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Prevalence and predictors of metabolically healthy obesity in severely obese Asian children. Pediatr Res 2022; 92:1374-1380. [PMID: 35132129 DOI: 10.1038/s41390-022-01941-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Obese individuals who have little or no metabolic syndrome components are proposed to be "metabolically healthy obese (MHO)". This study aim to evaluate the prevalence of MHO and examine the predictors associated with MHO in a multi-ethnic Asian cohort of severely obese children. METHODS This study included a cross-sectional cohort of 406 Chinese, Malay and Indian children aged 5-20 years old with BMI for age ≥ 97th percentile. Metabolic syndrome (MS) and metabolic health (MH) definitions based on the presence or absence of metabolic abnormalities (High triglycerides, low HDL cholesterol, elevated blood pressure and high glucose) were used to define MHO in the cohort. RESULTS The prevalence of MHO is 63.5% by MS definition and 22.4% by MH definition. Maternal healthy metabolic status (OR: 2.47), age (OR: 0.83, 0.80), paternal obesity (OR: 0.48, 0.53), Malay (OR: 1.97) and Indian ethnicity (OR: 6.38, 3.21) (compared to Chinese ethnicity) are independent predictors for MHO phenotype based on different MHO definitions. CONCLUSIONS Adiposity measures are not associated with MHO phenotype, but instead younger age, maternal healthy metabolic status, absence of paternal obesity, Malay and Indian ethnicity are independent predictors for MHO phenotype in a multi-ethnic Asian cohort of severely obese children. IMPACT The prevalence of metabolically healthy obese (MHO) in our multi-ethnic Asian cohort of severely obese children is 63.5% and 22.4%, respectively, based on different MHO definitions. Adiposity measures are not associated with the MHO phenotype. There are other factors that contribute to the metabolic phenotype in obese individuals. Younger age, maternal healthy metabolic status, absence of paternal obesity, Malay and Indian ethnicity are independent predictors for MHO phenotype. Parental influence is important in predicting metabolic health in obese individuals.
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Tabatabaei-Malazy O, Saeedi Moghaddam S, Masinaei M, Rezaei N, Mohammadi Fateh S, Dilmaghani-Marand A, Abdolhamidi E, Razi F, Khashayar P, Mahdavihezaveh A, Mirab Samiee S, Larijani B, Farzadfar F. Association between being metabolically healthy/unhealthy and metabolic syndrome in Iranian adults. PLoS One 2022; 17:e0262246. [PMID: 34990491 PMCID: PMC8735615 DOI: 10.1371/journal.pone.0262246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/20/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction The prevalence of metabolically healthy obesity (MHO) varies based on different criteria. We assessed the prevalence of MHO and metabolic unhealthiness based on body mass index (BMI) and their association with metabolic syndrome (MetS) in a nation-wide study. Methods Data were taken from the STEPs 2016 study, from 18,459 Iranians aged ≥25 years. Demographic, metabolic, and anthropometric data were collected. Subjects were stratified by BMI, metabolic unhealthiness, and having MetS. The latter was defined based on National Cholesterol Education Program Adult Treatment Panel III 2004 (NCEP ATP III), was then assessed. Results The prevalence of MHO and metabolic unhealthiness in obese subjects was 7.5% (about 3.6 million) and 18.3% (about 8.9 million), respectively. Most of the metabolic unhealthy individuals were female (53.5%) or urban residents (72.9%). Low physical activity was significantly and positively associated (Odds Ratio: 1.18, 95% CI: 1.04–1.35) with metabolic unhealthiness, while being a rural residence (0.83, 0.74–0.93), and having higher education (0.47, 0.39–0.58) significantly but negatively affected it. Dyslipidemia was the most frequent MetS component with a prevalence rate of 46.6% (42.1–51.1), 62.2% (60.8–63.6), 76.3% (75.1–77.5), and 83.4% (82.1–84.6) among underweight, normal weight, overweight and obese phenotypes, respectively. Conclusion BMI aside, an additional set of criteria such as metabolic markers should be taken into account to identify normal weight but metabolically unhealthy individuals. Given the highest prevalence of dyslipidemia among obese subjects, further interventions are required to raise public awareness, promote healthy lifestyles and establish lipid clinics.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Departments of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Patricia Khashayar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Center for Microsystems Technology, Imec and Ghent, University Ghent Belgium, Ghent, Belgium
| | | | - Siamak Mirab Samiee
- Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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Rossello X, Fuster V, Oliva B, Sanz J, Fernández Friera LA, López-Melgar B, Mendiguren JM, Lara-Pezzi E, Bueno H, Fernández-Ortiz A, Ibanez B, Ordovás JM. Association Between Body Size Phenotypes and Subclinical Atherosclerosis. J Clin Endocrinol Metab 2020; 105:5900885. [PMID: 32879953 PMCID: PMC7521861 DOI: 10.1210/clinem/dgaa620] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022]
Abstract
