Cuomo's paradox

Cuomo’s paradox is the observation of factors associated with disease prevention which have the opposite association with disease survival.[1] Research has highlighted occurrences of excess body mass[2][3], high cholesterol[4] and moderate alcohol consumption.[5]

Origin

The concept was proposed by biomedical scientist Raphael E. Cuomo in a 2025 publication in the Journal of Nutrition.[6] Cuomo analyzed clinical and epidemiological data suggesting that common nutritional risk factors including obesity, alcohol consumption, and cholesterol often play contrasting roles in disease prevention versus survival outcomes. The concept was later expanded in discussions about cancer, cardiovascular disease, and chronic inflammation.[7]

Public interest grew in August 2025 after an Instagram post by Princess Leonor of Spain sparked online debate on Reddit.[8][9]

Scientific discussion

A 2025 paper proposed integrating the concept into stage-specific clinical guidance, suggesting that counselling after diagnosis may differ from primary prevention advice.[10] Related work has examined analogous questions in cardiology,[11] tumor biology including redox homeostasis,[12] and frameworks for medical artificial intelligence.[13]

Reporting summarized potential differences between prevention-oriented dietary patterns and post-diagnosis survival associations,[14] including accounts that factors commonly viewed as unhealthy may increase disease risk yet correlate with improved survival in some settings.[15] Additional commentary considered applications in oncology and stage-specific pharmacologic care,[16] and reports have highlighted claims that supplements viewed as harmful in prevention contexts do not always show adverse associations with survival after diagnosis.[17]

Public reception

The paradox attracted broader public attention, which emphasized its relevance to both individual dietary choices and systemic healthcare spending.[18][19] Additional perspectives focused on the implications of aligning diet with one’s health trajectory.[20]

Some commentators have described Cuomo’s paradox as a notable development, citing its potential impact on dietary policy and personalized care, and its relevance for stage-specific clinical guidelines.[21][22]

