Mixed
High predicted fat mass is strongly and monotonically associated with increased all-cause, cardiovascular, and cancer mortality in men, whereas low predicted lean body mass is the primary driver of the 'obesity paradox' (increased mortality at low BMI).
For men, maintaining muscle mass is as critical as managing fat for longevity. High fat mass increases mortality risk linearly, while low muscle mass increases risk significantly. Focus on resistance training to preserve lean mass and dietary quality to manage fat, rather than just chasing a specific BMI number.
Predicted fat mass showed a strong positive monotonic association with mortality, whereas predicted lean body mass showed a strong U shaped association with mortality... The obesity paradox controversy may be largely explained by low lean body mass, rather than low fat mass, in the lower range of BMI.
Why this rating
Large prospective cohort (n=38,006), long follow-up (mean 21.4 years), validated prediction equations, but observational design limits causal inference.
Source
Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study
Dong Hoon Lee et al. · BMJ · 2018
DOI 10.1136/bmj.k2575
Related findings · Mixed
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