The DOI matches its Crossref record; 41 of the 42 references it cites were found in a registry or an index.
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]
Citations
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Body Fat Distribution and Risk of Cardiovascular Disease: An Update
Després, J.-P. (2012) · Circulation · doi:10.1161/circulationaha.111.067264 · Cited by 1,481 · cited 1×
“Altered fat distribution is associated with lower risk of CV diseases, independent of total adiposity.(27) Available evidence suggests that ectopic fat depots may be lower in fit individuals independent of BMI,(28) and in a study of over 13,000 men with hypertension from the ACLS(29) among those with high CRF, those w…”
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1 of the 42 references couldn’t be matched to a known paper.
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Neeland, I. J., Poirier, P., & Després, J.-P. (2018) · Circulation · doi:10.1161/circulationaha.117.029617 · Cited by 881
An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases
Elagizi, A., Kachur, S. M., Lavie, C. J., Carbone, S., Pandey, A., Ortega, F. B., & Milani, R. V. (2018) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2018.07.003 · Cited by 718
Obesity and Cardiovascular Diseases
Lavie, C. J., McAuley, P. A., Church, T. S., Milani, R. V., & Blair, S. N. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.01.022 · Cited by 685
Self-citationFrank, L. D., Iroz‐Elardo, N., MacLeod, K. E., & Hong, A. (2019) · Journal of Transport & Health · doi:10.1016/j.jth.2018.11.008 · Cited by 289
Healthy obese versus unhealthy lean: the obesity paradox
Lavie, C. J., De Schutter, A., & Milani, R. V. (2015) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.165 · Cited by 266
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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