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Study finds no sign of ‘obesity paradox’ in patients with stroke

Sunday June 8, 2014
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There’s no evidence being overweight or obese protects a person from dying after a stroke, despite past studies showing the possibility of what researchers called the “obesity paradox,” according to a new study.

Some studies have suggested overweight or obese patients have lower mortality rates than underweight or normal weight patients, contrary to evidence associating obesity with increased health-related complications and death. Some experts believe these findings are evidence the paradox exists, while others believe those findings were caused by selection bias in studies.

Danish researchers conducted a study to determine whether the obesity paradox was a real finding in stroke patients or if it was a result of selection bias in studies. To overcome selection bias in their research, the authors included only deaths caused by stroke using Danish Stroke Register and the Danish Registry of Causes of Death.

Researchers examined data from 71,617 people who suffered a stroke from 2003-12, including factors such as age, sex and stroke type and severity. Body mass index was available for 53,812 of those included in the study.

The findings showed 11% (7,878) of the 71,617 patients died within the first month; stroke was the reported cause of death for 70% of that group (5,512 patients). When the researchers limited the group to only patients with BMI information, they found 9.7% were underweight, 39% were normal weight, 34.5% were overweight and 16.8% were obese.

The study found no significant difference in risk of death by stroke in the first month among patients who were normal weight, overweight or obese. However, stroke occurred at a younger age among patients with a higher BMI, the findings showed.

“This study was unable to confirm the existence of an obesity paradox in stroke,” the authors wrote in the discussion of their findings. “Obesity was not associated with a lower risk for death after a stroke. … The risk of obese patients with stroke for death did not differ from that of normal-weight patients with stroke nor was there evidence of a survival advantage associated with being overweight.”

These findings suggest obese patients with stroke should aim for a normal weight, the authors wrote.

Abstract: http://archneur.jamanetwork.com/article.aspx?articleid=1875832

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