VCU news

By Leha Byrd

Although obesity increases the risk of heart failure, it might also provide some protective effects once heart failure is diagnosed because of an obese individual’s increased amount of lean or muscle mass, according to new findings published in the Mayo Clinic Proceedings.

The article, “Obesity and Heart Failure: Focus on the Obesity Paradox,” is based on a review of literature from 1960 to 2016. Salvatore Carbone, research instructor of medicine in the Department of Internal Medicine in the Virginia Commonwealth University Pauley Heart Center, worked with Carl “Chip” Lavie, M.D., of John Ochsner Heart and Vascular Institute, and Ross Arena, M.D., from University of Illinois at Chicago, on the writing and research of the article, which is featured, in its entirety, on the Mayo Clinic Proceedings website.

“We wanted to do this comprehensive review of the literature because the role of obesity in heart failure is not completely understood,” Carbone said.

Among the findings was evidence that obesity is an independent risk factor for the development of heart failure and that body composition assessment should be performed in patients with heart failure. Body composition is defined as the proportion of fat and fat-free mass — including muscle — in the body. A healthy body composition shows a lower proportion of body fat and a higher proportion of fat-free mass.

Because body composition is one measurement used to assess an individual’s health and fitness level, this research is critical, Carbone said. 

“In prior articles, the role of obesity was only investigated based on the body mass index or just body weight, which does not take into consideration body composition,” he said. “In this article we emphasized the importance of body composition assessment and we hope that it will increase the attention of clinicians in this matter, not just measuring body weight, but also body composition for more accurate risk stratification.”

Heart failure affects about 38 million people in the world, almost 6 million in the United States. More than one-third of adults are considered obese, making them subsequently susceptible to heart disease, stroke, type 2 diabetes and certain cancers.

Within the manuscript, Carbone’s research recommends the importance of diet in the development and progression of heart failure, in the hope that providers will pay more attention to diet and nutrition when treating heart failure patients, he said.

“I’m excited to have this research published so broadly with regard to an issue that is so broad and affects so many,” Carbone said. “In our research we are already constantly measuring body composition in heart failure patients.”