Addition of Cardiorespiratory Fitness Within an Obesity Risk Classification Model Identifies Men at Increased Risk of All-Cause Mortality

Ricketts, T. Alexander; Sui, Xuemei; Lavie, Carl J.; Blair, Steven N.; Ross, Robert

doi:10.1016/j.amjmed.2015.11.015

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…Similarly, the rise of AUROC for HTN and DM were larger than DLP and MetS, which might be due to the fact that DLP and MetS were primarily influenced by abdominal obesity; while HTN and DM also depended on the amount of fat to some extent. In addition, BMI and WC were the preferable combinations in general, which was in agreement with Zhu et al’s and Ricketts et al ’ s study [40,42]. Besides, the AUROC of younger age groups was the largest in most cases, which implied that obesity might have much more impact on young people.…”

Section: Discussionsupporting

confidence: 89%

“…Firstly, the definition of MetS had an overlap with WC, which might lead to overestimations of adjusted AUROC and ORs for MetS. Secondly, age was adjusted in our studies; however, other confounders that might have impact on CVD risk factors and MetS [42,43,44,45,46,47,48], such as physical activity or fitness, smoking, etc., were not under our consideration. Finally, the results in our study were attained from Jilin province, which might limit our ability to generalize the results to the rest of China.…”

Section: Discussionmentioning

confidence: 91%

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Comparison of the Combined Obesity Indices to Predict Cardiovascular Diseases Risk Factors and Metabolic Syndrome in Northeast China

Tao

Tao³

et al. 2016

IJERPH

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Background: Obesity is associated with cardiovascular disease (CVD) risk factors (hypertension, dyslipidemia and diabetes) and metabolic syndrome (MetS), and it may be flawed that most studies only use one obesity index to predict these risk factors. Therefore, our study aims to compare the various combined obesity indices systematically, and to find the optimal combined obesity indices to predict CVD risk factors and MetS. Methods: A total of 16,766 participants aged 18–79 years old were recruited in Jilin Province in 2012. Receiver operating characteristic curve (ROC) curves and multiple logistic regressions were used to evaluate the predictive capacity of the combined obesity indices for CVD risk factors and MetS. Results: The adjusted area under receiver operating characteristic (AUROC) with two combined obesity indices had been improved up to 19.45%, compared with one single obesity index. In addition, body mass index (BMI) and waist circumference (WC) were the optimal combinations, where the AUROC (95% confidence interval (CI)) for hypertension, dyslipidemia, diabetes and MetS in males were 0.730 (0.718, 0.740), 0.694 (0.682, 0.706), 0.725 (0.709, 0.742) and 0.820 (0.810, 0.830), and in females were 0.790 (0.780, 0.799), 0.727 (0.717, 0.738), 0.746 (0.731, 0.761) and 0.828 (0.820, 0.837), respectively. Conclusions: The more abnormal obesity indices that one has the higher the risk for CVD risk factors and MetS, especially in males. In addition, the combined obesity indices have better predictions than one obesity index, where BMI and WC are the optimal combinations.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 91%

Comparison of the Combined Obesity Indices to Predict Cardiovascular Diseases Risk Factors and Metabolic Syndrome in Northeast China

Tao

Tao³

et al. 2016

IJERPH

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“…Another study found that the average percent body fat in five LOPD patients was in the obese range at ~45% (23). Consequently, it appears that obesity is a significant issue in LOPD patients and is concerning for it will increase the risk of obesity-associated morbidities (34), especially when combined with low PA (35)(36)(37). Furthermore, the extra weight is a major issue in a patient with SM weakness and will further impair activities of daily living (ADL).…”

Section: Body Compositionmentioning

confidence: 99%

Nutrition and exercise in Pompe disease

Tarnopolsky¹,

Nilsson²

2019

Ann. Transl. Med

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The current standard of care for Pompe disease (PD) is the administration of enzyme replacement therapy (ERT). Exercise and nutrition are often considered as complementary strategies rather than "treatments" per se. Nutritional assessment is important in patients with locomotor disability because the relative hypodynamia limits energy expenditure and thus the total amount of energy must be reduced to avoid obesity. A lower total energy intake often leads to lower protein and micronutrient intake. Consequently, ensuring that Pompe patients are tested for and replaced for deficiencies (protein, vitamin D, vitamin B12, etc.) is an important aspect of care. Furthermore, given the role of autophagy in the pathophysiology of PD and the fact that fasting induces autophagy, it is important that strategies such as nutritional timing and amino acid intake (L-arginine, L-leucine) be evaluated as therapies. Exercise interventions have been shown to improve six-minute walk testing distance by more than what was seen in the seminal ERT study in late-onset PD. Exercise therapy can also activate autophagy, and this is likely another component of its efficacy. The current review will evaluate the theoretical and practical aspects of nutrition and exercise as therapies for patients with PD.

