Impact of obesity on total and cardiovascular mortality--fat or fiction?
Obesity is an excessive accumulation of fat that can impair health. Because the direct measurement of body fat is difficult to perform, a number of anthropometric measures have been employed as surrogates, of which BMI is the most commonly used. However, its usefulness has been questioned as a BMI in the overweight and mildly obese range is associated with improved survival and fewer cardiovascular events than a BMI in the normal range, a phenomenon known as the 'obesity paradox'. Waist circumference, waist-to-hip ratio, and waist-to-height ratio take into consideration body-fat distribution, especially abdominal obesity, and seem to predict cardiovascular risk better than does BMI.
Department of Internal Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein Professional Building, Suite 300, Philadelphia, PA 19141, USA.
Beatriz
B
Cepeda-Valery
Gregg S
GS
Pressman
Vincent M
VM
Figueredo
Abel
A
Romero-Corral
D000273:Adipose Tissue / Q000378:metabolism*; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000473:pathology; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D056128:Obesity, Abdominal / Q000473:pathology; D012306:Risk; D018570:Risk Assessment
Eur Heart J. 2010 Mar;31(6):737-46
19933515
MMWR Morb Mortal Wkly Rep. 2010 Aug 6;59(30):951-5
20689500
Lancet. 2006 Aug 19;368(9536):666-78
16920472
Nutr Metab Cardiovasc Dis. 2006 Dec;16(8):513-23
17126766
Am J Clin Nutr. 2009 Apr;89(4):1213-9
19190072
Circulation. 2009 Jun 30;119(25):3263-71
19506107
Int J Obes Relat Metab Disord. 2002 Mar;26(3):410-6
11896498
Obes Res. 2004 Jul;12(7):1042-9
15292467
Ann Epidemiol. 2005 Feb;15(2):87-97
15652713
Int J Obes Relat Metab Disord. 2003 May;27(5):610-6
12704405
Circulation. 2008 Jul 29;118(5):482-90
18625893
J Clin Epidemiol. 2008 Jul;61(7):646-53
18359190
Nature. 2006 Dec 14;444(7121):881-7
17167477
JAMA. 2007 Nov 7;298(17):2028-37
17986696
Ann Hum Biol. 1996 Mar-Apr;23(2):127-47
8702212
Am J Cardiol. 1994 Mar 1;73(7):460-8
8141087
Am J Clin Nutr. 2000 Sep;72(3):694-701
10966886
Int J Obes Relat Metab Disord. 2000 Jan;24(1):33-7
10702748
CMAJ. 2010 Sep 21;182(13):1427-32
20643837
N Engl J Med. 2006 Aug 24;355(8):763-78
16926275
Am J Clin Nutr. 2004 Mar;79(3):379-84
14985210
Circulation. 2007 Oct 23;116(17):1942-51
17965405
Lancet. 2005 Nov 5;366(9497):1640-9
16271645
Curr Opin Clin Nutr Metab Care. 2008 Sep;11(5):566-72
18685451
Int J Obes (Lond). 2008 Jun;32(6):959-66
18283284
Circulation. 2006 Feb 14;113(6):898-918
16380542
Lancet. 2009 Mar 28;373(9669):1083-96
19299006
Eur Heart J. 2007 Apr;28(7):850-6
17403720
Arterioscler Thromb Vasc Biol. 2008 Jun;28(6):1039-49
18356555