Re: Underweight patient and ergoantropometric classification.
We read with great interest the article by Heitmann and Frederiksen1.
We want to hightlight two elements.
First, age might be the most important prognostic factor in primary2 and
secondary prevention3 and Heitmann et al. excluded age in their
statistical model; although compared with the men and women who died
during follow-up, baseline age was 20 and 10 years lower for the men and
women who survived in each case
Second, a focus on thigh circumference might help general practitioners to
identify individuals who are at increased risk of early morbidity and
mortality. We can state that in general underweight patients are a high
risk group.4, but this fact is not taken into account in the current
obesity classification of the National Institutes of Health5.
Recently, we published a new ergoanthropometric classification (Table 1),
which it takes into consideration that underweight (body mass index BMI,
<_18.5 kg="kg" m2="m2" is="is" an="an" increased="increased" risk="risk" especially="especially" in="in" secondary="secondary" prevention="prevention" and="and" includes="includes" assessment="assessment" of="of" waist="waist" circumference="circumference" physical="physical" fitness="fitness" addition="addition" to="to" bmi67.="bmi67." p="p"/>References
1. Heitmann BL and Frederiksen P. Thigh circumference and risk of heart
disease and premature death: prospective cohort study. BMJ 2009;339: b3292
2. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh
A, et al. Predicting cardiovascular risk in England and Wales: prospective
derivation and validation of QRISK2. BMJ 2008;336:a33
3. Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, Lemos JA, et
al. TIMI Risk Score for ST-Elevation Myocardial Infarction: A Convenient,
Bedside, Clinical Score for Risk Assessment at Presentation: An
Intravenous nPA for Treatment of Infarcting Myocardium Early II Trial
Substudy. Circulation. 2000;102:2031-2037.
4. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess Deaths
Associated With Underweight, Overweight, and Obesity JAMA. 2005;293:1861-
1867
5. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al.
Obesity and cardiovascular disease: pathophysiology, evaluation, and
effect of weight loss: an update of the 1997 American Heart Association
scientific statement on obesity and heart disease from the Obesity
Committee of the Council on nutrition, physical activity, and metabolism.
Circulation. 2006;113:898-91
6. Morales Salinas A, Coca A. Obesity, physical activity and
cardiovascular risk: ergo-anthropometric classification, pharmacological
variables, biomarkers and ‘‘obesity paradox’’. Med Clin(Barc).2009.
doi:10.1016/j.medcli.2009.02.038
7. Morales Salinas A, Coca A. Ergoanthropometric assessment. Mayo Clinic
Proceedings. Mayo Clin Proc.2009;84(10):939-942
Rapid Response:
Re: Underweight patient and ergoantropometric classification.
We read with great interest the article by Heitmann and Frederiksen1.
We want to hightlight two elements.
First, age might be the most important prognostic factor in primary2 and
secondary prevention3 and Heitmann et al. excluded age in their
statistical model; although compared with the men and women who died
during follow-up, baseline age was 20 and 10 years lower for the men and
women who survived in each case
Second, a focus on thigh circumference might help general practitioners to
identify individuals who are at increased risk of early morbidity and
mortality. We can state that in general underweight patients are a high
risk group.4, but this fact is not taken into account in the current
obesity classification of the National Institutes of Health5.
Recently, we published a new ergoanthropometric classification (Table 1),
which it takes into consideration that underweight (body mass index BMI,
<_18.5 kg="kg" m2="m2" is="is" an="an" increased="increased" risk="risk" especially="especially" in="in" secondary="secondary" prevention="prevention" and="and" includes="includes" assessment="assessment" of="of" waist="waist" circumference="circumference" physical="physical" fitness="fitness" addition="addition" to="to" bmi67.="bmi67." p="p"/>References
1. Heitmann BL and Frederiksen P. Thigh circumference and risk of heart
disease and premature death: prospective cohort study. BMJ 2009;339: b3292
2. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh
A, et al. Predicting cardiovascular risk in England and Wales: prospective
derivation and validation of QRISK2. BMJ 2008;336:a33
3. Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, Lemos JA, et
al. TIMI Risk Score for ST-Elevation Myocardial Infarction: A Convenient,
Bedside, Clinical Score for Risk Assessment at Presentation: An
Intravenous nPA for Treatment of Infarcting Myocardium Early II Trial
Substudy. Circulation. 2000;102:2031-2037.
4. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess Deaths
Associated With Underweight, Overweight, and Obesity JAMA. 2005;293:1861-
1867
5. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al.
Obesity and cardiovascular disease: pathophysiology, evaluation, and
effect of weight loss: an update of the 1997 American Heart Association
scientific statement on obesity and heart disease from the Obesity
Committee of the Council on nutrition, physical activity, and metabolism.
Circulation. 2006;113:898-91
6. Morales Salinas A, Coca A. Obesity, physical activity and
cardiovascular risk: ergo-anthropometric classification, pharmacological
variables, biomarkers and ‘‘obesity paradox’’. Med Clin(Barc).2009.
doi:10.1016/j.medcli.2009.02.038
7. Morales Salinas A, Coca A. Ergoanthropometric assessment. Mayo Clinic
Proceedings. Mayo Clin Proc.2009;84(10):939-942
Competing interests:
None declared
Competing interests: No competing interests