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The paradox of low body mass index and body: Obesity or BMI Paradox? Beneath the Tip of the Iceberg

Community Prevention and Control of Cardiovascular Diseases.

Lucas Cox
Wednesday, June 17, 2020
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  • Finally, confounding factors have not been always considered in those studies.

  • Ofthe final participantsthat underwent allmeasurements wereChinese,76wereMalaysand were Indians.

  • American journal of epidemiology.

  • National Heart, Lung, and Blood Institute. The dummy variables for ethnicity were E 1 and E 2.

Introduction

A smaller proportion of overweight and obese patients died during follow-up compared with underweight or healthy-weight patients. A number of mechanisms have been postulated to support the existence of obesity paradox; however, marked heterogeneity was found across studies and this has cast doubt on the actual presence of this phenomenon. Obesity and atrial fibrillation prevalence, pathogenesis, and prognosis: effects of weight loss and exercise.

Prog Cardiovasc Dis. Because eligibility criteria padadox otherwise identical, we combined data from the main and ancillary trials. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Obesity: Preventing and managing the global epidemic. The primary end point of the DIG trial was all-cause death within 37 months of randomization range, months. There was no consistent recognition of the association between high or low body mass index BMI and health related quality of life HRQL.

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Chinese SF Health Survey: translation, cultural adaptation, validation, and normalization. Human body composition Springer: New York Developing a clearer understanding of the underlying mechanisms and impact of the obesity paradox in patients with HF is necessary before definitive recommendations concerning weight and weight control can be made for this population. This could be due to a combination of climate warm and humidliving and working conditions and well-organized and highly effective public transport, all factors which are disincentives for any sort of physical activity or exercise during leisure time other than in air-conditioned rooms. Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity. PMID Full size image.

First, it isridiculed. After 20 years, researchers found that at the same BMI, Asians had more than double the risk of developing type 2 diabetes than whites; Hispanics and blacks also had higher risks of diabetes than whites, but to a lesser degree. These subjects were slightly older mean age of Metab Syndr Relat Disord. PubMed Google Scholar.

Community Prevention and Control of Cardiovascular Diseases. The study samples was selected purposively from the population sample of the National Health Survey NHS conducted into ensure that there was adequate representation fromeachofthethreeethnic groups Chinese,Malaysand Indians for eachgender group. It isan equatorial country withrelatively uniform temperature Progress in obesity research. Google Scholar. The presence of cardiovascular risk factors at different BMI levels will be further studied among the three ethnicgroupsinSingaporetotestthishypothesis paper inpreparation.

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There was substantial percentage of underweight persons [ 2246 ] in Asian countries, including China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors also wish to document their appreciation to the Epidemiology and Disease Control Department Ministry of Health for providing data from the National Health Survey and to the Department of Nutrition Ministry of Healthfor administrative and logistic support. Is nutritional intake adequate in chronic heart failure patients?

View Large Download. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. All the study subjects signed a written informed consent. They were purposely selected from a larger representative population sample of the National Health Survey NHSto ensure adequate representation from the entire range of age and BMI, with almost equal numbers from all the ethnic and gender groups, rather than having similar age, BMI, ethnic and gender distribution to the general population. Overall, the class I obese had better HRQL in both the physical and the mental domains than the normal weight, especially in the mental well-being. The association between body mass index and health-related quality of life: influence of ethnicity on this relationship. Launch Research Feed Feed.

Objective: We investigated the obesity paradox in cancer patients by loa body composition. More research in different ethnic groups is necessary, and, as the differences between the American Caucasians and the European Caucasians in this study show, also within one 'ethnic' group there could be differences that could be large enough to be important. SloanMatthew N. According to mathematician Nick Trefethen"BMI divides the weight by too large a number for short people and too small a number for tall people. This would then coincide with a higher prevalence of obesity. The bias for hydrometry was close to zero for all groups.

Publications

View author publications. Portnay, MD ; Seth I. A stocky person low slenderness index is likely to have pardaox bone, connective tissue and muscle mass, thus less body fat for a given body height and weight than a more slender person. The obesity paradox: body mass index and outcomes in patients with heart failure.

Accepted : 07 April When these high prevalence of population at risk are considered together with greatly increased relative risks of having at least one risk factor experienced at these levels, it is obviously necessary to re-examine the validity of WHO's cut off values for the various indicesofobesity for Singaporeans. Importance: Reports of an obesity paradox have led to uncertainty about secondary prevention in obese patients with stroke. Published : 06 September Stevens NHC.

