High percent body fat mass predicts lower risk of cardiac events in patients with heart failure: an explanation of the obesity paradox

Abstract Background Although high body mass index (BMI) is a risk factor of heart failure (HF), HF patients with a higher BMI had a lower mortality rate than that in HF patients with normal or lower BMI, a phenomenon that has been termed the “obesity paradox”. However, the relationship between body composition, i.e., fat or muscle mass, and clinical outcome in HF remains unclear. Methods We retrospectively analyzed data for 198 consecutive HF patients (76 years of age; males, 49%). Patients who were admitted to our institute for diagnosis and management of HF and received a dual-energy X-ray absorptiometry scan were included regardless of left ventricular ejection fraction (LVEF) categories. Muscle wasting was defined as appendicular skeletal muscle mass index < 7.0 kg/m2 in males and < 5.4 kg/m2 in females. Increased percent body fat mass (increased FM) was defined as percent body fat > 25% in males and > 30% in females. Results The median age of the patients was 76 years (interquartile range [IQR], 67–82 years) and 49% of them were male. The median LVEF was 47% (IQR, 33–63%) and 33% of the patients had heart failure with reduced ejection fraction. Increased FM and muscle wasting were observed in 58 and 67% of the enrolled patients, respectively. During a 180-day follow-up period, 32 patients (16%) had cardiac events defined as cardiac death or readmission by worsening HF or arrhythmia. Kaplan-Meier survival curves showed that patients with increased FM had a lower cardiac event rate than did patients without increased FM (11.4% vs. 22.6%, p = 0.03). Kaplan-Meier curves of cardiac event rates did not differ between patients with and those without muscle wasting (16.5% vs. 15.4%, p = 0.93). In multivariate Cox regression analyses, increased FM was independently associated with lower cardiac event rates (hazard ratio: 0.45, 95% confidence interval: 0.22–0.93) after adjustment for age, sex, diabetes, muscle wasting, and renal function. Conclusions High percent body fat mass is associated with lower risk of short-term cardiac events in HF patients.

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Body Morphometrics in NAFLD Population

Proceedings of IMPRS ◽

10.18060/23455 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Harkeerat Dhami ◽

Niharika Samala

Keyword(s):

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Percent Body Fat ◽

Composition Analysis ◽

Processed Meat ◽

Body Fat Mass ◽

High Sodium ◽

Obstructive Sleep

Introduction: NAFLD is one of the common causes of liver disease in the US and is commonly associated with metabolic syndrome. Among obese, prevalence of NAFLD is 7090%. We wanted to determine body morphometrics in NAFLD. Methods: All individuals presenting to Indiana University Hospital with NAFLD were approached to participate in cross-sectional study. All participants were offered beverage, diet (REAP) questionnaires and body composition analysis using InBody 570, which utilizes bioelectrical impedance. Results: Of the 321 NAFLD individuals enrolled, 256 completed body morphometric analysis. Mean age of the cohort was 51.58 ± 13.54, 58% were female, 297 White and had a mean BMI of 35.92. 76% were obese, 48% had type 2 diabetes, 49.2% had hypertension, 38.6% had dyslipidemia, and 20.5% had obstructive sleep apnea. Despite having similar BMI, females had lower lean body mass (51.01 vs 70.51) and skeletal muscle mass (28.05 vs 39.70), higher body fat mass (46.71 vs 41.04) and percent body fat (46.59 vs. 35.7). Regular coffee consumers had lower BMI (35.3 vs 38, p=0.038), but lower body fat mass (39.9 vs 46.2, p=0.01), percent body fat (41.1 vs 44.4, p=0.05) and higher lean body mass % (58.8 vs 55.5, p=0.049). Processed meat consumption was associated with higher BMI (39 vs 35.3, P=0.01), percent body fat (45.5 vs 42, p=0.04), and lower lean body mass percentage (54.5 vs 58.2, P=0.04). Similar trends were seen with consumption of high sodium processed foods and watching television for ≥ 2 hours/day. Conclusion: Among individuals with NAFLD, we saw a higher female preponderance, who were found to have unfavorable body morphometrics despite similar BMI as males. Consumption of high sodium processed food and meat and excess screen time have unfavorable, while regular coffee drinkers have favorable body morphometrics, which offer modifiable measures for risk factors associated with NAFLD.

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Assessment of Body Composition, Endurance and Nutrient Intakes among Females Team Players in Sports Club

Arab Journal of Nutrition and Exercise (AJNE) ◽

10.18502/ajne.v1i3.1231 ◽

2017 ◽

Vol 1 (3) ◽

pp. 142

Author(s):

Amita Attlee ◽

Shaimaa S. Altunaiji ◽

Mariam Muayyad ◽

Zainab Ali ◽

Mona Hashim ◽

...

