Approved Research

Associations of body fat and inflammation with the development of non-communicable chronic disease: A prospective cohort study

Lay summary

Obesity associates with prevalent chronic disease, particularly type 2 diabetes, cardiovascular and pulmonary diseases, and cancers.

However obesity, defined as high body mass index (BMI), does not correlate with a higher risk of mortality in many clinical populations. In fact, when statistical modelling accounts for key confounders - inflammation and/or fasting insulin - high BMI (and high fat percentage) has been shown to associate with a lower risk of mortality in a general American adult population. These two confounders also associate with disease development. Neither confounder has been shown to be downstream from or caused by obesity. Given that adiposity functions as part of our immune system, obesity may arise as part of a protective response to disease development.

Besides BMI, there are many different ways and perhaps better ways to measure body fat (i.e., visceral fat, body adiposity index, body composition, relative fat mass, and waist circumference).

While there have been many systematic reviews noting the obesity paradox, (whereby mortality is lower for people with higher BMI) there have been few or no studies demonstrating that body fat, however measured, when accounting for inflammation, may protect against or delay the development of chronic disease.

In this prospective cohort study of UK adults, we will evaluate the associations of various body fat measures, independent of inflammation, with the development of chronic disease.