The association of fitness and body mass index (BMI) on all-cause mortality in cancer survivors: The Henry Ford Exercise Testing Project (The FIT Project).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7060-7060
Author(s):  
Catherine Handy Marshall ◽  
Paul A McAuley ◽  
Hua-Ling Tsai ◽  
Zeina Dardari ◽  
Mouaz H Al-Mallah ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Cancer Diagnosis ◽  
Exercise Test ◽  
Normal Weight ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Henry Ford

7060 Background: The obesity paradox –i.e. inverse associations between body mass index (BMI) and mortality – has been reported in patients with cancer, heart failure, and diabetes. However, the influence of cardiorespiratory fitness (CRF) on this relationship is not well established. This study assesses the association of BMI and CRF with all-cause mortality among cancer patients. Methods: The Henry Ford (HF) FIT Project is a retrospective cohort study of 69,885 consecutive patients who underwent physician-referred exercise stress testing from 1991 through 2009. Cancer diagnosis was identified through linkage to the HF tumor registry. We included patients 40-70 years old, with BMI recorded, at time of exercise test, with a history of cancer > 6 months prior. BMI was categorized as normal (18.5-24.9kg/m2), overweight (25-29.9kg/m2), or obese ( > = 30kg/m2). All-cause mortality was obtained from the National Death Index. Because of a significant interaction between BMI and cancer type, patients with breast or prostate cancer were excluded. Multivariable adjusted Cox proportional hazard models were used to evaluate the association of CRF andBMI with all-cause mortality; adjusted for age at exercise test, sex, diabetes, smoking, cancer stage, and time from cancer diagnosis to exercise test. Results: Included were 676 patients with a mean age of 58 years (SD 7.5), 51% female, 70% White, 25% Black, with a median of 4.8 years from diagnosis to exercise test and median follow up time of 10.3 years. Among patients achieving < 10 METs, those who are overweight and obese had a lower risk of mortality HR 0.47 (95% CI 0.25,0.86) and HR 0.44 (95% CI 0.26, 0.74, respectively), compared to those with normal BMI. Among patients with METs > = 10, those who were overweight had the lowest risk of all-cause mortality (HR 0.23, 95% CI 0.09-0.62) compared to normal weight, while no statistically significant different risk of mortality was observed when comparing those who are obese to normal weight (HR 0.37, 95% CI 0.13-1.06). In an analysis combining BMI and fitness groups (four categories), those with BMI > = 25 and METs > = 10 had the lowest risk of all-cause mortality (Table). Conclusions: In non-breast/non-prostate cancer patients, increased BMI is associated with improved overall survival in those with METs < 10, while a U-shaped relationship between BMI and all-cause mortality exists among those with METs > = 10. [Table: see text]

scholarly journals Prevention of Advanced Cancer by Vitamin D3 Supplementation: Interaction by Body Mass Index Revisited

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1408
Author(s):  
Hermann Brenner ◽  
Sabine Kuznia ◽  
Clarissa Laetsch ◽  
Tobias Niedermaier ◽  
Ben Schöttker
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Cancer Patients ◽  
Body Mass ◽  
Advanced Cancer ◽  
Vitamin D3 ◽  
Normal Weight ◽  
The Body ◽  
Published Data ◽  
Vitamin D3 Supplementation

Meta-analyses of randomized controlled trials (RCTs) have demonstrated a protective effect of vitamin D3 (cholecalciferol) supplementation against cancer mortality. In the VITAL study, a RCT including 25,871 men ≥ 50 years and women ≥ 55 years, protective effects of vitamin D3 supplementation (2000 IU/day over a median of 5.3 years) with respect to incidence of any cancer and of advanced cancer (metastatic cancer or cancer death) were seen for normal-weight participants but not for overweight or obese participants. We aimed to explore potential reasons for this apparent variation of vitamin D effects by body mass index. We conducted complementary analyses of published data from the VITAL study on the association of body weight with cancer outcomes, stratified by vitamin D3 supplementation. Significantly increased risks of any cancer and of advanced cancer were seen among normal-weight participants compared to obese participants in the control group (relative risk (RR), 1.27; 95% confidence interval (CI), 1.07–1.52, and RR, 1.44; 95% CI, 1.04–1.97, respectively). No such patterns were seen in the intervention group. Among those with incident cancer, vitamin D3 supplementation was associated with a significantly reduced risk of advanced cancer (RR, 0.86; 95% CI, 0.74–0.99). The observed patterns point to pre-diagnostic weight loss of cancer patients and preventive effects of vitamin D3 supplementation from cancer progression as plausible explanations for the body mass index (BMI)—intervention interactions. Further research, including RCTs more comprehensively exploring the potential of adjuvant vitamin D therapy for cancer patients, should be pursued with priority.