  • Lean mass and fat mass as contributors to physical fitness in an overweight and obese African American Population. Objective: To study the relationship between body fat percentage and body mass index BMI in three different ethnic groups in Singapore Chinese, Malays and Indians in order to evaluate the validity of the BMI cut-off points for obesity.

  • The main causes of deaths moved from those arising frominfectious diseases and poor environmental conditions to the so-called lifestyle diseases Figure 2. Use of dual-energy X-ray absorptiometry in bodycomposition studies:notyet a 'gold standard'.

  • Finally, some normal-weight subjects may have previously been obese but have lost weight due to illness reverse causalityhence representing a high-risk of mortality with normal or low BMI being the consequence of a significant illness

  • Differences in the relationship between body fat and body mass index between two different Indonesian ethnic groups: the effect of body build Eur J Clin Nutr 53 : — PubMed Google Scholar.

  • Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. View Correction.

Different mechanisms have been postulated to support the existence of xnd paradox. Thus, the objective of this research was 1 to study the association between BMI and HRQL in the general adult population in Chinese after adjusting for potential confounders, and 2 to further explore the stability of that association between BMI and HRQL subgroup by status of chronic conditions. The mean prediction error ranged from 2. Seminars in Dialysis. A correction of 0.

Manifestation of cardiovascular risk factors at lowlevels ofbodymass pparadox and waist-hipratio in Singaporean Chinese. Comparison of body composition assessments by bio-electrical impedance and anthropometry inpre-menopausal Chinese women. There is a fairly extensive intermingling of all races in Singaporeans resulting in diets comprising foods originating from different ethnic backgrounds. Validation of air displacement plethysmography for estimating body fet in young adults. Human Kinetics, II

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Greenland, Sander, —, Lash, Timothy L. Preventive Medicine. If obesity is regarded as an excess of body fat and not as an excess of weight increased BMIthe cut-off points for obesity in Singapore based on the BMI would need to be lowered. Some features of the site may not work correctly.

Tobacco Control. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Generally considered overweight and obesity were negatively associated with worse outcome.

Bray GA. European journal of public health. The American Journal of Cardiology. Browse Subject Areas? DOI:

Publication types

Book Google Scholar. Medical concepts. The prevalence of body overweight and obesity and its changes among Chinese people during to The release of N-terminal pro-B-type natriuretic peptide The paradox of low body mass index and body by cardiomyocytes, due to increased wall tension, may be considered as a major prognostic factor for mortality in acute coronary disease. The obesity paradox excluding the cholesterol paradox was first described in in overweight and obese people undergoing hemodialysis[9] and has subsequently been found in those with heart failure[4] [10] [11] myocardial infarction[12] acute coronary syndrome[13] chronic obstructive pulmonary disease COPD[14] and in older nursing home residents.

Onewasthatthe cut-off values should coincide with increased body fat accumulation and the other was that there boxy be increased risks for the co-morbidities associated with the indices of obesity. For 28 data points body fat was determined by densitometry underwater weighingin 26 studies by dual energy X-ray absorptiometry DXA in 13 studies by dilution techniques deuterium oxide dilutionin 13 studies by a three or four-compartment model and in 14 studies using bioelectrical impedance analysis or skinfold thickness measurements. Weight and height measurements weretakenduringthefirstinterview. Such relationships have been clearly established in a number of studies involving mainly Europids. All survey field workers werebriefed extensively on the survey methodology and underwent rigoroustraining inthe survey procedures assigned tothem. Asians have lower body mass index BMI buthigher percent body fet than do whites: comparisons ofanthropometric measurements.

Significant heterogeneity was found across studies supporting the presence of the obesity paradox e. The indrx of the stool was subtracted from the reading. BartelsAlara OzsanLuz H. Accessed April 4, S2CID Kaplan-Meier survival curves were plotted for each BMI group and compared using a log-rank test. Related conditions.

For example, research suggests that under-nutrition during fetal life, such as during the Chinese famine of toraises the risk of diabetes in adulthood, especially when individuals live in nutritionally rich environments later in life. This is in accordance with findings of Wang et al 18 ' 19 but in contrast with findings of a study in Beijing Chinese Circulation ; Trends in mortality from ischaemic heart disease in Singapore, to BartelsAlara OzsanLuz H. Overweight and obesity areknowntobeassociated with elevated risk factors for CVD.

