Breaking News
January 21, 2019 - How Much Caffeine is Too Much?
January 21, 2019 - Take a timeout before you force your child to apologize
January 21, 2019 - Scientists design two AI algorithms to improve early detection of cognitive impairment
January 21, 2019 - Novel therapy for children with chronic hormone deficiency provides lifeline for parents
January 21, 2019 - Bioethicists call for oversight of poorly regulated, consumer-grade neurotechnology products
January 21, 2019 - Study shows hereditary hemochromatosis behind many cancers and joint diseases
January 21, 2019 - Short bouts of stairclimbing throughout the day can improve cardiovascular health
January 20, 2019 - Liver Transplant Survival May Improve With Race Matching
January 20, 2019 - Study implicates hyperactive immune system in aging brain disorders
January 20, 2019 - Cancer Diagnosis May Quadruple Suicide Risk
January 20, 2019 - Parkinson’s disease experts devise a roadmap
January 20, 2019 - Research brings new hope to treating degenerative brain diseases
January 20, 2019 - Scientists pinpoint a set of molecules that wire the body weight center of the brain
January 20, 2019 - Researchers get close to developing elusive blood test for Alzheimer’s disease
January 20, 2019 - UCLA researchers demonstrate new technique to develop cancer-fighting T cells
January 20, 2019 - Researchers discover how cancer cells avoid genetic meltdown
January 20, 2019 - Exercise makes even the ‘still overweight’ healthier: study
January 20, 2019 - University of Utah to establish first-of-its-kind dark sky studies minor in the US
January 20, 2019 - School-based nutritional programs reduce student obesity
January 20, 2019 - Improved maternity care practices in the southern U.S. reduce racial inequities in breastfeeding
January 20, 2019 - New enzyme biomarker test indicates diseases and bacterial contamination
January 20, 2019 - Republican and Democratic governors have different visions to transform health care, say researchers
January 20, 2019 - Researchers discover that spin flips happen in only half a picosecond in the course of a chemical reaction
January 20, 2019 - Suicide Risk Up More Than Fourfold for Cancer Patients
January 20, 2019 - Doctors find 122 nails in Ethiopian’s stomach
January 20, 2019 - UV disinfection technology eliminates up to 97.7% of pathogens in operating rooms
January 20, 2019 - Researchers discover mechanism which drives leukemia cell growth
January 20, 2019 - AHA: Infection as a Baby Led to Heart Valve Surgery for Teen
January 20, 2019 - Injection improves vision in a form of childhood blindness
January 20, 2019 - Multiple sclerosis therapies delay progression of disability
January 20, 2019 - New study finds infrequent helmet use among bike share riders
January 20, 2019 - Clearing up information about corneal dystrophies
January 20, 2019 - Researchers describe new behavior in energy metabolism that refutes existing evidence
January 20, 2019 - New study takes first step toward treating endometriosis
January 20, 2019 - Researchers find how GREB1 gene promotes resistance to prostate cancer treatments
January 20, 2019 - Replacing Sitting Time With Activity Lowers Mortality Risk
January 20, 2019 - A simple, inexpensive intervention makes birth safer for moms and babies in parts of Africa
January 19, 2019 - New anti-inflammatory compound acts as ‘surge protector’ to reduce cancer growth
January 19, 2019 - Significant flaws found in recently released forensic software
January 19, 2019 - New Leash on Life? Staying Slim Keeps Pooches Happy, Healthy
January 19, 2019 - Men and women remember pain differently
January 19, 2019 - Rising air pollution linked with increased ER visits for breathing problems
January 19, 2019 - Study uses local data to model food consumption patterns among Seattle residents
January 19, 2019 - The brain’s cerebellum plays role in controlling reward and social behaviors, study shows
January 19, 2019 - Relationship between nurse work environment and patient safety
January 19, 2019 - Pioneering surgery restores movement to children paralyzed by acute flaccid myelitis
January 19, 2019 - Genetic variants linked with risk tolerance and risky behaviors
January 19, 2019 - New research provides better understanding of our early human ancestors
January 19, 2019 - First-ever tailored reporting guidance to improve patient care and outcomes
January 19, 2019 - 4.6 percent of Massachusetts residents have opioid use disorder
January 19, 2019 - New study suggests vital exhaustion as risk factor for dementia
January 19, 2019 - New antibiotic discovery heralds breakthrough in the fight against drug-resistant bacteria
January 19, 2019 - Ural Federal University scientists synthesize a group of multi-purpose fluorophores
January 19, 2019 - Researchers identify new therapeutic target in the fight against chronic liver diseases
January 19, 2019 - Preparation, characterization of Soyasapogenol B loaded onto functionalized MWCNTs
January 19, 2019 - FDA Approves Ontruzant (trastuzumab-dttb), a Biosimilar to Herceptin
January 19, 2019 - Tobacco use linked with higher use of opioids and sedatives
January 19, 2019 - Study delves deeper into developmental dyslexia
January 19, 2019 - Anti-vaccination movement one of the top health threats in 2019 says WHO
January 19, 2019 - Newly developed risk score more effective at identifying type 1 diabetes
January 19, 2019 - Highly effective protocol to prepare cannabis samples for THC/CBD analysis
January 19, 2019 - Prinston Pharmaceutical Inc. Issues Voluntary Nationwide Recall of Irbesartan and Irbesartan HCTZ Tablets Due to Detection of a Trace Amount of Unexpected Impurity, N-Nitrosodiethylamine (NDEA) in the Products
January 19, 2019 - How does solid stress from brain tumors cause neuronal loss, neurologic dysfunction?
January 19, 2019 - $14.7 million partnership to supercharge vaccine development
January 19, 2019 - Ian Fotheringham receives Charles Tennant Memorial Lecture award
January 19, 2019 - Brain vital signs detect neurophysiological impairments in players with concussions
January 19, 2019 - Lack of job and poor housing conditions increased likelihood of people attending A&E
January 19, 2019 - Novel targeted drug delivery system improves conventional cancer treatments
January 19, 2019 - Rutgers study finds gene responsible for spread of prostate cancer
January 19, 2019 - Complications Higher Than Expected for Invasive Lung Tests
January 19, 2019 - 3-D printed implant promotes nerve cell growth to treat spinal cord injury
January 19, 2019 - Automated texts lead to improved outcomes after total knee or hip replacement surgery
January 19, 2019 - Poor cardiorespiratory fitness could increase risk of future heart attack, finds new study
January 19, 2019 - Drinking soft drinks while exercising in hot weather may increase risk of kidney disease
January 19, 2019 - Formlabs 3D prints anatomical models
January 19, 2019 - Heart-Healthy Living Also Wards Off Type 2 Diabetes
January 19, 2019 - Teaching Kids to Be Smart About Social Media (for Parents)
January 19, 2019 - Metabolite produced by gut microbiota from pomegranates reduces inflammatory bowel disease
January 19, 2019 - Researchers examine how spray from showers and toilets expose us to disease causing bacteria
January 19, 2019 - Behavioral experiments confirm that additional neurons improve brain function
‘Obesity paradox’ not found when measuring new cases of cardiovascular disease

