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A Review of Obesity, Physical Activity, and Cardiovascular Disease

Current Obesity Reports volume 9, pages 571–581 (2020)Cite this article

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.

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Fig. 1

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:

Metabolically healthy obesity

MI:

Myocardial infarction

PA:

Physical activity

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Authors and Affiliations

  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

    Andrew Elagizi, Sergey Kachur & Carl J. Lavie

  2. Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA

    Salvatore Carbone

  3. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Steven N. Blair

Authors
  1. Andrew Elagizi
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  2. Sergey Kachur
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  3. Salvatore Carbone
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  4. Carl J. Lavie
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  5. Steven N. Blair
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Corresponding author

Correspondence to Carl J. Lavie.

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Conflicts of Interest

Salvatore Carbone is supported by a Career Development Award 19CDA34660318 from the American Heart Association.

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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

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Elagizi, A., Kachur, S., Carbone, S. et al. A Review of Obesity, Physical Activity, and Cardiovascular Disease. Curr Obes Rep 9, 571–581 (2020). https://doi.org/10.1007/s13679-020-00403-z

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  • DOI: https://doi.org/10.1007/s13679-020-00403-z

Keywords

  • Obesity
  • Cardiovascular disease
  • Coronary artery disease
  • Heart failure
  • Atrial fibrillation
  • Cardiorespiratory fitness
  • Physical activity