Summary
This umbrella review and meta-analysis integrated evidence from 53 observational meta-analyses (>501 cohort studies) and 12 Mendelian randomization studies to clarify causal versus associational relationships between adiposity and CVD. Whilst observational data consistently associated higher BMI with increased CVD risk across multiple endpoints, Mendelian randomization confirmed causal effects for most outcomes except stroke and all-cause mortality. The integration of observational and genetic evidence provides a methodological framework for reliably interpreting epidemiological relationships in cardiovascular disease aetiology, with approximately half of identified associations supported by high-level evidence.
Regional applicability
The study's global population base across multiple regions supports applicability to UK populations, and its findings on BMI–CVD relationships are relevant to UK public health guidance on obesity and cardiovascular risk. However, the study provides no farm-to-health or food systems intervention data, so translation to agricultural or dietary policy would require additional evidence on effective dietary or lifestyle modification pathways.
Key measures
Relative risk (RR) with 95% confidence intervals; certainty of evidence (high/moderate/low); causal effect estimates from Mendelian randomization studies
Outcomes reported
The study synthesised observational and genetic evidence to distinguish between association and causality in the relationship between body mass index (BMI) and cardiovascular disease (CVD) risk, across multiple CVD endpoints and mortality outcomes. It quantified relative risk increases for various CVD outcomes per 5 kg/m² increase in BMI and assessed the certainty of evidence supporting each association.
Topic tags
Dig deeper with Pulse AI.
Pulse AI has read the whole catalogue. Ask about this record, its theme, or how the findings apply to UK farming and policy — every answer cites the underlying studies.