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PURE – Implications of obesity on CVD and death

Darryl Leong, an investigator at Population Health Research Institute (PHRI), presented the findings of data analysis from the global Prospective Urban and Rural Epidemiological (PURE) study on September 2, 2019 at the European Society of Cardiology (ESC) Congress that offer new insights into obesity and cardiovascular disease and death.

Obesity is traditionally measured by the body mass index (BMI). However, BMI does not measure where on one’s body the weight is distributed (waist versus hips), and BMI does not measure muscle mass. The PURE data analysis takes these aspects (known as anthropometrics) into consideration to determine obesity and cardiovascular disease and death.

The PURE analysis involved 150,000 middle-aged people in 21 low, middle and high-income countries.

“What we sought was to evaluate relationship between different measurements of weight and body composition, and what happened to these individuals after about nine years of follow-up,” said Leong.

Discoveries from the PURE analysis included:

  • Being underweight (under a BMI of 20) was associated with a very high risk of deaths; so under-nutrition is a real concern.
  • A high BMI (25 to 30) was not associated with death; only at extremely high BMI.
  • Measurement of one’s waist circumference to hip circumference is a stronger indicator of CVD and death than is one’s BMI.
  • Newer index: muscle strength as measured by hand grip, divided by one’s body weight. Found that lower the strength, the higher the risk of death.