurs, patients with obesity may have a survival benefit. This apparently runs counter to the epidemiology of obesity, which may increase the risk for non‐communicable diseases (NCDs). The scientific community is split on obesity paradox, with some supporting it, while others call it BMI paradox. This review: (a) defines the obesity paradox, and its proposed role in overall mortality in NCDs; (b) delineates evidence for and against obesity paradox; (c) presents the importance of using different indices of body mass to assess the risk in NCDs; (d) examines the role of metabolically healthy obesity in obesity paradox, and emerging importance of cardio‐respiratory fitness (CRF) as an independent predictor of CVD risk and all‐cause mortality in patients with/without obesity. Evidence suggests that the development of obesity and insulin resistance are influenced by genetic (or ethnic) make up and dietary habits (culture) of the individuals. Hence, this review presents lean diabetes, which has higher total CVD and non‐CVD mortality as compared to diabetics with obesity and the possibility of maternal factors programming cardiometabolic risk during fetal development, which may lead to a paradigm shift in our understanding of obesity.https://doi.org/10.14814/phy2.70107BMI paradoxcardio‐respiratory fitnesscardiovascular decompensationlean diabetesmetabolically healthy obesitynon‐communicable diseases |
| spellingShingle | Bellamkonda K. Kishore Reverse epidemiology of obesity paradox: Fact or fiction? Physiological Reports BMI paradox cardio‐respiratory fitness cardiovascular decompensation lean diabetes metabolically healthy obesity non‐communicable diseases |
| title | Reverse epidemiology of obesity paradox: Fact or fiction? |
| title_full | Reverse epidemiology of obesity paradox: Fact or fiction? |
| title_fullStr | Reverse epidemiology of obesity paradox: Fact or fiction? |
| title_full_unstemmed | Reverse epidemiology of obesity paradox: Fact or fiction? |
| title_short | Reverse epidemiology of obesity paradox: Fact or fiction? |
| title_sort | reverse epidemiology of obesity paradox fact or fiction |
| topic | BMI paradox cardio‐respiratory fitness cardiovascular decompensation lean diabetes metabolically healthy obesity non‐communicable diseases |
| url | https://doi.org/10.14814/phy2.70107 |
| work_keys_str_mv | AT bellamkondakkishore reverseepidemiologyofobesityparadoxfactorfiction |