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Contribution of Cardiorespiratory Fitness to the Obesity Paradox
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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“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]
In the citing paper
“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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Metadata
- Authors
- McAuley, P. A., & Beavers, K. M.
- Affiliations
- Winston-Salem State University (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- McAuley, Paul A.
- Venue
- Progress in Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 56
- Issue
- 4
- Pages
- 434-440
- ISSN
- 0033-0620 (ISSN-L)
- 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
- Locations
- Progress in Cardiovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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