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Obesity paradox and stroke: a narrative review
Stefano Forlivesi1, Manuel Cappellari2, Bruno Bonetti2
1Neurology Unit, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via don A. Sempreboni, 5, 37024, Negrar, Verona, Italy. forlivesi.sf@gmail.com.
Eating and Weight Disorders : EWD
|March 4, 2020
Summary
The obesity paradox suggests better stroke outcomes for overweight individuals, but evidence is limited. Further high-quality research is needed to confirm this association and understand its implications for stroke patients.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Obesity is a known stroke risk factor, yet paradoxically, obese patients often show better outcomes.
- This phenomenon, termed the obesity paradox, is observed across cardiovascular diseases.
Purpose of the Study:
- To provide a narrative overview of the obesity paradox in the context of stroke.
- To synthesize existing literature on the association between obesity and stroke outcomes.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE/PubMed, CINAHL, EMBASE, and Cochrane Library up to 2019.
- Studies examining the relationship between obesity, stroke outcome, and mortality were selected for review.
Main Results:
- Most studies indicate lower mortality and improved functional outcomes in overweight/obese stroke patients compared to normal/underweight individuals.
- However, significant methodological limitations exist, including retrospective designs, reliance on Body Mass Index (BMI), and short follow-up periods.
Conclusions:
- The existence of an obesity paradox in stroke remains controversial due to methodological concerns.
- Higher quality evidence is required to definitively establish the link between obesity and stroke prognosis.
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