The Fat but Fit paradox: what we know and don’t know about it

Ortega, Francisco B.; Ruiz, Jonatan R.; Labayen, Idoia; Lavie, Carl J.; Blair, Steven N.

doi:10.1136/bjsports-2016-097400

Cited by 141 publications

(143 citation statements)

References 11 publications

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“…Our results do not support the so‐called “Fat but Fit paradox” in relation with CVD risk. In this sense, it has been previously suggested that CRF has the potential to counteract the deleterious effect that weight status exerts on the CVD profile; however, most of these evidence comes from studies conducted in adult population, and the information about the Fat but Fit paradox in children and adolescents is still sparse . Nonetheless, and despite differences in the methodology, regarding the cardiovascular risk factors and the statistical procedures used, our results coincide with those reported recently by Nyström et al, who found that weight status has a larger negative effect on the metabolic profile than low CRF.…”

Section: Discussionsupporting

confidence: 88%

“…In this sense, it has been previously suggested that CRF has the potential to counteract the deleterious effect that weight status exerts on the CVD profile; however, most of these evidence comes from studies conducted in adult population, and the information about the Fat but Fit paradox in children and adolescents is still sparse. 36 37 , and it is considered a predictor of adiposity in later years. 5,7,38 The physiological mechanisms by which CRF affects adiposity may include the effect that aerobic exercise exerts on the expression and activity of carnitine palmitoyl transferase I (an enzyme that controls the fatty acids movement into the mitochondria), as well as the increase in β-Hydroxy acyl-CoA dehydrogenase protein expression (a key enzyme that regulates fat oxidation).…”

Section: Discussionmentioning

confidence: 99%

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The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: The UP&DOWN Study

et al. 2018

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Background The combined effect of cardiorespiratory fitness (CRF) and body mass index (BMI) on cardiovascular disease (CVD) risk in young people remains to be fully determined. We examined the individual and combined associations of CRF and BMI with clustered CVD risk factors, and the mediator role of BMI in the association between CRF and clustered CVD risk factors in children and adolescents. Methods 237 children (111 girls) and 260 adolescents (120 girls) were included in this cross‐sectional study. Height and weight were assessed and BMI was calculated. A CVD risk factor index (CVDRF‐I) was computed from: waist circumference, systolic blood pressure, triglycerides, high‐density lipoprotein cholesterol and glucose. CRF was assessed using the 20‐m shuttle run test. Regression analysis, analysis of covariance and mediation analysis (Baron and Kenny procedures) were used to test the independent and combined effect of CRF and BMI on CVDRF‐I, and to test mediation hypothesis, respectively. Results CRF was negatively associated with CVDRF‐I (all P < 0.05); however, after adjusting for BMI the associations were no longer significant in children and adolescents of both sex groups. Contrary, the association between BMI and CVDRF‐I was independent of CRF (all P < 0.001). The effect of CRF on CVDRF‐I was mediated by BMI. The percentage of the total effect of CRF on CVDRF‐I mediated by BMI for boys and girls children and boys and girls adolescents were 79.5%, 100%, 81.2% and 55.7%, respectively. Conclusions BMI is an independent predictor of CVDRF‐I and a mediator of the association between CRF and CVDRF‐I in children and adolescents. These results help to clarify the associations between CRF, weight status and cardiovascular health, suggesting that future CVD health would benefit from maintaining an optimal weight status.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: The UP&DOWN Study

et al. 2018

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“…This scoring structure, similar to that used in the Canadian Assessment of Physical Literacy,55 56 could help identify the fitness components/subdomains in need of attention in order to provide appropriate feedback and advice to children about how to best improve their overall physical fitness. In this context, the lowest quintile has extensively been used as a threshold for defining low fitness or unfit youth 57. In prospective cohort studies, this group has been shown to have a disproportionately higher risk for future diseases 58.…”

Section: Discussionmentioning

confidence: 99%

European normative values for physical fitness in children and adolescents aged 9–17 years: results from 2 779 165 Eurofit performances representing 30 countries

et al. 2017

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“…Ortega and colleagues in a recent editorial summarized concerns regarding the “state of the art” of the called “fat but fit paradox.” Among the gaps related to this paradox is the lack of evidence on its demographic distribution in the general population. For example, it is unclear if physical activity has greater protection against the negative influence of body adiposity on chronic diseases in men than women or in adults than older adults.…”

Section: Introductionmentioning

confidence: 99%

Does leisure‐time physical activity attenuate or eliminate the positive association between obesity and high blood pressure?

Werneck

Oyeyemi

Gerage

et al. 2018

J of Clinical Hypertension

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We examine the joint association of weight status and leisure-time physical activity on high blood pressure in a nationally representative sample of adults and older adults in Brazil. This was a national cross-sectional survey conducted in Brazil in 2013 (Brazilian Health Survey). The sample consisted of 59 402 participants (56% women, aged 18 to 100 years). Outcome was objectively assessed blood pressure. Body mass index (BMI) was objectively measured, while self-reported information on leisure-time physical activity, TV viewing, chronological age, race, educational status, tobacco smoking, sodium consumption, and hypertension medication was obtained using questionnaires. Logistic regression analysis with adjusted odds ratio was conducted to test the joint association of BMI and leisure-time physical activity categories on high blood pressure. Overall, compared to normal weight (NW) and physically active group, the NW/inactive (OR = 1.28; 1.04 to 1.58), overweight/active (OR = 1.38; 1.08 to 1.78), overweight/inactive (OR = 1.89; 1.53 to 2.33), obese/active (OR = 2.19; 1.59 to 3.01) and obese/inactive (OR = 2.54; 2.05 to 3.15) groups were 28% to 254% more likely to have high blood pressure. The attenuation and high blood pressure was greater for women and adults than for men and older adults. Thus, leisure-time physical inactivity and being overweight and obesity were associated with high blood pressure in Brazilian population. Engaging in sufficient level of physical activity during leisure could attenuate, but not eliminate, the negative influence of obesity on high blood pressure in Brazilian adults and older adults.

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The Fat but Fit paradox: what we know and don’t know about it

Cited by 141 publications

References 11 publications

The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: The UP&DOWN Study

The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: The UP&DOWN Study

European normative values for physical fitness in children and adolescents aged 9–17 years: results from 2 779 165 Eurofit performances representing 30 countries

Does leisure‐time physical activity attenuate or eliminate the positive association between obesity and high blood pressure?

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