Contribution of Cardiorespiratory Fitness to the Obesity Paradox

McAuley, Paul A.; Beavers, Kristen M.

doi:10.1016/j.pcad.2013.09.006

Cited by 127Cardiovascular and exercise physiologyObesity, Physical Activity, DietPhysical Activity and Health

Contribution of Cardiorespiratory Fitness to the Obesity Paradox

McAuley, Paul A., Beavers, Kristen M.·2014·Progress in Cardiovascular Diseases

DOI 10.1016/j.pcad.2013.09.006

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Abstract

Until recently, cardiorespiratory fitness (CRF) has been overlooked as a potential modifier of the inverse association between obesity and mortality (the so-called obesity paradox), observed in patients with known or suspected cardiovascular (CV) disease. Evidence from five observational cohort studies of 30,104 patients (87% male) with CV disease indicates that CRF significantly alters the obesity paradox. There is general agreement across studies that the obesity paradox persists among patients with low CRF, regardless of whether adiposity is assessed by body mass index, waist circumference, or percentage body fat. However, among patients with high CRF, risk of all-cause mortality is lowest for the overweight category in some, but not all, studies, suggesting that higher levels of fitness may modify the relationship between body fatness and survival in patients manifesting an obesity paradox. Further study is needed to better characterize the joint contribution of CRF and obesity on mortality in diverse populations.

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Improved cardiorespiratory fitness largely neutralizes the adverse effects of increased adiposity and other traditional cardiovascular disease risk factors.
“Growing evidence suggests that improved CRF largely neutralizes the adverse effects of increased adiposity as well as other traditional CVD risk factors. 8”
From What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis (2021) · cites this paper as [8]
Cardiorespiratory fitness (CRF) exerts more influence on morbidity and mortality than body fat percentage (%BF) and its distribution.
“Despite a growing body of evidence that demonstrates that CRF exerts more influence on morbidity and mortality than %BF and its distribution, 8 , 88”
From What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis (2021) · cites this paper as [8]

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Authors: McAuley, P. A., & Beavers, K. M.
Affiliations: Winston-Salem State University (US)
Wake Forest University Health Sciences (US)
Corresponding author: McAuley, Paul A.
ORCID: McAuley, Paul A.
Beavers, Kristen M.
Venue: Progress in Cardiovascular Diseases
Publisher: Elsevier BV
Published: 2014-01
Volume: 56
Issue: 4
Pages: 434-440
ISSN: 0033-0620 (ISSN-L)
DOI: 10.1016/j.pcad.2013.09.006
OpenAlex: W2152068779
Cited by: 127
References: 42
Citations by year: 2026: 1 · 2025: 7 · 2024: 9 · 2023: 7 · 2022: 8 · 2021: 14 · 2020: 6 · 2019: 10 · 2018: 10 · 2017: 12 · 2016: 16 · 2015: 15 · 2014: 12
FWCI: 33.71
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Progress in Cardiovascular Diseases (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords: cardiorespiratory fitness, obesity paradox, obesity, cardiovascular disease, all-cause mortality, body mass index, waist circumference, body fat percentage, overweight, adiposity
MeSH terms: Age Factors, Aged, Cardiovascular Physiological Phenomena, Cause of Death, Coronary Disease, Female, Heart Function Tests, Humans, Male, Middle Aged, Obesity, Obesity, Morbid, Physical Fitness, Prognosis, Sex Factors, Body Mass Index, Prevalence, Survival Analysis, Risk Assessment

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Contribution of Cardiorespiratory Fitness to the Obesity Paradox

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