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Nat Rev Cardiol. 2011 Apr;8(4):233-7. doi: 10.1038/nrcardio.2010.209. Epub 2011 Jan 25.

Impact of obesity on total and cardiovascular mortality--fat or fiction?

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Department of Internal Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein Professional Building, Suite 300, Philadelphia, PA 19141, USA.


Obesity is an excessive accumulation of fat that can impair health. Because the direct measurement of body fat is difficult to perform, a number of anthropometric measures have been employed as surrogates, of which BMI is the most commonly used. However, its usefulness has been questioned as a BMI in the overweight and mildly obese range is associated with improved survival and fewer cardiovascular events than a BMI in the normal range, a phenomenon known as the 'obesity paradox'. Waist circumference, waist-to-hip ratio, and waist-to-height ratio take into consideration body-fat distribution, especially abdominal obesity, and seem to predict cardiovascular risk better than does BMI.

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