A Review of Obesity, Physical Activity, and Cardiovascular Disease
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ETIOLOGY OF OBESITY (M ROSENBAUM, SECTION EDITOR)
A Review of Obesity, Physical Activity, and Cardiovascular Disease Andrew Elagizi 1
&
Sergey Kachur 1 & Salvatore Carbone 2 & Carl J. Lavie 1 & Steven N. Blair 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The focus of this review is to discuss obesity, physical activity (and physical inactivity/sedentary behavior), cardiovascular disease (CVD), and their often interrelated health implications. The authors summarize the pathophysiological changes associated with obesity, which lead to the development of CVD, recommendations for interventions such as diet, increased physical activity, and weight loss according to current literature and guidelines, and the critical importance of cardiorespiratory fitness (CRF). Recent Findings Clinical trials continue to demonstrate improved outcomes among overweight or obese individuals who achieve a healthy weight using various methods. Increasing CRF levels appears to demonstrate the largest health improvements, regardless of underlying comorbidities or achieving weight loss. Summary CRF, which is perhaps the single most important predictor of overall health, seems more important than weight loss alone regarding improved CVD outcomes in the obese population. These findings are reproduced in studies involving patients with various forms of CVD and CVD risk factors. The importance of CRF is well established; future endeavors to establish specific CRF targets for various patient cohorts are needed. Keywords Obesity . Cardiovascular disease . Coronary artery disease . Heart failure . Atrial fibrillation . Cardiorespiratory fitness . Physical activity
Key Points • Obesity and sedentary behavior are leading preventable causes of CVD and mortality. • Increasing fitness levels appears to be the most effective way to improve outcomes in obese populations, both with and without CVD, compared with weight loss alone. • Understanding that individuals may respond very differently to the same diet can help patients and clinicians avoid “diet centrism.” This article is part of the Topical Collection on Etiology of Obesity * Carl J. Lavie [email protected] 1
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483, USA
2
Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA
3
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Abbreviations ACC American College of Cardiology AF Atrial fibrillation AHA American Heart Association BMI Body mass index CAD Coronary artery disease CRF Cardiorespiratory fitness CV Cardiovascular CVD Cardiovascular disease DHHS Department of Health and Human Services DM Diabetes mellitus HF Heart failure HTN Hypertension MET Metabolic equivalent MetS Metabolic syndrome MHO Metab
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