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“…The fat but fit paradigm suggests that having high fitness may attenuate most of the adverse effects of obesity on all-cause and CVD morbidity and mortality. 16 , 17 , 18 , 19 , 20 , 21 , 22 Furthermore, overweight and even mild obesity may be associated with better survival, especially in older populations. 20 , 22 Together these findings raise the possibility of a disparate effect of fitness and fatness on risk factors for CVD as compared with CVD events and especially mortality in an older cohort.…”

Section: Discussionmentioning

confidence: 99%

“… 7 Indeed, high fitness has been reported to attenuate most of the adverse effects of overweight and even mild obesity on all-cause and CVD mortality and morbidity. 7 , 8 , 16 , 17 , 18 , 19 , 20 , 21 Individuals who are fat but fit have lower mortality rates than lean but unfit individuals both in the general adult population 11 , 12 , 13 and in older adults. 10 , 14 , 22 However, whether high fitness can modify the deleterious association between body fatness and cardiometabolic risk factors has not been adequately addressed in older adults, and findings in the general population have been inconsistent.…”

mentioning

confidence: 99%

Combined Association of Cardiorespiratory Fitness and Body Fatness With Cardiometabolic Risk Factors in Older Norwegian Adults: The Generation 100 Study

Sandbakk

Nauman

Lavie

et al. 2017

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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ObjectiveTo investigate the independent and combined associations of fitness and fatness with cardiometabolic risk factors in older Norwegian women and men.Patients and MethodsWe conducted a cross-sectional study of 505 women and 417 men aged 70 to 77 years enrolled in the Generation 100 study in Norway. Fitness was assessed as peak oxygen uptake and fatness as high body mass index (BMI; ≥25 kg/m2), waist circumference (WC) of 88 cm or greater for women and 102 cm or greater for men, and percent body fat (%BF) of 35% or greater and 25% or greater for women and men, respectively. High cardiometabolic risk was defined as the presence of 2 or more of the following risk factors: elevated triglyceride level, reduced high-density lipoprotein cholesterol concentration, elevated blood pressure, and elevated fasting glucose level or pharmacological treatment of these conditions.ResultsReceiver operating characteristic curve analyses identified fitness levels of less than 25.7 and less than 30.7 mL/kg per minute in women and men, respectively, as critical thresholds for having high cardiometabolic risk. Individuals with levels below these thresholds had an adjusted odds ratio of 2.77 (95% CI, 2.09-3.66) for having high cardiometabolic risk, while high BMI, WC, and %BF had odds ratios (95% CIs) of 3.58 (2.69-4.77), 3.06 (2.29-4.10), and 3.26 (2.47-4.30), respectively. In our combined analyses, being lean did not attenuate the cardiometabolic risk associated with low fitness, and combinations of low fitness and/or high BMI, WC, or %BF cumulatively increased cardiometabolic risk.ConclusionLow fitness and indication of fatness were independently and cumulatively associated with poor cardiometabolic health. Our results emphasize the importance of including both physical fitness and body fatness in the assessment of cardiometabolic risk and health promotion efforts in older adults.

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Addition of Cardiorespiratory Fitness Within an Obesity Risk Classification Model Identifies Men at Increased Risk of All-Cause Mortality

Abstract: Background: Guidelines for identification of obesity-related risk stratify disease risk

Cited by 10 publications

References 32 publications

Comparison of the Combined Obesity Indices to Predict Cardiovascular Diseases Risk Factors and Metabolic Syndrome in Northeast China

Comparison of the Combined Obesity Indices to Predict Cardiovascular Diseases Risk Factors and Metabolic Syndrome in Northeast China

Nutrition and exercise in Pompe disease

Combined Association of Cardiorespiratory Fitness and Body Fatness With Cardiometabolic Risk Factors in Older Norwegian Adults: The Generation 100 Study

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