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Impact of obesity on total and cardiovascular mortality—fat or fiction?

Nature Reviews Cardiology volume 8, pages 233–237 (2011)Cite this article

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Abstract

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.

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Figure 1: Relative risk of total and cardiovascular mortality according to BMI.
Figure 2: Variation in body fat percentage among men and women with a BMI of 25.0 kg/m2.
Figure 3: Odds ratio for waist index, waist-to-hip ratio, waist circumference, and BMI after adjustment for cardiovascular risk factors.
Figure 4: Hazard ratios relative to Z-scores for BMI, body fat, and lean mass.

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Authors and Affiliations

  1. Department of Internal Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein Professional Building, Suite 300, Philadelphia, 19141, PA, USA

    Beatriz Cepeda-Valery & Abel Romero-Corral

  2. Einstein Institute for Heart and Vascular Health, Albert Einstein Medical Center, 5501 Old York Road, Levy 3232, Philadelphia, 19141, PA, USA

    Gregg S. Pressman & Vincent M. Figueredo

Authors
  1. Beatriz Cepeda-Valery
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  3. Vincent M. Figueredo
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  4. Abel Romero-Corral
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Contributions

B. Cepeda-Valery and A. Romero-Corral contributed to discussion of content for the article and researched data to include in the manuscript. All the authors reviewed and edited the manuscript before submission, and revised the manuscript in response to the peer-reviewers' comments.

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Correspondence to Abel Romero-Corral.

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The authors declare no competing financial interests.

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Cepeda-Valery, B., Pressman, G., Figueredo, V. et al. Impact of obesity on total and cardiovascular mortality—fat or fiction?. Nat Rev Cardiol 8, 233–237 (2011). https://doi.org/10.1038/nrcardio.2010.209

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