View article

Background: The obesity paradox has been described in several cohort studies. However, evidence of intentionality of weight loss on all-cause mortality and major cardiovascular events (MACE) in prospective cohorts is not clear.

Aim: To summarize and evaluate the observational evidence of the effects of intentionality of weight loss on MACE and all-cause mortality.

Methods: Through a systematic review, multiple electronic databases (MEDLINE/PubMed, Web of Science, SciELO and LILACS) were searched and manual search for studies published up to September 2016 was performed. Cohort studies that reported intentionality (intentional and unintentional) weight loss compared to no weight change with risk estimates for MACE and mortality in primary prevention cohorts were included. A pre-defined protocol in accordance with the standards of quality for reporting meta-analysis of observational studies …