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]
The concept was proposed by biomedical scientist Raphael E. Cuomo in a 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.[7] The concept was later expanded in discussions about cancer,[8] cannabis,[9] and precision health.[10] Public interest grew after an Instagram post by Princess Leonor of Spain sparked online debate on Reddit.[11][12]
Scientific discussion
Analyses have proposed integrating the concept into stage-specific clinical guidance, suggesting that counselling after diagnosis may differ from primary prevention advice.[13] Related work has examined analogous questions in cardiology,[14] tumor biology including redox homeostasis,[15] and frameworks for medical artificial intelligence.[16]
Reporting summarized potential differences between prevention-oriented dietary patterns and post-diagnosis survival associations,[17] including accounts that factors commonly viewed as unhealthy may increase disease risk yet correlate with improved survival in some settings.[18] Additional commentary considered applications in oncology and stage-specific pharmacologic care,[19] and reports have highlighted claims that supplements viewed as harmful in prevention contexts do not always show adverse associations with survival after diagnosis.[20]
Public reception
The paradox attracted broader public attention, which emphasized its relevance to both individual dietary choices and systemic healthcare spending.[21][22] Additional perspectives focused on the implications of aligning diet with one's health trajectory.[23][24]
Some commentators have described Cuomo's paradox as a notable development, citing its potential impact on dietary policy and personalized care,[25][26] and its relevance for stage-specific clinical guidelines.[27][28]
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