Publication types

Te Singapore National Medical Research Council approved the study protocol andallsubjects gavetheir informed consentbefore themeasurements. Results: The relationship between body fat percent and BMI differs in the ethnic groups studied. The mean values of left and right widths were used in the statistical calculations. Conclusion It is recognised that the case for lowering of cut-off values would be strengthened if there would be supporting longitudinal data on morbidity and mortality.

Obesity and depressive symptoms in Chinese elderly. Journal of cachexia, sarcopenia and muscle. Similarly, the DIG investigators did not obtain measures of nutritional status and caloric intake. Of the final participants that underwent all measurements, were Chinese, 76 were Malays and were Indians. Ministry of Health. Schmidt and W.

Issue Date : 01 August These differences could be ascribed to differences in body build. Churchill Livingstone, London SPSS for Windows, v 8. The correction factor was obtained by 20 repeated phantom measurements on each machine and also by repeated sets of measurements of two subjects scanned by both machines over one year.

  • The imputation model was supplied to handle the missing values, and 21, cases were included in this study after excluding persons under 18 years of age. Human body composition Springer: New York

  • The odds ratio for having at least one of the mentioned risk factors was in the different BMI quintiles for females 1. Body mass index as a measure of body fatness: age- and sex- specific prediction formulas.

  • Thus, the obese population represented in these studies is characterized by obese but likely healthier individuals

This may explain the discordance between the risks of death and hospitalization observed in the present study. Obesity paradox in a cohort of consecutive patients undergoing percutaneous coronary intervention. Jebb SA. There was substantial percentage of underweight persons [ 2246 ] in Asian countries, including China.

Ill Inmanypublications, inappropriate useofbodycomposition methodology has resulted inquestionable conclusions. Ministry of Health. According to the U. The scaling factor of 1. Fuller NJ, Elia M. The use of adequate cut-off points is of great importance for reliable prevalence figures for obesity and consequent public health policies.

REVIEW article

Geneva, Duxbury Press, Pacific Grove From the given dose and the deuterium concentration in plasma TBW was calculated, assuminga5percent non-aqueousdilutionofthedeuterium inthe body2. Archived from the original on 23 August

  • In fact, the adjustment for potential confounders may scale down the protective association of obesity with te 27 — The aim of the present narrative review is to summarize evidence underlying the concept of obesity paradox, focusing on limitations and bias related to this phenomenon, with emphasis on the use of BMI.

  • Archived PDF from the original on

  • National Health Service Information Centre.

  • The BMI is a convenient rule of thumb used to broadly categorize a person as underweightnormal weightoverweightor obese based on tissue mass musclefat, and bone and height.

Age and age distribution were similar between males and females. The BMI of Indonesians for example is3. You can also search for this author in PubMed Google Scholar. It is concluded that the newly developed FFQ is an adequate tool for classifying individual's intakesintoquintilesfor epidemiological studiesamongSingaporeanadults.

  • Body fat measurement among Singaporean Chinese, Malays and Indians: a comparative study using a four-compartment model and different two-compartment models.

  • It is obvious that differences in body fat percent for the same BMI can be remarkable.

  • Staveren and P. Patient population.

  • Intakes of energy and each of the nutrients obtained from the FFQ and multiple hour dietary recalls were divided into quintiles of intake. Archived from the original on November 22,

  • The Atherosclerosis Risk in Communities Study.

  • Finally, some normal-weight subjects may have previously been obese but have lost weight due to illness reverse causalityhence representing a high-risk of mortality with normal or low BMI being the consequence of a significant illness

Psychological medicine. Body mass index and percent body fat: a meta analysis among different ethnic groups Int J Obes Relat Metab Disord 22 : — Statistical analysis. However, the combination of techniques required makes this method expensive and not suitable for use in large epidemiological studies. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Douglas; Gibler, W. The participation of the subjects in this study is highly appreciated.

Densitometry, using underwater weighing or more recently air-displacement, 5 is a classical method, long regarded as a method of reference. These differences could be ascribed to differences in body build. Stevens NHC. Malay males and females had a significant higher slenderness index than Chinese and Indians.

Purchase access Subscribe to JN Learning for one year. In fact, the adjustment for potential confounders may scale down the protective association of obesity with mortality 27 — In China, the lifetime prevalence of major depressive disorder MDD was 3. Full size image.

Abstract Objective: To study the relationship between body fat percentage and body bodj index BMI in three different ethnic groups in Singapore Chinese, Malays and Indians in order to evaluate the validity of the BMI cut-off points for obesity. You are using a browser version with limited support for CSS. The obesity paradox: a misleading term that should be abandoned. Download references. Relationship between body fat and body mass index: differences between Indonesians and Dutch Caucasians.

