Body composition phenotypes and obesity paradox.

Abstract:

PURPOSE OF REVIEW:The obesity paradox is a highly controversial concept that may be attributed to methodological limitations related to its identification. One of the primary concerns is the use of BMI to define obesity. This index does not differentiate lean versus adipose tissue compartments (i.e. body composition) confounding health consequences for morbidity and mortality, especially in clinical populations. This review will describe the past year's evidence on the obesity paradox phenomenon, primarily focusing on the role of abnormal body composition phenotypes in explaining the controversies observed in the literature. RECENT FINDINGS:In spite of the substantial number of articles investigating the obesity paradox phenomenon, less than 10% used a direct measure of body composition and when included, it was not fully explored (only adipose tissue compartment evaluated). When lean tissue or muscle mass is taken into account, the general finding is that a high BMI has no protective effect in the presence of low muscle mass and that it is the latter that associates with poor prognosis. SUMMARY:In view of the body composition variability of patients with identical BMI, it is unreasonable to rely solely on this index to identify obesity. The consequences of a potential insubstantial obesity paradox are mixed messages related to patient-related prognostication.

authors

Prado CM,Gonzalez MC,Heymsfield SB

doi

10.1097/MCO.0000000000000216

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

535-51

issue

6

eissn

1363-1950

issn

1473-6519

journal_volume

18

pub_type

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