A new study has debunked a popular belief that people with heart failure who are overweight or obese have a lower chance of going to the hospital or dying than those with normal weight. Instead, the study showed that waist-to-height ratio is actually a better indicator of outcomes in patients with heart failure than Body Mass Index (BMI).
Doctors recently released a study that shows that if they measure how big your waist is compared to your height, instead of looking at how much you weigh with the body mass index (BMI). This means that having BMI of 25 or higher doesn’t provide any special advantage.
The “obesity paradox” means that people who are overweight or obese may be more likely to have heart problems, but if they already have a heart condition, they are actually less likely to die than those with a normal weight. Some believe that extra fat can help protect them from any further complications or even dying when someone is very ill and losing weight.
Professor John McMurray from the University of Glasgow examined the belief that being overweight is actually good for people with heart failure. He concluded that this idea was not correct and mentioned that Body Mass Index (BMI) could not define how much excess fat a person has.
Two experts—Professor Stephan von Haehling, a Consultant Cardiologist, and Dr. Ryosuke Sato, who works in the University of Göttingen Medical Center (Germany)—have written an opinion piece about how BMI doesn’t show what part of your body is made of fat, muscle and bone or where that fat is located. They asked if professional wrestlers from America and Japan who have the same BMI but different amounts of fat will both have a similar risk of being unhealthy. The same goes for Arnold Schwarzenegger when he was young and starred as the ‘Terminator’ movie with a BMI of around 30kg/m2.
A new study was done on Wednesday that looks into different ways of seeing how big or small someone is – like body mass index (BMI) and other things like the ratio between your waist and height, the size of your waist, and the ratio between your waist and hips. The study also looked at other things that can affect these numbers, like hormones in your blood from when your heart has too much pressure (like in heart failure).
According to Prof. McMurray, natriuretic peptides are critical when it comes to predicting a person’s health when they have heart failure. People with heart failure usually have higher levels of these peptides than normal, but if someone has obesity, their levels will typically be lower.
Prof. McMurray and his team studied info from a huge group of people (1832 women + 6567 men) across the world suffering from heart failure. They gathered details about their BMI, blood pressure, body measurements, blood tests results and medical history when they enrolled in an experiment called PARADIGM-HF trial. The researchers wanted to observe which patients ended up being hospitalized due to heart failure or who died because of it in the end.
At first, it appeared that people with a Body Mass Index (BMI) of 25 kg/m2 or higher had lower death rates. However, when the results were adjusted to consider all possible factors affecting the outcomes including a type of protein in your body called natriuretic peptides, this trend disappeared.
Dr. Jawad Butt carried out analysis and he came up with a discovery that was surprising – when looking at the ratio of waist-to-height, it showed that people with more body fat were at greater risk of death or hospitalization due to heart failure. After adjusting for prognostic variables, they found that those in the top 20% with the most fat had a 39% higher chance of being hospitalized for heart failure when compared to those in the bottom 20% who had the least fat.
Professor McMurray did a study that showed there is no connection between being overweight and having better health outcomes when people use more accurate ways to measure body fat. This means that BMI (Body Mass Index) – which calculates the weight-to-height ratio – doesn’t show how much fat someone has relative to their muscle, bones or other factors such as age, sex, and race. With heart failure specifically, fluid buildup can also lead to increased weight which isn’t taken into account with BMI measurements either.
The professor’s study used measures (like waist-to-height ratio) that don’t work off of just weight and it showed that it’s actually worse for your health if you have more fat on your body – not better like before. People with higher amounts of body fat had higher rates of hospitalizations and lower quality of life than those who are leaner.
Eating too much food isn’t good for people who already have heart failure and reduced ejection fraction. Scientists want to know if these symptoms can be improved by losing weight, so we need studies to test this. In the United Kingdom, a different system is used that looks at waist-to-height ratio instead of just body mass index (BMI). We should use this same system with people who have heart failure.
It’s really important because doctors don’t usually recognize heart failure in people with obesity. Usually, a patient’s symptoms of being out of breath are mistaken for just being due to their weight instead of something worse. Being overweight is one factor that can cause and worsen heart failure. Even though a few years ago, losing weight used to be recommended for people with heart failure and not enough blood ejection, now it’s actually obese people who should be paying attention to this issue.
In an editorial, Professor von Haehling and Doctor Sato are warning us about the saying that overweight people with heart failure actually have better outcomes than their healthy peers. This should not lead people to thinking they don’t need to do anything to improve their health – it’s important to look deeper into this belief by measuring obesity not only via the Body Mass Index (BMI), but also looking at things like the Waist-To-Height Ratio (WHtR). It is very important to test if there really is a benefit for those who are truly obese when it comes to dealing with Heart Failure.
This study has some flaws that may make it less reliable. It’s harder to measure body shapes such as waist circumference properly when it’s done by different people. There might also be other things that could affect the results and we don’t know about them yet. Additionally, the analysis only looked at measurements taken when people first started the study. So it didn’t consider any changes in weight or waist size over the follow-up period. We also have no idea how physically fit each person was and this could have changed the link between their measurements and outcomes.
Finally, not many people were underweight with a BMI of <18.5 kg/m2 or had a healthy waist-to-height ratio (less than 0.4) so we can’t use this study to generalize these groups of people.
This passage talks about a study called “Anthropometric Measures and Adverse Outcomes in Heart Failure with Reduced Ejection Fraction”. It was released in March 2023 in the European Heart Journal. The goal of this study was to better understand how people’s body measurements can be linked to problems in their heart failure.
In March 2023, scientists Ryosuke Sato and Stephan von Haehling published a study in the European Heart Journal. The study was about the obesity paradox in heart failure and which is the best way to measure obesity. The title of this research is “Revisiting the Obesity Paradox in Heart Failure: What Is the Best Anthropometric Index to Gauge Obesity?”
The PARADIGM-HF trial was a closely watched experiment with people who have chronic heart failure with reduced ejection fraction (HFrEF). They were divided into two different groups to compare the safety and effectiveness of two medicines: saubitril/valsartan which is an angiotensin receptor-neprilysin inhibitor, and enalaparil. Both groups received regular treatment too.
To measure someone’s body weight, the World Health Organization (WHO) set four categories of BMI, which stands for body mass index. Being underweight is having a BMI lower than 18.5 kg/m2, being normal weight is having a BMI of 18.5-24.9 kg/m2, being overweight is having a BMI between 25-29.9 kg/m2 and lastly being obese is 30 kg/m2 or above.