The final prediction equation. Eur J Heart Fail. There are slight differences between Chinese and Malays but the difference with Indians is more pronounced. Design: Cross-sectional study. Cardioprotective effects of ghrelin in heart failure: from gut to heart. For each set these two subjects were measured twice within 1 week with both systems.

Validation of air displacement plethysmography for estimating body fet in young adults. Themostappropriate method isdependent onthepurpose ofthe study. Such risk factors include obesity, abdominal fat distribution, elevated blood pressure, abnormal blood lipids, elevated blood glucose and insulin.

The odds ratio for having at least one te the mentioned risk factors was in the different BMI quintiles for females 1. Measure of relative weight based on an individual's mass and height. Also, in a stepwise multiple regression model with BMI, age, sex, relative sitting height and slenderness as independent variables, ethnicity did not contribute significantly anymore. Deuteriumwasanalysed after sublimation oftheplasmausing infrared spectroscopy August

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Competing interests: The authors have declared that no competing interests exist. Subjects with excess fat mass, irrespective of BMI, were characterized by a reduced lean mass e. Densitometry, using underwater weighing or inddx recently air-displacement, 5 is a classical method, long regarded as a method of reference. Obes Rev. As such, well-designed clinical trials are needed to determine whether weight loss is an appropriate recommendation for overweight and obese patients with HF. The underweight had significantly lower scores in six dimensions except physical functioning and role-emotional and there was more than 3 points in the general health dimension.

  • Forbes GB.

  • In obese subjects the body fat percentage calculated with Siri'sformula isan overestimation.

  • Body mass index and health-related quality of life in apparently healthy individuals.

  • SPSSfor Windows, v 8. The mean values of left and right widthswereused inthestatistical calculations.

  • Conclusions In a cohort of outpatients with established HF, higher BMIs were associated with lower mortality risks; overweight and obese patients had lower risk of death compared with those at a healthy weight.

In Indonesians, Thai and Ethiopians the prediction equation largely underestimated body fat. In other words, persons with small frames would be carrying more fat than optimal, but their BMI indicates that they are normal. The reason for this underestimation remains unclear, but body build of some Asians is rather slender49 and we reported earlier a slender body build in Ethiopians31 and recently also in Indonesians16, According tothe World Health Organisation,obesity isdefined asa condition with excessive fat accumulation inthe body to the extent that health and well being are adversely affected1. Body height of Malay males and females was shorter thanthat oftheir Chinese and Indian counterparts. The Singapore National Medical Research Council approved the study protocol and all subjects gavetheirwritteninformed consentbefore themeasurements. Retrieved 7 April

Related conditions. Norgan has discussed the importance of relative leg length for the interpretation of the BMI, and it is knownthatthere are differences inrelative sitting height between Caucasians and Blacks and paraxox Caucasians andAsians,withBlacks having relatively longer legsand Asians having relatively shorter legs They were purposely selected from a larger representative population sample of the National Health Survey NHSto ensure adequate representation from the entire range of age and BMI, with almost equal numbers from all the ethnic and gender groups, rather than having similar age, BMI, ethnic and gender distribution to the general population. It is calculated in the same way as for adults but then compared to typical values for other children of the same age. Category 1 of the various obesity indices has been used as the reference category when computing relative risks ORs for cardiovascular risk for two main reasons.

It has a resident population of 3. If BMI was not reported in the original study, the index was calculatedfromthe mean weight andheight. Obesity Homepage in Japanese. The differences can be explained by differences in body build. Am J ClinNutr ;

These differences could be ascribed to differences in body build. Allanthropometric measurementswereperformed bytrained observers. BMI Prime is tthe clinically because it shows by what ratio e. Collection commenced on the morning after the interviews. Statistical analyses were performed using SPSS 8. For the same level body fat, age and sex, American Blacks have a 1. Int J Obesity ;

Assumptions about the distribution between muscle mass and fat mass are inexact. Environment International. J Assoc Physicians India. Dietaryfactorsrelatedtocardiovascular riskfactors The role ofdiet in cardiovascular diseases is well documented. The use of inappropriate BMI cut-off points could explain the discrepancy in the apparently low prevalence of obesity and high prevalence of obesity-related diseases in Singapore.

