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7 t h E u r o p e a n C o n g r e s s o n
Obesity and
Eating Disorder
Obesity 2018
Journal of Obesity & Eating Disorders
ISSN 2471-8203
A p r i l 1 2 - 1 3 , 2 0 1 8
Am s t e r d a m , N e t h e r l a n d s
Page 39
The positive association between overweight, obesity, and cardiovascular
and all-cause mortality is well established, even though this relation is
typically U shaped with an increased risk also in low-weight subjects. However,
being overweight or obese has been associated with a better prognosis in
subjects suffering from chronic diseases, id est the “obesity paradox”. In both
community-dwelling and hospitalized patients with COPD, several studies
have reported a signi cant protective effect of obesity on all-cause mortality,
indicating that also in obstructive pulmonary diseases an obesity paradox may
be present. Interestingly, the “paradox” is more evident for subjects with severe
bronchial obstruction (i.e. a lower FEV1), while in mild-moderate conditions
the weight-related mortality shows a behavior similar to that observed in the
general population. Several factors may confound the relation between COPD,
obesity and mortality. The lower FEV1 found in obese people may be linked to
a restrictive defect rather than to an obstructive one. Due to the modified chest
wall mechanical properties related to increased fat mass-obese COPD patients
may present, respect to their lean counterpart, a lower lung hyperinflation
which is associated to higher mortality. The traditional classification of COPD
attributes to obese “blue bloaters” a low grade emphysema in opposition to
lean “pink puffers”; the fact that emphysema extent is related to mortality
may bias the relationship between weight and survival. It is also to underline
that the majority of the studies consider BMI rather than body composition
(a better predictor of mortality) when studying the intriguing relation between
weight, COPD and mortality. Reverse bias has also to be taken into account,
hypothesizing that an unintentional weight loss may be the deleterious factor
related to mortality, rather than considering obesity a protective one.
Biography
Francesco Spelta is a PhD student at the University of Verona,
Italy. After attending the School of Medicine (at the University
of Ferrara, Italy), he enrolled in the Internal Medicine Residency
at the University of Verona and, once finished it, he joined the
PhD programme in Biomedical, Clinical and Experimental Sci-
ences at the same university. During the Residency, he spent
more than one year at Washington University in St. Louis, USA,
working with Dr. Luigi Fontana’s group on clinical trials about the
role of calorie restriction and intermittent fasting on longevity
and health. Hismain interests in research are related to nutrition
and different conditions, with particular regards to cardio-pul-
monary diseases and healthy aging.
Body weight and mortality in COPD: focus on the obesity
paradox
Francesco Spelta, A M Fratta Pasini, L Cazzoletti and M Ferrari
University of Verona, Italy
Francesco Spelta et al., J Obes Eat Disord 2018, Volume: 4
DOI: 10.21767/2471-8203-C1-008