New Study Challenges Obesity Paradox
Increasing adiposity raises cardiovascular disease (CVD) health in middle-aged men and women, according to new study published in the European Heart Journal. These results challenge the “obesity paradox,” which suggests a protective layer of fat reduces CVD risk.
In the study, 296,535 European adults with a baseline free of CVD were followed for 5 years. During this period, 3.3% of women and 5.7% of men developed a cardiovascular event.
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After 5 years of follow-up, the researchers found that individuals with a BMI of 18.5 kg/m2 or less (low BMI) or a BMI of 24 kg/m2 (high BMI) had a higher incidence of CVD, compared with those who had a normal BMI (22-23 kg/m2).
Additional adiposity markers measured include waist circumference, hip circumference, waist-to-hip ratio, and waist-to-height ratio, and percentage body mass.
A one standard deviation increase in waist circumference was associated with a hazard ratio of 1.16 for women and 1.10 for men; similar associations were also found for waist-to-hip ratio, waist-to-height ratio, and percentage body fat mass.
Moderate to vigorous physician activity did not modify the associations between adiposity measures and CVD outcomes. Smoking was an effect modifier for the association between BMI and CVD in men without CVD as baseline.
“Increasing adiposity has a detrimental association with CVD health in middle-aged men and women,” the researchers concluded.
“The association of BMI with CVD appears more susceptible to confounding due to pre-existing comorbidities when compared with other adiposity measures. Any public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged.”
—Amanda Balbi
Reference:
Illiodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent [published online March 16, 2018]. Euro Heart J. https://doi.org/10.1093/eurheartj/ehy057.