{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:58:34Z","timestamp":1769821114527,"version":"3.49.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Despite that nutritional deficiency existed in congestive heart failure (CHF), there is a large amount of CHF patients suffering from obesity. This study aimed to identify the differences for increased BMI or obesity in CHF patients.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This cross-sectional study included adults from the National Health and Nutrition Examination Survey 2007\u20132016. Differences were compared between CHF participants vs. non-CHF participants, and BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup> vs. BMI &amp;lt; 30 kg\/m<jats:sup>2<\/jats:sup> CHF participants.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> CHF participants were with higher BMI, lower energy and macronutrient intake, lower physical activity level and longer rest time, and lower hematocrit and hemoglobin level (all <jats:italic>P<\/jats:italic> &amp;lt; 0.05) than non-CHF participants. The prevalence of BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup> in participants with CHF was 53.48%. There was no significant difference observed in energy and macronutrient intake between CHF participants with BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup> or &amp;lt;30 kg\/m<jats:sup>2<\/jats:sup>. The water intake (<jats:italic>P<\/jats:italic> = 0.032), sedentary time (<jats:italic>P<\/jats:italic> = 0.002), and hematocrit (<jats:italic>P<\/jats:italic> = 0.028) were significantly different between CHF with BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup> and with &amp;lt;30 kg\/m<jats:sup>2<\/jats:sup>.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Compared with non-CHF participants, CHF participants exhibited higher BMI with lower energy and macronutrient intake, lower physical activity level, longer rest time, and hemodilution with lower hematocrit and hemoglobin level. Among CHF participants with BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup>, higher sedentary time and hematocrit were observed.<\/jats:p>","DOI":"10.3389\/fcvm.2021.680371","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T05:24:42Z","timestamp":1623216282000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Congestive Heart Failure Exhibited Higher BMI With Lower Energy Intake and Lower Physical Activity Level: Data From the National Health and Examination Nutrition Survey"],"prefix":"10.3389","volume":"8","author":[{"given":"Tianyu","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haobin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingchun","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingli","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.jacc.2013.11.053","article-title":"The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries","volume":"63","author":"Ambrosy","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","article-title":"Epidemiology and aetiology of heart failure","volume":"13","author":"Ziaeian","year":"2016","journal-title":"Nat Rev Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1590\/S0066-782X2009001100016","article-title":"Nutritional status and adequacy of energy and nutrient intakes among heart failure patients","volume":"93","author":"Louren\u00e7o","year":"2009","journal-title":"Arq Bras Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"442","DOI":"10.3390\/nu8070442","article-title":"Nutritional deficiency in patients with heart failure","volume":"8","author":"Sciatti","year":"2016","journal-title":"Nutrients"},{"key":"B5","doi-asserted-by":"publisher","first-page":"56","DOI":"10.5603\/KP.a2013.0184","article-title":"Does heart failure determine the nutrition of patients?","volume":"72","author":"Makarewicz-Wujec","year":"2014","journal-title":"Kardiol Pol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1002\/ehf2.12501","article-title":"Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications","volume":"6","author":"Chien","year":"2019","journal-title":"ESC Heart Fail"},{"key":"B7","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.jchf.2018.03.014","article-title":"Malnutrition in heart failure: important but undervalued issue","volume":"6","author":"Kinugawa","year":"2018","journal-title":"JACC Heart Fail"},{"key":"B8","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ahj.2009.10.026","article-title":"Obesity and survival in patients with heart failure and preserved systolic function: a U-shaped relationship","volume":"159","author":"Kapoor","year":"2010","journal-title":"Am Heart J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1161\/CIRCULATIONAHA.109.887893","article-title":"Joint effects of physical activity, body mass index, waist circumference, and waist-to-hip ratio on the risk of heart failure","volume":"121","author":"Hu","year":"2010","journal-title":"Circulation"},{"key":"B10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ahj.2008.02.014","article-title":"Body mass index and mortality in heart failure: a meta-analysis","volume":"156","author":"Oreopoulos","year":"2008","journal-title":"Am Heart J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ijcard.2016.03.180","article-title":"Physical activity, weight status, and mortality among congestive heart failure patients","volume":"214","author":"Loprinzi","year":"2016","journal-title":"Int J Cardiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1111\/obr.12777","article-title":"Pre- and post-diagnosis body mass index and heart failure mortality: a dose-response meta-analysis of observational studies reveals greater risk of being underweight