‘Obesity paradox’ not found when measuring new cases of cardiovascular disease

image_pdfDownload PDFimage_print
Credit: CC0 Public Domain

Although obesity is a well-known risk factor for getting cardiovascular disease, a controversial body of research suggests that obesity may actually be associated with improved survival among people who have cardiovascular disease.

However, a new study by NYU College of Global Public Health and the University of Michigan finds that this “obesity paradox” is not present among people with new cases of cardiovascular disease. Most prior work examines people with more longstanding disease, where disease-related factors can bias findings towards the observation of a paradox.

“Given that many diseases result in wasting at the end of life, the notion that extra catabolic reserve can prolong survival makes intuitive sense. There are also explanations relating to a various inflammatory and neurohormonal processes. However, despite the plausibility of these hypotheses, we did not find evidence of an obesity paradox when using methods that are less prone to bias,” said Virginia Chang, MD, PhD, associate professor of social and behavioral sciences at NYU College of Global Public Health and the study’s lead author. The study is published online in the journal PLOS ONE.

Past research has largely looked at people with existing cardiovascular disease (prevalent disease), rather than focusing on those newly diagnosed (incident disease). Using incident disease data, however, can be valuable in helping researchers to control for confounding factors.

For instance, illness-related weight loss can influence how weight status is categorized. Disease can lead to both death and weight loss, and both are a sign of more severe disease. If people categorized as normal weight have lost weight because of more severe disease, researchers will underestimate the adverse effects of being obese relative to normal weight. In addition, those who are both obese and have severe disease are more likely to die early, while more robust obese individuals survive and are ultimately studied. Both of these biases can be reduced by examining people at the time of an incident diagnosis and using their pre-diagnosis weight.

In this study, the researchers examined the association between obesity and mortality among people with cardiovascular disease, comparing incident and prevalent disease cases in the same dataset. They used the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults aged 50 years and older conducted by the University of Michigan. The study, initiated in 1992, links surveys of more than 30,000 individuals to Medicare claims.

The researchers focused on specific cardiovascular disease diagnoses: myocardial infarction (heart attack), chronic heart failure, stroke, and ischemic heart disease. When looking at prevalent disease, the researchers used individuals’ current weights; when studying incident disease, they used their pre-diagnosis weights.

Among those with prevalent disease, the researchers observed a strong and significant obesity paradox, replicating earlier findings. The risk of death was 18 to 36 percent lower for people in obese class I (a body mass index of 30-34.9) compared with those of normal weight.

However, in incident disease models of the same cardiovascular conditions, and using the same dataset, there was no evidence of this survival benefit.

“The loss of an obesity paradox when switching from prevalent to incident cases and pre-diagnosis weight in the same dataset suggests that prevalent models are likely biased by factors such as disease-related weight loss and selective survival,” Chang said.

If obesity improved survival among people with new and existing cases of cardiovascular disease, the finding would have important clinical and public health implications. However, the researchers conclude that their findings do not support reevaluating guidelines in pursuit of a potential obesity paradox.


Explore further:
Does carrying extra weight offer better survival following a stroke?

Journal reference:
PLoS ONE

Provided by:
New York University

Tagged with:

About author

Related Articles