OBJECTIVE: This review explored whether cardiorespiratory fitness or physical activity act as either confounders or effect modifiers of the relationship between adiposity markers and all-cause mortality in older adults. METHODS: Systematic searches were carried out to identify observational studies that examined the association of adiposity markers (BMI, waist circumference, and waist-hip ratio) with all-cause mortality in adults aged ≥ 60 which took into account cardiorespiratory fitness or physical activity. Data from each included study was analyzed to produce a graphical representation of this relationship. RESULTS: Fourteen of the fifteen identified studies found that increasing BMI had a non-positive association with all-cause mortality, with persistence of the obesity paradox despite adjustment for physical activity or cardiorespiratory fitness. Physical activity measurement methods were all subjective and often unvalidated. The two studies stratifying for cardiorespiratory fitness did not find that fitness had a significant impact on the relationship between excess adiposity and mortality but found that overweight and fit people had better survival than normal-weight unfit people, CONCLUSIONS: The predominant use of poor physical activity measurement suggests that studies are currently not adequately accounting for possible physical activity confounding. More studies are needed for addressing the modification of the relationship between adiposity markers and mortality by cardiorespiratory fitness.
OBJECTIVE: This review explored whether cardiorespiratory fitness or physical activity act as either confounders or effect modifiers of the relationship between adiposity markers and all-cause mortality in older adults. METHODS: Systematic searches were carried out to identify observational studies that examined the association of adiposity markers (BMI, waist circumference, and waist-hip ratio) with all-cause mortality in adults aged ≥ 60 which took into account cardiorespiratory fitness or physical activity. Data from each included study was analyzed to produce a graphical representation of this relationship. RESULTS: Fourteen of the fifteen identified studies found that increasing BMI had a non-positive association with all-cause mortality, with persistence of the obesity paradox despite adjustment for physical activity or cardiorespiratory fitness. Physical activity measurement methods were all subjective and often unvalidated. The two studies stratifying for cardiorespiratory fitness did not find that fitness had a significant impact on the relationship between excess adiposity and mortality but found that overweight and fit people had better survival than normal-weight unfit people, CONCLUSIONS: The predominant use of poor physical activity measurement suggests that studies are currently not adequately accounting for possible physical activity confounding. More studies are needed for addressing the modification of the relationship between adiposity markers and mortality by cardiorespiratory fitness.
Authors: Uba Backonja; Mary L Hediger; Zhen Chen; Diane R Lauver; Liping Sun; C Matthew Peterson; Germaine M Buck Louis Journal: J Womens Health (Larchmt) Date: 2017-05-24 Impact factor: 2.681
Authors: J Fernandes de Souza Barbosa; C Dos Santos Gomes; J Vilton Costa; T Ahmed; M V Zunzunegui; C-L Curcio; F Gomez; R Oliveira Guerra Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075
Authors: Pablo Jorge Marcos-Pardo; Noelia González-Gálvez; Abraham López-Vivancos; Alejandro Espeso-García; Luis Manuel Martínez-Aranda; Gemma María Gea-García; Francisco Javier Orquín-Castrillón; Ana Carbonell-Baeza; José Daniel Jiménez-García; Daniel Velázquez-Díaz; Cristina Cadenas-Sanchez; Emanuele Isidori; Chiara Fossati; Fabio Pigozzi; Lorenzo Rum; Catherine Norton; Audrey Tierney; Ilvis Äbelkalns; Agita Klempere-Sipjagina; Juris Porozovs; Heikki Hannola; Niko Niemisalo; Leo Hokka; David Jiménez-Pavón; Raquel Vaquero-Cristóbal Journal: Nutrients Date: 2020-12-22 Impact factor: 5.717