than being overweight","volume":"20","author":"Milajerdi","year":"2018","journal-title":"Obes Rev"},{"key":"B13","first-page":"1","article-title":"National health and nutrition examination survey: plan and operations, 1999-2010","author":"Zipf","year":"2013","journal-title":"Vital Health Stat 1"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1001\/archinte.158.17.1855","article-title":"Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults","volume":"158","author":"Pi-Sunyer","year":"1998","journal-title":"Arch Intern Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1186\/s12872-017-0669-0","article-title":"The top tertile of hematocrit change during hospitalization is associated with lower risk of mortality in acute heart failure patients","volume":"17","author":"Zhou","year":"2017","journal-title":"BMC Cardiovasc Disord"},{"key":"B16","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.pcad.2016.01.008","article-title":"Obesity and prevalence of cardiovascular diseases and prognosis-the obesity paradox updated","volume":"58","author":"Lavie","year":"2016","journal-title":"Prog Cardiovasc Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jchf.2013.01.006","article-title":"Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure","volume":"1","author":"Lavie","year":"2013","journal-title":"JACC Heart Fail"},{"key":"B19","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1093\/eurjhf\/hfq218","article-title":"Body mass indices and outcome in patients with chronic heart failure","volume":"13","author":"Futter","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1016\/j.ahj.2005.02.004","article-title":"Obesity as a prognostic factor in chronic symptomatic heart failure","volume":"150","author":"Bozkurt","year":"2005","journal-title":"Am Heart J"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1016\/j.amjcard.2015.02.024","article-title":"Meta-analysis of the relation of body mass index to all-cause and cardiovascular mortality and hospitalization in patients with chronic heart failure","volume":"115","author":"Sharma","year":"2015","journal-title":"Am J Cardiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"639","DOI":"10.2217\/fca-2016-0029","article-title":"Body habitus in heart failure: understanding the mechanisms and clinical significance of the obesity paradox","volume":"12","author":"Parto","year":"2016","journal-title":"Future Cardiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1136\/heartjnl-2018-313312","article-title":"Malnutrition, congestion and mortality in ambulatory patients with heart failure","volume":"105","author":"Sze","year":"2019","journal-title":"Heart"},{"key":"B24","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1590\/s0066-782x2009001100016","article-title":"Adequacy of energy and nutrient intake in patients with heart failure","volume":"31","author":"Sanches","year":"2015","journal-title":"Nutr Hosp"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1016\/S0735-1097(03)00946-X","article-title":"Is nutritional intake adequate in chronic heart failure patients?","volume":"42","author":"Aquilani","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00380-020-01590-4","article-title":"Prognostic impact of a novel index of nutrition and inflammation for patients with acute decompensated heart failure","volume":"35","author":"Maeda","year":"2020","journal-title":"Heart Vessels"},{"key":"B27","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1177\/1474515119864970","article-title":"Prognostic impact of malnutrition assessed using geriatric nutritional risk index in patients aged \u226580 years with heart failure","volume":"19","author":"Nakamura","year":"2020","journal-title":"Eur J Cardiovasc Nurs"},{"key":"B28","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/j.1749-6632.2009.05100.x","article-title":"Return to the fetal gene program: a suggested metabolic link to gene expression in the heart","volume":"1188","author":"Taegtmeyer","year":"2010","journal-title":"Ann N Y Acad Sci"},{"key":"B29","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.hfc.2012.06.003","article-title":"Sphingolipids, lipotoxic cardiomyopathy, and cardiac failure","volume":"8","author":"Park","year":"2012","journal-title":"Heart Fail Clin"},{"key":"B30","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1161\/01.CIR.51.4.621","article-title":"The effect of hypoglycemia on myocardial ischemic injury during acute experimental coronary artery occlusion","volume":"51","author":"Libby","year":"1975","journal-title":"Circulation"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1056\/NEJMra063052","article-title":"The failing heart\u2013an engine out of fuel","volume":"356","author":"Neubauer","year":"2007","journal-title":"N Engl J Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"S66","DOI":"10.1053\/ajkd.2001.20748","article-title":"National kidney foundation K\/DOQI clinical practice guidelines for nutrition in chronic renal failure","volume":"37","author":"Kopple","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2275","DOI":"10.1152\/japplphysiol.00421.2004","article-title":"Regulation of fuel metabolism by preexercise muscle glycogen content and exercise intensity","volume":"97","author":"Arkinstall","year":"2004","journal-title":"J Appl Physiol (1985)"},{"key":"B34","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/00000441-200104000-00003","article-title":"Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome","volume":"321","author":"Alpert","year":"2001","journal-title":"Am J Med Sci"},{"key":"B35","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1161\/01.CIR.103.6.820","article-title":"Relations