CONTEXT The underlying relationship between body mass index (BMI), cardiometabolic disorders, and subclinical atherosclerosis is poorly understood. OBJECTIVE To evaluate the association between body size phenotypes and subclinical atherosclerosis. DESIGN Cross-sectional. SETTING Cardiovascular disease-free cohort. PARTICIPANTS Middle-aged asymptomatic subjects (n = 3909). A total of 6 cardiometabolic body size phenotypes were defined based on the presence of at least 1 cardiometabolic abnormality (blood pressure, fasting blood glucose, triglycerides, low high-density lipoprotein cholesterol, homeostasis model assessment-insulin resistance index, high-sensitivity C-reactive protein) and based on BMI: normal-weight (NW; BMI <25), overweight (OW; BMI = 25.0-29.9) or obese (OB; BMI >30.0). MAIN OUTCOME MEASURES Subclinical atherosclerosis was evaluated by 2D vascular ultrasonography and noncontrast cardiac computed tomography. RESULTS For metabolically healthy subjects, the presence of subclinical atherosclerosis increased across BMI categories (49.6%, 58.0%, and 67.7% for NW, OW, and OB, respectively), whereas fewer differences were observed for metabolically unhealthy subjects (61.1%, 69.7%, and 70.5%, respectively). When BMI and cardiometabolic abnormalities were assessed separately, the association of body size phenotypes with the extent of subclinical atherosclerosis was mostly driven by the coexistence of cardiometabolic risk factors: adjusted OR = 1.04 (95% confidence interval [CI], 0.90-1.19) for OW and OR = 1.07 (95% CI, 0.88-1.30) for OB in comparison with NW, whereas there was an increasing association between the extent of subclinical atherosclerosis and the number of cardiometabolic abnormalities: adjusted OR = 1.21 (95% CI, 1.05-1.40), 1.60 (95% CI, 1.33-1.93), 1.92 (95% CI, 1.48-2.50), and 2.27 (95% CI, 1.67-3.09) for 1, 2, 3, and >3, respectively, in comparison with noncardiometabolic abnormalities. CONCLUSIONS The prevalence of subclinical atherosclerosis varies across body size phenotypes. Pharmacologic and lifestyle interventions might modify their cardiovascular risk by facilitating the transition from one phenotype to another.
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Affiliation(s)
- Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- CIBER de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Icahn School of Medicine at Mount Sinai, New York, New York
- Correspondence and Reprint Requests: Valentin Fuster, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), C/Melchor Fernandez Almagro 3, 28029 Madrid, Spain. E-mail: ; or José M. Ordovás, Nutrition and Genomics, JM-USDA-HNRCA at Tufts University, 711 Washington Street, Boston, Massachusetts 02111. E-mail:
| | - Belén Oliva
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Javier Sanz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Leticia A Fernández Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain
- Universidad CEU San Pablo, Madrid, Spain
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain
- Universidad CEU San Pablo, Madrid, Spain
| | | | - Enrique Lara-Pezzi
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 deOctubre (imas12), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Hospital Clínico San Carlos, Universidad Complutense, IdISSC, Madrid, Spain
| | - Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- CIBER de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - José María Ordovás
- U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- Correspondence and Reprint Requests: Valentin Fuster, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), C/Melchor Fernandez Almagro 3, 28029 Madrid, Spain. E-mail: ; or José M. Ordovás, Nutrition and Genomics, JM-USDA-HNRCA at Tufts University, 711 Washington Street, Boston, Massachusetts 02111. E-mail:
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Xu Y, Wei Y, Long T, Wang R, Li Z, Yu C, Wu T, He M. Association between urinary metals levels and metabolic phenotypes in overweight and obese individuals. CHEMOSPHERE 2020; 254:126763. [PMID: 32957263 DOI: 10.1016/j.chemosphere.2020.126763] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
Epidemiologic studies suggest that circulating metals from the natural environment are linked with cardiometabolic health. However, few studies examined the relationship between multiple metals exposure and metabolic phenotypes, especially in obese individuals. We conducted a cross-sectional study to explore the association between 23 urinary metals and metabolic phenotypes in 1392 overweight and obese individuals (592 males, 800 females, mean age 43.1 ± 9.8 years). Participants were classified as metabolically unhealthy if they had ≥2 of the following metabolic abnormalities: elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol. Odds ratios (ORs) of unhealthy metabolic phenotypes for metal levels categorized into tertiles were assessed using logistic regression models. Five metals (barium, copper, iron, uranium, and zinc) were associated with unhealthy metabolic phenotypes in single-metal models, while in the multiple-metal model, only zinc and zinc-copper ratio remained significant. The ORs (95% CIs) comparing extreme tertiles were 2.57 (1.69, 3.89) for zinc and 1.68 (1.24, 2.27) for zinc-copper ratio after adjustment for confounders (both p-trends were <0.001). The numbers of metabolic abnormalities significantly increased with the levels of zinc and the zinc-copper ratio increased. Similar associations were observed with metabolic syndrome risk. High levels of urinary zinc were positively associated with elevated fasting blood glucose (p-trend < 0.001) and elevated triglycerides (p-trend = 0.003). The results suggest that urinary zinc and zinc-copper ratio are positively associated with increased risk of unhealthy metabolic phenotype. Further prospective studies with a larger sample size are required to verify these findings.
