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Impact of Dietary and Exercise Interventions on Brain Insulin Action and Brain Function
Published in André Kleinridders, Physiological Consequences of Brain Insulin Action, 2023
The absence of obesity and even weight loss are not unanimous indicators of good health and long-life expectancy. The “obesity paradox” addresses a multifactorial problem of normal- to underweight elderly adults: increased mortality, even and especially when suffering from T2DM, CVD or cancer (39–41). Maintaining desirable depots of adipose tissue (femoral vs. abdominal fat; subcutaneous vs. visceral fat) might be crucial in providing physiological storage for nutrients, assuring sufficient production of estrogen, adiponectin, and other beneficial hormones and protecting mechanically relevant structures in the context of aging, sarcopenia, and osteoporosis.
Relationship between body mass index and the degree of mitral valve stenosis: Supporting evidence for the obesity paradox phenomenon
Published in Ade Gafar Abdullah, Isma Widiaty, Cep Ubad Abdullah, Medical Technology and Environmental Health, 2020
A.N. Lestari, I.R. Alie, M.R. Akbar
Although the phenomenon of the obesity paradox is still widely studied throughout the world, many global studies have shown this. A meta-analysis found that the obese and overweight groups had lower risk of cardiovascular mortality compared to the normal BMI group. Shah and colleagues in Parto et al. (2016), 2014 evaluated 6,142 patients with decompensated acute heart failure on four continents and found that for every 5 kg/m2 increase in BMI, there was an 11% reduction in 30-day mortality rate and also a 9% decrease in annual mortality.
Counseling Coronary Patients About Their Body Weight: Implications Regarding the Obesity Paradox
Published in James M. Rippe, Lifestyle Medicine, 2019
Sergey Kachur, Carl J. Lavie, Richard V. Milani
The obesity paradox is present in those with chronic disease, advanced age, and low cardiorespiratory fitness. Those with higher fitness have not been shown to benefit from excess mass. In young er individuals, obesity accelerates the onset of chronic disease and may shorten overall lifespan.
Appetite and energy intake following a bout of circuit resistance training in chronic hemiparetic stroke patients: a preliminary randomized controlled trial
Published in Topics in Stroke Rehabilitation, 2023
Tatiana R. Dos Santos, Sandra A. Billinger, Adrian W. Midgley, André C. Michalski, Victor A. B. Costa, Guilherme F. Fonseca, Felipe A. Cunha
Stroke patients often present with dysphagia,21 loss of appetite,22 reduced energy intake,37 nutrition deficits,37 and considerable risk of developing sarcopenia.20 One could therefore question whether CRT would be a favorable training strategy for these patients, due to the post-exercise decrease in appetite and relative energy intake, and the associated negative energy balance that could lead to long-term weight loss. This is considered risky for these patients22 as obesity and overweight improves survival in stroke patients.38 This is a notable issue since CRT improves strength and functional performance in chronic stroke patients39 and is recommended in the joint scientific statement of the American Heart Association and American Stroke Association.6 This creates the obesity paradox, as obesity is an independent risk factor for cardiovascular disease and mortality.40 The lack of understanding of this topic highlights the urgent need for research to elucidate the role of exercise on appetite regulation and weight management in chronic hemiparetic stroke patients and how these impact on long-term energy balance, cardiovascular risk, and mortality.
Influence of body mass index and age on day-of-surgery discharge, prolonged admission, and 90-day readmission after fast-track unicompartmental knee arthroplasty
Published in Acta Orthopaedica, 2021
Christian Bredgaard Jensen, Anders Troelsen, Pelle Baggesgaard Petersen, Christoffer Calov JØrgensen, Henrik Kehlet, Kirill Gromov
Some studies investigating recovery and complications after surgery, as well as arthroplasty surgery, report better outcome in overweight/obese patients compared with normal-weight patients (Shaparin et al. 2016, Smith et al. 2020). This is labelled the “obesity paradox.” The findings of Sundaram et al. (2019) mentioned above also reported fewer complications in overweight patients. A study by Katakam et al. (2021) investigating LOS in patients undergoing total hip arthroplasty and TKA found that being either underweight or morbidly obese resulted in increased LOS. It is suggested that the relationship between BMI and various outcomes is not linear but rather quadratic, with slight overweight in elderly patients countering sarcopenia and malnutrition (Shaparin et al. 2016, Smith et al. 2020). However, patient selection is also proposed as the reason for these findings, as surgeons might refrain from operating on obese patients with additional comorbidity, thus creating a healthier cohort (Zhang et al. 2018).
Survival in Patients with Paramedic-Identified ST-Segment Elevation Myocardial Infarction
Published in Prehospital Emergency Care, 2021
Tan N. Doan, Kirsten Wilson, Brendan V. Schultz, Brett Rogers, William Vollbon, Marcus Prior, Stephen Rashford, Emma Bosley
We found that being overweight was associated with lower risk of 30-day mortality, consistent with previous studies (20, 21). Our finding is another example of the “obesity paradox” that has been described in patients with acute myocardial infarction (AMI), in which overweight and obese patients are found to have lower short-term mortality after AMI than normal weight patients (20, 21). Several theories have been proposed to explain this obesity paradox. It is hypothesized that excess weight confers a protective advantage by providing nutritional reserves to overcome acute stress and increased metabolic demands during AMI (21). Another theory suggests that clinicians may treat overweight and obese patients more aggressively due to their perceived high risks of cardiovascular disease associated with obesity (22). Because of their cardiovascular risk factors, patients with elevated BMI may also receive more aggressive secondary prevention after discharge (21). New evidence, although controversial, also suggests that overweight and obesity may enhance endothelial function, reducing the progression of atherosclerosis and risk of mortality (23).