Current opinion in clinical nutrition and metabolic care
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Curr Opin Clin Nutr Metab Care · Sep 2013
ReviewObesity paradox and the heart: which indicator of obesity best describes this complex relationship?
Despite the detrimental effects of obesity on coronary heart disease (CHD) and heart failure, obesity is found to be paradoxically associated with improved survival in secondary care of CHD and heart failure. This 'obesity paradox' is an area of active research, and it might be the result of an inaccurate working definition of obesity, which is traditionally defined in terms of BMI. We reviewed the recent literature on the paradox and examined different anthropomorphic measurements and their association with prognosis in cardiovascular diseases. ⋯ Body composition, including waist circumference, body fat and FFM have a role in clinical practice. Emphasis should be placed on improving CRF, regardless of weight status. Intentional weight loss, particularly while maintaining FFM, should be encouraged in obese individuals.