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Affiliation(s)
- Yali Xu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Wei
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tengfei Long
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ruixin Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhaoyang Li
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Caizheng Yu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Public Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Klitgaard HB, Kilbak JH, Nozawa EA, Seidel AV, Magkos F. Physiological and Lifestyle Traits of Metabolic Dysfunction in the Absence of Obesity. Curr Diab Rep 2020; 20:17. [PMID: 32232577 DOI: 10.1007/s11892-020-01302-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Individuals with metabolically unhealthy normal weight (MUNW) have an adverse cardiometabolic risk factor profile in the absence of excess body weight, and increased risk for diabetes and heart disease. We critically review some physiological traits and lifestyle characteristics of the MUNW phenotype. RECENT FINDINGS The prevalence of MUNW varies considerably around the world and among ethnicities, partly because of different definitions; on average, this phenotype affects about ~ 30% of normal weight persons globally. Most studies have recruited MUNW subjects who, although within the normal weight range, are significantly "more obese" than their metabolically healthy lean peers (greater body mass index or total body fat); hence one cannot ascertain whether observed differences are true traits of the MUNW phenotype of simply secondary to greater relative adiposity within the normal range. Carefully matched studies have indicated that MUNW can exist in the absence of excess total body fat. These subjects have a preferential accumulation of fat in the upper body (abdominal subcutaneous and visceral adipose tissues) and the liver, but not skeletal muscle; perhaps surprisingly, this predominantly "android" fat distribution does not translate into increased waist circumference. The MUNW phenotype is associated with lower aerobic fitness and muscle mass and strength, but whether this is simply due to inadequate regular physical activity is not entirely clear. Likewise, no consistent associations have been found between any dietary factors and the development of MUNW phenotype, but diet-induced modest weight loss facilitates its resolution. Delineating the mechanisms leading to metabolic dysfunction in the absence of increased body weight and body fat will likely reveal important targets for improving metabolic health and eventually for reducing the burden of cardiometabolic disease, not only in individuals with normal body weight but also in people with obesity.
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Affiliation(s)
- Hanna Bjørk Klitgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Hoffmann Kilbak
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Erica Arhnung Nozawa
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ann V Seidel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
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Ortega FB, Cadenas-Sanchez C, Migueles JH, Labayen I, Ruiz JR, Sui X, Blair SN, Martínez-Vizcaino V, Lavie CJ. Role of Physical Activity and Fitness in the Characterization and Prognosis of the Metabolically Healthy Obesity Phenotype: A Systematic Review and Meta-analysis. Prog Cardiovasc Dis 2018; 61:190-205. [PMID: 30122522 DOI: 10.1016/j.pcad.2018.07.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/02/2018] [Indexed: 12/18/2022]
Abstract
The aims of the present article are to systematically review and meta-analyze the existing evidence on: 1) differences in physical activity (PA), sedentary behavior (SB), cardiorespiratory fitness (CRF) and muscular strength (MST) between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO); and 2) the prognosis of all-cause mortality and cardiovascular disease (CVD) mortality/morbidity in MHO individuals, compared with the best scenario possible, i.e., metabolically healthy normal-weight (MHNW), after adjusting for PA, SB, CRF or MST. Our systematic review identified 67 cross-sectional studies to address aim 1, and 11 longitudinal studies to address aim 2. The major findings and conclusions from the current meta-analysis are: 1) MHO individuals are more active, spend less time in SB, and have a higher level of CRF (yet no differences in MST) than MUO individuals, suggesting that their healthier metabolic profile could be at least partially due to these healthier lifestyle factors and attributes. 2) The meta-analysis of cohort studies which accounted for PA (N = 10 unique cohorts, 100% scored as high-quality) support the notion that MHO individuals have a 24-33% higher risk of all-cause mortality and CVD mortality/morbidity compared to MHNW individuals. This risk was borderline significant/non-significant, independent of the length of the follow-up and lower than that reported in previous meta-analyses in this topic including all type of studies, which could be indicating a modest reduction in the risk estimates as a consequence of accounting for PA. 3) Only one study has examined the role of CRF in the prognosis of MHO individuals. This study suggests that the differences in the risk of all-cause mortality and CVD mortality/morbidity between MHO and MHNW are largely explained by differences in CRF between these two phenotypes.