Body mass index and mortality in prostate cancer patients: a dose–response meta-analysis

2016 ◽  
Vol 19 (2) ◽  
pp. 122-131 ◽  
Author(s):  
S Zhong ◽  
X Yan ◽  
Y Wu ◽  
X Zhang ◽  
L Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Dose Response ◽  
Meta Analysis

scholarly journals Association of Body Mass Index and Waist Circumference with All-Cause Mortality in Hemodialysis Patients

2020 ◽  
Vol 9 (5) ◽  
pp. 1289
Author(s):  
Chang Seong Kim ◽  
Kyung-Do Han ◽  
Hong Sang Choi ◽  
Eun Hui Bae ◽  
Seong Kwon Ma ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
Mortality Rate ◽  
Body Mass ◽  
The Body ◽  
National Health Insurance System ◽  
Cox Regression Analysis ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Nationally Representative

In this study based on a large nationally representative sample of Korean adults, we investigated the potential associations of the body mass index (BMI) and waist circumference (WC) with mortality in patients undergoing hemodialysis. We obtained the data of 18,699 participants >20 years of age who were followed up with for 4 years and for whom BMI and WC information were available, using a nationally representative dataset from the Korean National Health Insurance System. Patients were stratified into five levels by their baseline BMI and into six levels by their WC (5-cm increments). A total of 4975 deaths occurred during a median follow-up period of 48.2 months. Participants with a higher BMI had a lower mortality rate than those with a lower BMI. In a fully adjusted Cox regression analysis, being overweight and obese was associated with a significantly lower relative risk of all-cause mortality relative to the reference group. Conversely, the mortality rate was higher among participants with a high WC than among those with a low WC. Participants with the highest WC had a higher risk of mortality, while those with the lowest WC level had a significantly lower risk of mortality. In conclusion, all-cause mortality was positively associated with WC, a measure of abdominal obesity, and inversely associated with BMI, a measure of body volume, in patients undergoing hemodialysis.

scholarly journals An Analysis of the Potential Relationship of Triglyceride Glucose and Body Mass Index With Stroke Prognosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Zongyi Hou ◽  
Yuesong Pan ◽  
Yindong Yang ◽  
Xiaofan Yang ◽  
Xianglong Xiang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Normal Weight ◽  
Inverse Association ◽  
Stroke Outcome ◽  
Obese Patients ◽  
Stroke Patients ◽  
Tyg Index ◽  
All Cause Mortality

Background: The inverse association between obesity and outcome in stroke patients (known as the obesity paradox) has been widely reported, yet mechanistic details explaining the paradox are limited. The triglyceride glucose (TYG) index has been proposed as a marker of insulin resistance. We sought to explore possible associations of the TYG index, body mass index (BMI), and stroke outcome.Methods: We identified 12,964 ischemic stroke patients without a history of diabetes mellitus from the China National Stroke Registry and classified patients as either low/normal weight, defined as a BMI &lt;25 kg/m2, or overweight/obese, defined as a BMI ≥ 25 kg/m2. We calculated TYG index and based on which the patients were divided into four groups. A Cox or logistic regression model was used to evaluate the association between BMI and TYG index and its influence on stroke outcomes, including stroke recurrence all-cause mortality and poor outcome (modified Rankin Scale score of 3–6) at 12 months.Results: Among the patients, 63.3% were male, and 36.7% were female, and the mean age of the patient cohort was 64.8 years old. The median TYG index was 8.62 (interquartile range, 8.25–9.05). After adjusting for multiple potential covariates, the all-cause mortality of overweight/obese patients was significantly lower than that of the low/normal weight patients (6.17 vs. 9.32%; adjusted hazard ratio, 0.847; 95% CI 0.732–0.981). The difference in mortality in overweight/obese and low/normal weight patients with ischemic stroke was not associated with TYG index, and no association between BMI and TYG index was found.Conclusion: Overweight/obese patients with ischemic stroke have better survival than patients with low/normal weight. The association of BMI and stroke outcome is not changed by TYG index.

Body mass index and mortality in men treated for locally advanced prostate cancer: An analysis of RTOG 85–31

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5128-5128
Author(s):  
J. A. Efstathiou ◽  
K. Bae ◽  
W. U. Shipley ◽  
G. E. Hanks ◽  
M. V. Pilepich ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Advanced Prostate Cancer ◽  
Cox Regression ◽  
Locally Advanced ◽  
Specific Antigen ◽  
Phase Iii ◽  
Locally Advanced Prostate Cancer ◽  
All Cause Mortality