Introduction

Body mass index and percent body fat: a meta analysis among different paeadox. Brit JNutr Measurements: Body weight, body height, sitting height, wrist and femoral widths, skinfold thicknesses, total body water by deuterium oxide dilution, densitometry with Bodpod R and bone mineral content with Hologic R QDR Design:metaanalysisof literature data.

  • View 3 excerpts, cites background. Body fat percentage was calculated using a four-compartment model.

  • Bonemineral density, however, isnot significantly different fromCaucasianswhencorrected for weight, height and age

  • Of the final participants that underwent all measurements, were Chinese, 76 were Malays and were Indians. Dual energy X-rays absorptiometry results differ between machines Lancet : —

  • Blood pressure was measured to the nearest 2 mmHg using a standard mercury sphygmomanometer, with systolic pressure being the level where the first phase isheard and diastolicpressure beingthe levelwherethesoundscease fifth phase. During data analysis, appropriate weight values were appliedtoreflect theethnic,ageandgender distribution inthepopulation.

ISSN Von Haehling S. The joint effects of cardiorespiratory fitness and adiposity on mortality risk in men with hypertension. Conclusion The actual paradox seems to be keeping defining obesity using BMI, which is not able to quantify body fat percentage and adiposity distribution, nor the degree of metabolic disturbances that it can underlie. Another potential explanation is the presence of cardiac cachexia, a wasting syndrome observed in patients with advanced HF that has no accepted definition but is characterized by significant weight loss in the absence of peripheral edema. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Thirdly, community residents, students and subjects were drawn out from each community, college and health examination center by systemic sampling. Scientific Reports

  • And the International Diabetes Federation now includes ethnic-specific criteria for the definition of abdominal obesity. Air displacement plethysmography compared to multi-component models for estimating body composition in African American men.

  • Although observed associations between obesity and mortality do not prove causality, a major cause of the discrepancy across studies may be related to the use of BMI in the definition of obesity that should consider, instead, excess body fat as the main characteristic of this disease and as the unique determinant of its complications Ethn Dis.

  • Arch Intern Med. Thus, the objective of this research was 1 bodh study the association between BMI and HRQL in the general adult population in Chinese after adjusting for potential confounders, and 2 to further explore the stability of that association between BMI and HRQL subgroup by status of chronic conditions.

S2CID Moreover, in the eight dimensions, compared to the normal weight group, the SFscores of the healthy were reduced by 3 points or more in the bodily pain dimension of the class II obese, and in the general health dimension of the underweight group. Our results were consistent with these previous reports. Comparing subjects with overweight or obesity to subjects belonging to this heterogeneous stratum may lead to a misinterpretation of the correlation between BMI and mortality

National Heart, Lung and Blood Institute. Partofthisdifference isdueto difference ingender anddifference inage. Subjects with a small frame but the same body height are likely to have a relatively lower FFM due to lower muscle mass and hence BMI is likely to underestimate their body fat whenusingprediction formulas developed insubjects withabiggerbodybuild. Body fat percentage was calculated using a four-compartment model. Am J Human Biol ; The composition of the FFM calculated using the 4C model by gender and ethnic group is presented at Table 2.

This counterintuitive association of BMI and HRQL was similar in the healthy and those with chronic conditions, but it was significant in the participants with chronic conditions. In China, Further research should be prompted in order to promote correct phenotyping of patients. Figures, Tables, and Topics from this paper.

  • Significant heterogeneity was found across studies supporting the presence of the obesity paradox e.

  • Indians have the highest incidence of acute myocardial infarcts followed by Malays andChinese2.

  • Cardioprotective effects of ghrelin in heart failure: from gut to heart. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer.

  • Validation of air displacement plethysmography for estimating body fet in young adults.

  • Bubnis D ed. It is known that Chinese have generally thinner bonescompared to Caucasians

Save Preferences. Part A: vitamins. Nutrition Journal. We also examined 3 prespecified secondary outcomes from the DIG trial death due to cardiovascular causes, death due to worsening HF, and hospitalization for worsening HF as well as all-cause hospitalization.

  • Nutr Res Rev. Body mass index and percent body fat: a meta analysis among different ethnic groups.

  • However, not allstudiesamong different ethnic groups showed differences inthe relationship between body fat andBMI

  • Modern epidemiology.

  • Curvilinear regression didnot result inbetter predicted values resultsnot shown. As increased body fat and not increased weight mass BMI isthe risk factor for excess mortality1'3, cut-off points for obesity based on the BMI could be different for different populations and as a result population specific rather than general cut-off points have to be defined.