of stroke volume and cardiac output to body composition: the strong heart study","volume":"103","author":"Collis","year":"2001","journal-title":"Circulation"},{"key":"B36","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.mayocp.2016.11.001","article-title":"Obesity and heart failure: focus on the obesity paradox","volume":"92","author":"Carbone","year":"2017","journal-title":"Mayo Clin Proc"},{"key":"B37","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1161\/01.CIR.0000052623.16194.80","article-title":"Hemodilution is common in patients with advanced heart failure","volume":"107","author":"Androne","year":"2003","journal-title":"Circulation"},{"key":"B38","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1139\/y86-002","article-title":"The physiologic reserve in oxygen carrying capacity: studies in experimental hemodilution","volume":"64","author":"Chapler","year":"1986","journal-title":"Can J Physiol Pharmacol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/0735-1097(88)90375-0","article-title":"Effect on peripheral arterioles of chronic fluid and sodium retention in heart failure","volume":"12","author":"Wilson","year":"1988","journal-title":"J Am Coll Cardiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1093\/eurjhf\/hft097","article-title":"Salt and fluid restriction is effective in patients with chronic heart failure","volume":"15","author":"Philipson","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"B41","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1161\/CIRCULATIONAHA.109.933275","article-title":"Potential effects of aggressive decongestion during the treatment of decompensated heart failure on renal function and survival","volume":"122","author":"Testani","year":"2010","journal-title":"Circulation"},{"key":"B42","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1161\/CIRCRESAHA.118.312669","article-title":"Sedentary behavior, exercise, and cardiovascular health","volume":"124","author":"Lavie","year":"2019","journal-title":"Circ Res"},{"key":"B43","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1111\/j.1474-9726.2012.00844.x","article-title":"The impact of aging on mitochondrial function and biogenesis pathways in skeletal muscle of sedentary high- and low-functioning elderly individuals","volume":"11","author":"Joseph","year":"2012","journal-title":"Aging Cell"},{"key":"B44","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1210\/jc.2012-2967","article-title":"Higher mitochondrial respiration and uncoupling with reduced electron transport chain content in vivo in muscle of sedentary vs. active subjects","volume":"98","author":"Conley","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e262","DOI":"10.1161\/CIR.0000000000000440","article-title":"Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the american heart association","volume":"134","author":"Young","year":"2016","journal-title":"Circulation"},{"key":"B46","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1249\/MSS.0b013e3181930355","article-title":"Sitting time and mortality from all causes, cardiovascular disease, and cancer","volume":"41","author":"Katzmarzyk","year":"2009","journal-title":"Med Sci Sports Exerc"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e80000","DOI":"10.1371\/journal.pone.0080000","article-title":"Daily sitting time and all-cause mortality: a meta-analysis","volume":"8","author":"Chau","year":"2013","journal-title":"PLOS ONE"},{"key":"B48","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1001\/jamacardio.2016.1567","article-title":"Continuous dose-response association between sedentary time and risk for cardiovascular disease: a meta-analysis","volume":"1","author":"Pandey","year":"2016","journal-title":"JAMA Cardiol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"123","DOI":"10.7326\/M14-1651","article-title":"Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis","volume":"162","author":"Biswas","year":"2015","journal-title":"Ann Intern Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1016\/S0140-6736(16)30370-1","article-title":"Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women","volume":"388","author":"Ekelund","year":"2016","journal-title":"Lancet"},{"key":"B51","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jchf.2015.12.005","article-title":"Bulking Up skeletal muscle to improve heart failure prognosis","volume":"4","author":"Lavie","year":"2016","journal-title":"JACC Heart Fail"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1002\/ejhf.1314","article-title":"Muscling up to improve heart failure prognosis","volume":"20","author":"Ventura","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"B53","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1177\/0148607114550189","article-title":"Lean tissue imaging: a new era for nutritional assessment and intervention","volume":"38","author":"Prado","year":"2014","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"B54","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.ijcard.2016.07.135","article-title":"Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life","volume":"222","author":"Bekfani","year":"2016","journal-title":"Int J Cardiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.680371\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T05:24:45Z","timestamp":1623216285000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.680371\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,9]]},"references-count":54,"alternative-id":["10.3389\/fcvm.2021.680371"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.680371","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,9]]},"article-number":"680371"}}