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(Circulation Research. 2006;98:576.)
© 2006 American Heart Association, Inc.

Editorials

Five Easy Pieces

The Obesity Paradigm

Nageswara R. Madamanchi, Marschall S. Runge

From the University of North Carolina at Chapel Hill, Carolina Cardiovascular Biology Center, Department of Medicine.

Correspondence to Marschall S. Runge, MD, PhD, Department of Medicine, University of North Carolina, 3033 Old Clinic Building, Chapel Hill, NC 27599-7005. E-mail mrunge@med.unc.edu

See related article, pages 626–634

Key Words: cardiovascular disease • obesity • inflammation • atherosclerosis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Efforts to eradicate cardiovascular disease (CVD) are progressing no faster than The Race for the Cure¹ is in breast cancer. In the case of CVD, although therapies for the ravages of atherosclerosis continue to improve, the prevalence of disease is more than keeping pace. Recently, the World Health Organization has predicted that today’s 17 million deaths worldwide attributable to heart disease and stroke will increase to more than 20 million by the year 2020, thus becoming the leading cause of death and disability in the world.² Most commonly blamed factors for the increase in CVD are increases in insulin resistance and type II diabetes as a result of dietary changes and more sedentary lifestyles.

Indeed, the pieces of the puzzle seem to be comprehensible. (1) Accompanying the changes in diet and lifestyle, the prevalence of obesity has exploded. (2) Innumerable studies have established that obesity predisposes to insulin resistance, a harbinger of type II diabetes. (3) Nearly all serum and histochemical markers of inflammation are increased in insulin resistance and diabetes. (4) Obesity also tips the balance between fibrinolysis and thrombosis toward the latter. (5) Obesity is, thus, a major risk factor for CVD and stroke. The data supporting this paradigm are intellectually compelling, and appear as unassailable as the Cadbury Fortress (the reputed site of King Arthur’s Camelot) and supported by the scientific community at the highest levels.³

So why question this paradigm? Because reports continue to appear that bring the theory into question, most recently the results from . . . [Full Text of this Article]

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Hideo Fujita, Myengmo Kang, Mesut Eren, Linda A. Gleaves, Douglas E. Vaughan, and Tsutomu Kume
Circ. Res. 2006 98: 626-634. [Abstract] [Full Text] [PDF]