JACC Focus Seminar: CV Health Promotion
JACC Focus Seminar
Healthy Weight and Obesity Prevention: JACC Health Promotion Series

https://doi.org/10.1016/j.jacc.2018.08.1037Get rights and content
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Abstract

Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the “obesity paradox,” and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on “healthy weight” with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery.

Key Words

cardiovascular disease
healthy weight
obesity

Abbreviations and Acronyms

AF
atrial fibrillation
AHA
American Heart Association
BF
body fat
BMI
body mass index
CHD
coronary heart disease
CO
cardiac output
CRF
cardiorespiratory fitness
CV
cardiovascular
CVD
cardiovascular disease
DASH
Dietary Approaches to Stop Hypertension
GI
glycemic index
HF
heart failure
HLM
healthy living medicine
HLP
Healthy Living Practitioner
HTN
hypertension
LV
left ventricle
LVH
left ventricular hypertrophy
MetS
metabolic syndrome
METs
metabolic equivalents
MHNW
metabolically healthy normal weight
MHO
metabolically healthy obesity
MUO
metabolically unhealthy obesity
OSA
obstructive sleep apnea
PA
physical activity
SSB
sugar sweetened beverages
T2DM
type 2 diabetes mellitus
WC
waist circumference

Cited by (0)

Dr. Ortega receives support for research activity from the Spanish Ministry of Economy and Competitiveness and FEDER (DEP2016-79512-R); additional funding from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Unit of Excellence on Exercise and Health (UCEES); and the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 667302. Dr. Kushner has served on the advisory board for Novo Nordisk, Weight Watchers, and Retrofit. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Listen to this manuscript's audio summary by JACC Editor-in-Chief Dr. Valentin Fuster.