Keyword(s):

Body Composition ◽

Body Fat ◽

Fat Mass ◽

Percent Body Fat ◽

Body Fat Mass ◽

Nutrient Intakes ◽

Basketball Players ◽

Tennis Players ◽

Fitness Score ◽

Sports Club

Aim: The aim of the study was to assess the body composition, endurance level and usual nutrient intakes in female players representing a Sports Club in Sharjah, United Arab Emirates.Materials and Methods: Twenty-six adult female players aged between 15-24 years were selected from three different teams (basketball=12, tennis=4, volleyball=10) using convenience sampling technique. All participants were assessed for body composition through bioelectrical impedance method, endurance level using step test and nutrient intakes using 24-hour recall method. Significant differences (P < 0.05) were determined among the three teams in relation to body composition, endurance levels and nutrient intakes.Results: Body composition of players in three sports was significantly different in terms of body mass index, body fat mass, and percentage body fat and fitness scores. Tennis players had significantly higher body fat mass (28.5 ± 8.2 kg) and percent body fat (41 ± 7%) in contrast to that in basketball players (body fat mass: 19.2 ± 10.5 kg; percent body fat: 30.6 + 7.9%) and tennis players (body fat mass: 13 ± 4.2 kg; percent body fat: 26.5 ± 6.5%), respectively. On the other hand, volleyball players had significantly higher fitness score (72.2 ± 3.5) as compared to basketball players (71 ± 6.7), and tennis players (63 ± 8.2).On an average, volleyball players scored “very good” endurance level in contrast to “good” scores in basketball and tennis team players. However, this difference was not statistically significant.The average intakes of all nutrients including energy, protein, vitamins and minerals were below the recommended intakes among players of all sports teams. Conclusions: Body composition and endurance level differ with the type of sports. Volleyball team players had the lowest BMI, body fat mass as well as percent body fat and highest fitness score and endurance level. However, the overall nutrient intakes of the female players representing the three teams were less than the recommended allowances for highly active women and did not differ with the type of sports played.

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Age–related rump fat, fat percent, body fat mass, leptin, androgens and semen parameters of Arab stallions

Asian Pacific Journal of Reproduction ◽

10.1016/s2305-0500(14)60024-5 ◽

2014 ◽

Vol 3 (3) ◽

pp. 184-191 ◽

Cited By ~ 5

Author(s):

Amal M. Abo El-Maaty ◽

Gamal A. El Sisy ◽

Mona H. Shaker ◽

Omima H. Ezzo

Keyword(s):

Body Fat ◽

Fat Mass ◽

Semen Parameters ◽

Percent Body Fat ◽

Body Fat Mass ◽

Age Related

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Prognostic Value of Body Fat Mass in Acutely Decompensated Heart Failure

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2014.06.168 ◽

2014 ◽

Vol 20 (8) ◽

pp. S59-S60

Author(s):

Namki Hong ◽

Jong Chan Youn ◽

Jaewon Oh ◽

Sungha Park ◽

Sang-Hak Lee ◽

...

Keyword(s):

Heart Failure ◽

Body Fat ◽

Fat Mass ◽

Prognostic Value ◽

Decompensated Heart Failure ◽

Body Fat Mass ◽

Acutely Decompensated Heart Failure

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P4542Revisiting the obesity paradox in heart failure: percent body fat as predictor of biomarkers and outcome

European Heart Journal ◽

10.1093/eurheartj/ehz745.0933 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

A Aimo ◽

J Januzzi ◽

G Vergaro ◽

R Latini ◽

I S Anand ◽

...

Keyword(s):

Heart Failure ◽

Body Fat ◽

Troponin T ◽

High Sensitivity ◽

Obesity Paradox ◽

Cardiovascular Death ◽

Percent Body Fat ◽

Obese Patients ◽

Jackson Pollock ◽

Patient Prognosis

Abstract Background Obesity defined by body mass index (BMI) is characterized by better prognosis and lower plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure (HF). We assessed whether another anthropometric measure, percent body fat (PBF), reveals different associations with outcome and HF biomarkers (NT-proBNP, high-sensitivity troponin T [hs-TnT], soluble suppression of tumorigenesis-2 [sST2]). Methods In an individual patient dataset, BMI was calculated as weight (kg)/height (m)2, and PBF through the Jackson-Pollock and Gallagher equations. Results Out of 6468 patients (median 68 years, 78% men, 76% ischaemic HF, 90% reduced EF), 24% died over 2.2 years (1.5–2.9), 17% from cardiovascular death. Median PBF was 26.9% (22.4–33.0%) with the Jackson-Pollock equation, and 28.0% (23.8–33.5%) with the Gallagher equation, with an extremely strong correlation (r=0.996, p<0.001). Patients in the first PBF tertile had the worst prognosis, while patients in the second and third tertile had similar survival. The risks of all-cause and cardiovascular death decreased by up to 36% and 27%, respectively, per each doubling of PBF. Furthermore, prognosis was better in the second or third PBF tertiles than in the first tertile regardless of model variables. Both BMI and PBF were inverse predictors of NT-proBNP, but not hs-TnT. In obese patients (BMI ≥30 kg/m2, third PBF tertile), hs-TnT and sST2, but not NT-proBNP, independently predicted outcome. Conclusion Patient prognosis improves with either BMI or PBF. Obesity, assessed with BMI or PBF, is associated with lower NT-proBNP but not hs-TnT or sST2. hs-TnT or sST2 are stronger prognostic predictors than NT-proBNP among obese patients.

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