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‘obesity paradox’: a parsimonious explanation for relations among obesity, mortality rate and aging
Objective: Current clinical guidelines and public health statements generically prescribe body mass index (BMI; kg m–2) categories regardless of the individual's situation (age, risk for diseases, and so on). However, regarding BMI and mortality rate, two well-established observations are (1) t...
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| Published in: | International Journal of Obesity 2010-08, Vol.34 (8), p.1231-1238 |
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| container_title | International Journal of Obesity |
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| creator | Childers, D.K Allison, D.B |
| description | Objective: Current clinical guidelines and public health statements generically prescribe body mass index (BMI; kg m–2) categories regardless of the individual's situation (age, risk for diseases, and so on). However, regarding BMI and mortality rate, two well-established observations are (1) there is a U-shaped (that is, concave) association—people with intermediate BMIs tend to outlive people with higher or lower BMIs; and (2) the nadirs of these curves tend to increase monotonically with age. Multiple hypotheses have been advanced to explain either of these two observations. In this study, we introduce a new hypothesis that may explain both phenomena, by drawing on the so-called obesity paradox: the unexpected finding that obesity is often associated with increased survival time among people who have some serious injury or illness in spite of being associated with reduced survival time among the general population. Results: We establish that the obesity paradox offers one potential explanation for two curious but consistently observed phenomena in the obesity field. Conclusion: Further research is needed to determine the extent to which the obesity paradox is actually an explanation for these phenomena, but if our hypothesis proves true the common practice of prescribing overweight patients to lower their BMI should currently be applied with caution. In addition, the statistical modeling technique used here could be applied in such other areas involving survival analysis of disjoint subgroups, to explain possible interacting causal associations and to determine clinical practice. |
| doi_str_mv | 10.1038/ijo.2010.71 |
| format | article |
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However, regarding BMI and mortality rate, two well-established observations are (1) there is a U-shaped (that is, concave) association—people with intermediate BMIs tend to outlive people with higher or lower BMIs; and (2) the nadirs of these curves tend to increase monotonically with age. Multiple hypotheses have been advanced to explain either of these two observations. In this study, we introduce a new hypothesis that may explain both phenomena, by drawing on the so-called obesity paradox: the unexpected finding that obesity is often associated with increased survival time among people who have some serious injury or illness in spite of being associated with reduced survival time among the general population. Results: We establish that the obesity paradox offers one potential explanation for two curious but consistently observed phenomena in the obesity field. Conclusion: Further research is needed to determine the extent to which the obesity paradox is actually an explanation for these phenomena, but if our hypothesis proves true the common practice of prescribing overweight patients to lower their BMI should currently be applied with caution. In addition, the statistical modeling technique used here could be applied in such other areas involving survival analysis of disjoint subgroups, to explain possible interacting causal associations and to determine clinical practice.</description><identifier>ISSN: 0307-0565</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/ijo.2010.71</identifier><identifier>PMID: 20440298</identifier><identifier>CODEN: IJOBDP</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Age ; Aging ; Aging - physiology ; Animals ; Biological and medical sciences ; Body Mass Index ; Causality ; Clinical medicine ; complications ; Disease ; disease prevention ; Epidemiology ; General aspects ; human diseases ; Humans ; Hypotheses ; Injuries ; longevity ; mathematical models ; Medical sciences ; Metabolic diseases ; Mortality ; Nutrition research ; Obesity ; Obesity - mortality ; obesity paradox ; Overweight ; Physiological aspects ; Practice Guidelines as Topic ; probabilistic models ; probabilistic risk assessment ; probability analysis ; Public health ; Public health. 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Hygiene-occupational medicine ; Random variables ; reference standards ; risk groups ; senescence ; Survival Analysis ; United States ; validity</subject><ispartof>International Journal of Obesity, 2010-08, Vol.34 (8), p.1231-1238</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Aug 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c681t-e67136f7367cd9331ae834180f32862a2da68bdacec84de0235959f64a2533</citedby><cites>FETCH-LOGICAL-c681t-e67136f7367cd9331ae834180f32862a2da68bdacec84de0235959f64a2533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,2744,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23074850$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20440298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Childers, D.K</creatorcontrib><creatorcontrib>Allison, D.B</creatorcontrib><title>‘obesity paradox’: a parsimonious explanation for relations among obesity, mortality rate and aging</title><title>International Journal of Obesity</title><addtitle>Int J Obes (Lond)</addtitle><description>Objective: Current clinical guidelines and public health statements generically prescribe body mass index (BMI; kg m–2) categories regardless of the individual's situation (age, risk for diseases, and so on). However, regarding BMI and mortality rate, two well-established observations are (1) there is a U-shaped (that is, concave) association—people with intermediate BMIs tend to outlive people with higher or lower BMIs; and (2) the nadirs of these curves tend to increase monotonically with age. Multiple hypotheses have been advanced to explain either of these two observations. In this study, we introduce a new hypothesis that may explain both phenomena, by drawing on the so-called obesity paradox: the unexpected finding that obesity is often associated with increased survival time among people who have some serious injury or illness in spite of being associated with reduced survival time among the general population. Results: We establish that the obesity paradox offers one potential explanation for two curious but consistently observed phenomena in the obesity field. Conclusion: Further research is needed to determine the extent to which the obesity paradox is actually an explanation for these phenomena, but if our hypothesis proves true the common practice of prescribing overweight patients to lower their BMI should currently be applied with caution. In addition, the statistical modeling technique used here could be applied in such other areas involving survival analysis of disjoint subgroups, to explain possible interacting causal associations and to determine clinical practice.</description><subject>Age</subject><subject>Aging</subject><subject>Aging - physiology</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Causality</subject><subject>Clinical medicine</subject><subject>complications</subject><subject>Disease</subject><subject>disease prevention</subject><subject>Epidemiology</subject><subject>General aspects</subject><subject>human diseases</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Injuries</subject><subject>longevity</subject><subject>mathematical models</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Mortality</subject><subject>Nutrition research</subject><subject>Obesity</subject><subject>Obesity - mortality</subject><subject>obesity paradox</subject><subject>Overweight</subject><subject>Physiological aspects</subject><subject>Practice Guidelines as Topic</subject><subject>probabilistic models</subject><subject>probabilistic risk assessment</subject><subject>probability analysis</subject><subject>Public health</subject><subject>Public health. 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Conclusion: Further research is needed to determine the extent to which the obesity paradox is actually an explanation for these phenomena, but if our hypothesis proves true the common practice of prescribing overweight patients to lower their BMI should currently be applied with caution. In addition, the statistical modeling technique used here could be applied in such other areas involving survival analysis of disjoint subgroups, to explain possible interacting causal associations and to determine clinical practice.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>20440298</pmid><doi>10.1038/ijo.2010.71</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aging Aging - physiology Animals Biological and medical sciences Body Mass Index Causality Clinical medicine complications Disease disease prevention Epidemiology General aspects human diseases Humans Hypotheses Injuries longevity mathematical models Medical sciences Metabolic diseases Mortality Nutrition research Obesity Obesity - mortality obesity paradox Overweight Physiological aspects Practice Guidelines as Topic probabilistic models probabilistic risk assessment probability analysis Public health Public health. Hygiene Public health. Hygiene-occupational medicine Random variables reference standards risk groups senescence Survival Analysis United States validity |
| title | ‘obesity paradox’: a parsimonious explanation for relations among obesity, mortality rate and aging |
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