  • Bodyweight wasmeasured tothe nearest 0. Increases in weight over time were more harmful in Asians than in the other ethnic groups: For every 11 pounds Asians gained during adulthood, they had an 84 percent increase in their risk of type 2 diabetes; Hispanics, blacks, and whites who gained weight also had higher diabetes risks, but again, to a much lesser degree than Asians.

Show results from All journals This journal. Portnay, MD ; Seth I. We conducted additional analyses to examine the robustness of the association of BMI and patient outcomes. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

However, because Inde is an imperfect method of measuring obesity, critics argue that studies using other measures of obesity in addition to BMI, such as waist circumference and waist to hip ratiorender the existence of the "paradox" questionable. They were purposely selected from a larger representative population sample of the National Health Survey NHSto ensure adequate representation from the entire range of age and BMI, with almost equal numbers from all the ethnic and gender groups, rather than having similar age, BMI, ethnic and gender distribution to the general population. Lukaski HC. In contrast, underweight patients had a higher risk of all-cause mortality HR, 1. Association of weight status with mortality in adults with incident diabetes.

Statistical analyses were performed anr software packages SAS, version 8. Accordingly, we are unable to examine the contribution of malnutrition to the obesity paradox. In contrast, underweight patients had a higher risk of all-cause mortality HR, 1. Lean mass and fat mass as contributors to physical fitness in an overweight and obese African American Population. Skip to main content Thank you for visiting nature.

Thehealth of Singaporeans. New York: Springer. When entered as a covariate in the multiple regression analysis, ethnicity was not found to have a significant impact on the ORs of the different categories of obesity indices data not shown. Duxbury Press,Pacific Grove By using a data-based approach, it was ensured that the food list would include foods that are commonly consumed by the adult population in Singapore. Six-compartment body composition model: Inter-method comparison of total body fat measurement Int J Obes Relat Metab Disord 22 : —

The association of body mass index with health-related quality of life: an exploratory study in a multiethnic Asian population. The obesity paradox: body mass index and outcomes in patients with heart failure. Arch Intern Med. The Case of BMI as a Proxy of Obesity Although observed associations between obesity and mortality do not prove causality, a major cause of the discrepancy across studies may be related to the use of BMI in the definition of obesity that should consider, instead, excess body fat as the main characteristic of this disease and as the unique determinant of its complications However, because BMI is an imperfect method of measuring obesity, critics argue that studies using other measures of obesity in addition to BMI, such as waist circumference and waist to hip ratiorender the existence of the "paradox" questionable.

Hydration of fat-free bodymass:reviewandcritique ofa classicbodycomposition constant. Of theonly 46 subjects hadvalidurinesamples two sampleswithcreatinine excretion within normallimits. BMI is used differently for children.

Effect ofbonedensityon bodycomposition bocy inyoung adult black and white women. Received : 24 September Within some medical contexts, such as familial amyloid polyneuropathyserum albumin is factored in to produce a modified body mass index mBMI. Bodyfatandcardiovascularriskfactors Obesity as an independent risk factor for cardiovascular diseases, particularly for coronary heart disease, has been documented in long term prospective studies1. One possible explanation is body fat. Vanltallie TB. For example Wang et al17 reported that Asians living inNew York have lower BMI but higher body fat compared to age and sex matched whites.

The impact of body build on the relationship inex body mass index and body fat percent Int J Obes Relat Metab Disord 23 : — Magnus; Smith, Sidney C. AL and EP participated in the study design and coordination and gave intellectual inputs on the manuscript. In the DIG trial, patients with stable HF in sinus rhythm were randomized to digoxin or placebo at centers in the United States and Canada between February and August In a recent meta-analysis, Ul-Haq et al. Compared to the normal weight group, the class I obese had significantly higher scores in the mental component summary MCS

The effect of relative bodj height has been discussed earlier by Norgan. Body weight and mortality in COPD: focus on the obesity paradox. We also verified that chronic disease was one of the first two predictive factors in HRQL [ 32 ]. The metabolic basis for the obesity paradox in heart failure. Bmi categories and outcomes.

Food andNutrition Department. The mean prediction error ranged from 2. Abstract Background: Obesity, defined by body mass index BMIappears to have a paradoxical protective effect in several chronic diseases. Ameasure of chronic energy deficiency in adults.

Similar results were found by Lin et al. Caan et al. Body mass index as predictor for body fat:comparison between Chinese and Dutch adult subjects. Heart Views. Plasma cytokine parameters and mortality in patients with chronic heart failure.

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