The Many Paradoxes of Our Modern World: Is There Really an Obesity Paradox or Is It Only a Matter of Adiposity Assessment?

Editorials1 December 2015The Many Paradoxes of Our Modern World: Is There Really an Obesity Paradox or Is It Only a Matter of Adiposity Assessment?Paul Poirier, MD, PhDPaul Poirier, MD, PhDFrom Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2435 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail We live in a world filled with paradox. Ours is a world in which some persons have famine while others deal with obesity—an epidemic that threatens their health. Obesity is increasing worldwide; currently, more than 2 billion persons worldwide are now overweight or obese (1).The terms underweight, normal weight, overweight, obesity, and severe obesity refer to a clinical continuum. The Metropolitan Life Insurance Company tables were once used to characterize obesity. Now there are several anthropometric measures to assess adiposity. Presently, body mass index (BMI) and waist circumference (WC) are 2 recommended clinical measures to evaluate patients' obesity-related health ...References1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766-81. [PMID: 24880830] CrossrefMedlineGoogle Scholar2. Cornier MA, Després JP, Davis N, Grossniklaus DA, Klein S, Lamarche B, et al; American Heart Association Obesity Committee of the Council on Nutrition. Assessing adiposity: a scientific statement from the American Heart Association. Circulation. 2011;124:1996-2019. [PMID: 21947291] CrossrefMedlineGoogle Scholar3. Després JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126:1301-13. [PMID: 22949540] CrossrefMedlineGoogle Scholar4. Bastien M, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis. 2014;56:369-81. [PMID: 24438728] CrossrefMedlineGoogle Scholar5. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010;56:1113-32. [PMID: 20863953] CrossrefMedlineGoogle Scholar6. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, et al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med. 2015;163:827-35. doi:10.7326/M14-2525 LinkGoogle Scholar7. Wahi G, Anand SS. Race/ethnicity, obesity, and related cardio-metabolic risk factors: a life-course perspective. Curr Cardiovasc Risk Rep. 2013;7:326-335. [PMID: 24672590] CrossrefMedlineGoogle Scholar8. van der A DL, Nooyens AC, van Duijnhoven FJ, Verschuren MM, Boer JM. All-cause mortality risk of metabolically healthy abdominal obese individuals: the EPIC-MORGEN study. Obesity (Silver Spring). 2014;22:557-64. [PMID: 23595997] CrossrefMedlineGoogle Scholar9. Wormser D, Kaptoge S, DiAngelantonio E, Wood AM, Pennells L, Thompson A, et al; Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet. 2011;377:1085-95. [PMID: 21397319] CrossrefMedlineGoogle Scholar10. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102-38. [PMID: 24222017] doi:10.1161/01.cir.0000437739.71477.ee CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.Disclosures: The author has disclosed no conflicts of interest. Form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2435.Corresponding Author: Paul Poirier, MD, PhD, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, 2725 Chemin Ste-Foy, Québec G1V 4G5, Canada; e-mail, paul.[email protected]ulaval.ca.This article was published online first at www.annals.org on 10 November 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNormal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality Karine R. Sahakyan , Virend K. Somers , Juan P. Rodriguez-Escudero , David O. Hodge , Rickey E. Carter , Ondrej Sochor , Thais Coutinho , Michael D. Jensen , Véronique L. Roger , Prachi Singh , and Francisco Lopez-Jimenez Metrics Cited byMetabolic syndromes responsible for cervical cancer and advancement of nanocarriers for efficient targeted drug delivery- A reviewCirculating Lipid- and Inflammation-Based Risk (CLIR) Score: A Promising New Model for Predicting Outcomes in Complete Colorectal Liver Metastases ResectionCorrelation between transabdominal sonographic prostate volume and anthropometric parametersAssociation between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective CohortOutcomes in Patients with Obesity and Coronary Artery Disease with and Without Bariatric SurgeryA simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for EnglandCould metabolic risk factors contribute to the development of cervical cancer?Obesity and Cancer Mechanisms: Tumor Microenvironment and InflammationImbalanced insulin action in chronic over nutrition: Clinical harm, molecular mechanisms, and a way forwardWaist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference 1 December 2015Volume 163, Issue 11Page: 880-881KeywordsBody mass indexCardiovascular disease riskCardiovascular diseasesFatsHazard ratioHealth surveysMedical risk factorsMortalityObesityOverweight ePublished: 10 November 2015 Issue Published: 1 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. 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