5128 Background: Greater body mass index (BMI) is associated with shorter time to prostate-specific antigen (PSA) failure following radical prostatectomy. We investigated whether BMI is associated with prostate cancer-specific mortality (PCSM) in a large randomized trial of men treated with radiation therapy (RT) and androgen deprivation therapy (ADT) for locally advanced prostate cancer. Methods: Between 1987 and 1992, 945 eligible men with locally advanced prostate cancer were enrolled on a phase III trial (RTOG 85- 31) and randomized to RT and immediate goserelin (Arm I) or RT alone followed by goserelin at relapse (Arm II). Height and weight data were available at baseline for 788 (83%) subjects. Cox regression analyses were performed to evaluate the relationships between BMI and all-cause mortality, PCSM, and non-prostate cancer mortality. Covariates included age, race, treatment arm, history of prostatectomy, nodal involvement, Gleason score, clinical stage, and BMI. Results: The 5-year PCSM rate for men with BMI<25kg/m2 was 6.5%, compared to 13.1% and 12.2% in men with BMI=25-<30 and BMI=30, respectively (Gray’s p=0.005). In multivariable analyses, as shown in the Table , greater BMI was significantly associated with higher PCSM [for BMI=25-<30, hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.02–2.27, p=0.04; for BMI=30, HR 1.65, 95% CI 1.02–2.66, p=0.04]. BMI was not associated with non-prostate cancer or all-cause mortality. Conclusions: Greater baseline BMI is independently associated with higher PCSM in men with locally advanced prostate cancer. Further studies are warranted to evaluate the mechanism(s) for increased mortality and to assess whether weight loss after prostate cancer diagnosis alters disease course. [Table: see text] No significant financial relationships to disclose.

Abstract TP195: The Association of Body Mass Index With Post-stroke Mortality: a Systematic Review

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Doris Y Leung ◽  
Janet W Sit ◽  
Raina Ching
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Body Mass ◽  
Lower Risk ◽  
Stroke Survivors ◽  
Obese Patients ◽  
Stroke Mortality ◽  
Stroke Patients ◽  
Risk Of Mortality ◽  
All Cause Mortality

Background: Previous studies have documented an obesity-stroke paradox, suggesting stroke patients who are overweight or obese (measured by body mass index, BMI) have a lower risk of post-stroke mortality as comparing those with normal (or lean) BMI. Purpose: This systematic review aims to synthesis the evidence regarding the association of BMI with mortality in stroke patients. Method: A search was conducted using databases MEDLINE, EMBASE, Ovid Nursing Database and CINAHL Plus from conception to July 2015. In addition, a hand search was done of the references of the eligible studies. Two reviewers independently evaluated the methodological quality of the studies reviewed. Result: Eleven studies met the inclusion criteria: eight cohort studies and four experimental studies. Seven studies examined both ischemic and hemorrhagic stroke while 5 examined ischemic stroke only. Ten studies examined all-cause mortality, and one study examined recurrence of stroke plus stroke and vascular-related mortality. Mean age of the participants ranged from 64 to 78.8. One study recruited postmenopausal women and another study used US-Japanese born men. Sample sizes per study ranged between 304 to 21,884 stroke survivors. Mortality follow-up ranged between 14 days to 16 years. Findings from four studies reported obese patients had a significantly lower risk of mortality compared to normal/lean patients; while four studies found non-significant results. However, the remaining three studies found that a significantly higher risk of mortality was reported in obese patients. In addition, five of the seven studies that had an underweight category reported that the underweight group had a significantly higher risk of mortality than normal weight patients. Conclusion: There is not enough evidence at present to support the association of lower all-cause mortality in overweight or obese stroke patients. Based on BMI measures in the existing literature, our findings suggest that obesity is not a protective factor for stroke survivors. Our review also highlights the importance of cautious interpretation of the association between BMI and all-cause mortality, while also taking into account potential etiologies of unintentional weight loss among stroke patients.

scholarly journals The Effect of Body Mass Index on Acute Cardiometabolic Responses to Graded Exercise Testing in Children: A Narrative Review

Sports ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 103 ◽  
Author(s):  
Pantelis Nikolaidis ◽  
Eleni Kintziou ◽  
Georgios Georgoudis ◽  
José Afonso ◽  
Rodrigo Vancini ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Exercise Testing ◽  
Exercise Test ◽  
Normal Weight ◽  
Narrative Review ◽  
Normal Body Mass Index ◽  
Graded Exercise Test ◽  
Graded Exercise

Although the beneficial role of exercise for health is widely recognized, it is not clear to what extent the acute physiological responses (e.g., heart rate (HR) and oxygen uptake (VO2)) to a graded exercise test are influenced by nutritional status (i.e., overweight vs. normal-weight). Therefore, the main objectives of the present narrative review were to examine the effect of nutritional status on acute HR, and VO2 responses of children to exercise testing. For this purpose, we examined existing literature using PubMed, ISI, Scopus, and Google Scholar search engines. Compared with their normal-body mass index (BMI) peers, a trend of higher HRrest, higher HR during submaximal exercise testing, and lower HRmax was observed among overweight and obese children (according to BMI). Independent from exercise mode (walking, running, cycling, or stepping), exercise testing was metabolically more demanding (i.e., higher VO2) for obese and overweight children than for their normal-weight peers. Considering these cardiometabolic differences according to BMI in children might help exercise specialists to evaluate the outcome of a graded exercise test (GXT) (e.g., VO2max, HRmax) and to prescribe optimal exercise intensity in the context of development of exercise programs for the management of body mass.

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