See also

References

  1. ^ "New Paper Describes Cuomo's Paradox: Dietary Habits Which Prevent Disease May Worsen Survival After Cancer or Heart Disease Diagnosis". UC San Diego School of Medicine. 4 August 2025. Retrieved 7 August 2025.
  2. ^ Butt, Jawad H; Petrie, Mark C; Jhund, Pardeep S; Sattar, Naveed; Desai, Akshay S; Køber, Lars; Rouleau, Jean L; Swedberg, Karl; Zile, Michael R; Solomon, Scott D; Packer, Milton; McMurray, John J V (2023-04-01). "Anthropometric measures and adverse outcomes in heart failure with reduced ejection fraction: revisiting the obesity paradox". European Heart Journal. 44 (13): 1136–1153. doi:10.1093/eurheartj/ehad083. ISSN 0195-668X. PMC 10111968. PMID 36944496.
  3. ^ Pavone, Matteo; Goglia, Marta; Taliento, Cristina; Lecointre, Lise; Bizzarri, Nicolò; Fanfani, Francesco; Fagotti, Anna; Scambia, Giovanni; Marescaux, Jacques; Querleu, Denis; Seeliger, Barbara; Akladios, Chérif (2024-08-01). "Obesity paradox: is a high body mass index positively influencing survival outcomes in gynecological cancers? A systematic review and meta-analysis". International Journal of Gynecological Cancer. 34 (8): 1253–1262. doi:10.1136/ijgc-2023-005252. ISSN 1048-891X.
  4. ^ Ravnskov, Uffe; Diamond, David M.; Hama, Rokura; Hamazaki, Tomohito; Hammarskjöld, Björn; Hynes, Niamh; Kendrick, Malcolm; Langsjoen, Peter H.; Malhotra, Aseem; Mascitelli, Luca; McCully, Kilmer S.; Ogushi, Yoichi; Okuyama, Harumi; Rosch, Paul J.; Schersten, Tore (2016-06-01). "Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review". BMJ Open. 6 (6): e010401. doi:10.1136/bmjopen-2015-010401. ISSN 2044-6055. PMID 27292972.
  5. ^ Wang, Yue; Duan, Hong; Yang, Helen; Lin, Jie (2015). "A pooled analysis of alcohol intake and colorectal cancer". International Journal of Clinical and Experimental Medicine. 8 (5): 6878–6889. ISSN 1940-5901. PMC 4509170. PMID 26221225.
  6. ^ Cuomo, Raphael E. (July 2025). "The nutritional epidemiology risk–survival paradox". The Journal of Nutrition. 155 (7): 1420–1432. doi:10.1016/j.jn.2025.06.009.
  7. ^ Press, Medical Science. "New Study Reveals Cuomo's Paradox: Poor Health Habits May Be Beneficial After Disease Diagnosis". PRLog. Retrieved 2025-08-07.
  8. ^ "Instagram". www.instagram.com. Retrieved 2025-08-07.
  9. ^ "Reddit - The heart of the internet". www.reddit.com. Retrieved 2025-08-07.
  10. ^ "Updating Clinical Guidance to Account for Cuomo's Paradox: Stage-Specific Integration into Foundational Health Guidelines". SSRN. 5 August 2025. Retrieved 7 August 2025.
  11. ^ Hussain, Sultana Monira; McNeil, John J. (2025-04-22). "An HDL Cholesterol paradox". Cardiovascular Drugs and Therapy. doi:10.1007/s10557-025-07703-3. ISSN 1573-7241.
  12. ^ Liu, Ying; Cai, Xingyu; Liu, Jinjie; Luo, Zhonghui; Zhang, Jinyan; Cao, Zhen; Ma, Wei; Tang, Yuxuan; Liu, Tingna; Wei, Hua; Yu, Cui-yun (2025-08-05). "The Role of Redox Homeostasis in Tumor Progression: Implications for Cancer Therapy". Acta Biomaterialia. doi:10.1016/j.actbio.2025.07.067. ISSN 1742-7061.
  13. ^ Myers, Daniel B.; Smith, Grace L. (2025-08-08). "Cuomo's Paradox and the Design of Artificial Intelligence in Medicine: A Stage-Specific Framework for Learning, Evaluation, and Deployment". Revista de Inteligencia Artificial en Medicina. 16 (1): 266–281. ISSN 2049-3630.
  14. ^ "Dietary habits which prevent disease may worsen survival after cancer or heart disease diagnosis". 4 August 2025. Retrieved 14 August 2025.
  15. ^ Krieger, Lisa M. (14 August 2025). "Conditions considered 'unhealthy' can promote disease but boost survival, UCSD scientist says". Retrieved 14 August 2025.
  16. ^ Sato, Ryo; Nakamura, Haruka; Watanabe, Takumi (13 August 2025). "Understanding Cuomo's Paradox in Oncology Research and its Implications for Pharmacologic Studies". American Journal of Pharmacy and Pharmacology. 6 (4): ?. Retrieved 14 August 2025.
  17. ^ "Controversial supplement may not be so bad after all—but only in these cases". 12 August 2025. Retrieved 14 August 2025.
  18. ^ "Cuomo's Paradox: Nutrition's Double Role In Prevention And Survival". Care City. 4 August 2025. Retrieved 7 August 2025.
  19. ^ "When Health Foods Go Rogue: Unpacking Cuomo's Paradox". Techie Tale. 6 August 2025. Retrieved 7 August 2025.
  20. ^ "Cuomo's Paradox: A Precision Approach to Optimize Global Health". Retrieved 5 August 2025.
  21. ^ "Cuomo's Paradox: A Precision Health Imperative". Targeted Medicine. 7 August 2025. Retrieved 7 August 2025.
  22. ^ "Why Cuomo's Paradox Might Be the Most Important Health Insight of the Decade". Maintaining Health. 7 August 2025. Retrieved 7 August 2025.
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