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Affiliation(s)
- Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden.
| | - Cristina Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Jairo H Migueles
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Idoia Labayen
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Vicente Martínez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Castilla-La Mancha, Cuenca, Spain and Universidad Autónoma de Chile, Health Sciences Faculty, Talca, Chile
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School -the University of Queensland School of Medicine, New Orleans, LA, USA
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Non-LDL dyslipidemia is prevalent in the young and determined by lifestyle factors and age: The LifeLines cohort. Atherosclerosis 2018; 274:191-198. [DOI: 10.1016/j.atherosclerosis.2018.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/28/2018] [Accepted: 05/10/2018] [Indexed: 02/06/2023]
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8
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Robson EM, Costa S, Hamer M, Johnson W. Life course factors associated with metabolically healthy obesity: a protocol for the systematic review of longitudinal studies. Syst Rev 2018; 7:50. [PMID: 29587826 PMCID: PMC5870377 DOI: 10.1186/s13643-018-0713-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 03/15/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is heterogeneity among obese individuals, as some appear to have healthier metabolic profiles and decreased health risks. These individuals are defined as metabolically healthy obese (MHO), whilst those with unhealthy metabolic profiles are defined as metabolically unhealthy obese (MUO). To date, most research on MHO has been cross-sectional or focused on disease prognosis. However, longitudinal studies are required to provide greater insight into the life course factors that contribute to the development of MHO. This study aims to systematically review longitudinal studies investigating the association between life course exposures and future MHO status. METHODS Electronic databases (MEDLINE, SCOPUS, and Web of Science) will be searched using a trialled search strategy. Studies will be included following a double-screening process according to inclusion criteria to assess eligibility. Studies eligible for inclusion will include those that have a longitudinal observational design where a life course exposure occurred or was measured at least 1 year before the outcome, investigate a human study population, are published in English after 1956, and investigate the association between ≥ 1 life course exposure and ≥ 1 outcome that reflects a measure of cardiometabolic resilience to obesity. Accepted life course exposures will include body size, body composition, pubertal development, smoking, diet, physical activity, sedentary behaviour, and psychosocial stress. The primary measure of cardiometabolic resilience to obesity will be MHO as an outcome (at follow-up). Studies investigating the development of cardiometabolic risk factors in an obese group without specifying MHO will also be accepted, such as the development of the metabolic syndrome (MetS) in an obese group. Key results of included studies will be tabulated, and a narrative synthesis will be conducted. DISCUSSION This will be the first systematic review to summarise the literature on the life course correlates of MHO. Importantly, it may highlight which modifiable lifestyle factors could be targeted to delay the onset of cardiometabolic complications among the obese. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017057992.
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Affiliation(s)
- E M Robson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - S Costa
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0QQ, UK
| | - M Hamer
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - W Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
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Gasull M, Castell C, Pallarès N, Miret C, Pumarega J, Téllez-Plaza M, López T, Salas-Salvadó J, Lee DH, Goday A, Porta M. Blood Concentrations of Persistent Organic Pollutants and Unhealthy Metabolic Phenotypes in Normal-Weight, Overweight, and Obese Individuals. Am J Epidemiol 2018; 187:494-506. [PMID: 29106481 DOI: 10.1093/aje/kwx267] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 06/23/2017] [Indexed: 12/19/2022] Open
Abstract
Factors underlying metabolic phenotypes, such as the metabolically healthy but obese phenotype, remain unclear. Differences in metabolic phenotypes-particularly, among individuals with a similar body mass index-could be related to concentrations of persistent organic pollutants (POPs). To our knowledge, no studies have analyzed POPs and metabolic phenotypes in normal-weight persons. We investigated the relationships between serum concentrations of POPs and metabolic phenotypes in 860 normal-weight, overweight, and obese participants in the 2002 Catalan Health Interview Survey (Spain). POP concentrations were significantly higher in metabolically unhealthy than in metabolically healthy individuals. In models adjusting for body mass index and other confounders, hexachlorobenzene, β-hexachlorocyclohexane, and polychlorinated biphenyls were associated with the unhealthy metabolic phenotype and metabolic syndrome. Among normal-weight individuals, the adjusted prevalence ratio of having an unhealthy phenotype for the upper category of the sum of orders of the 6 mentioned POPs (all individually associated with metabolic phenotypes) was 4.1 (95% confidence interval: 1.7, 10.0). Among overweight and obese individuals, the corresponding prevalence ratio for the sum of polychlorinated biphenyls was 1.4 (95% confidence interval: 1.0, 1.8). Our results supported the hypothesis that POP concentrations are associated with unhealthy metabolic phenotypes, not only in obese and overweight individuals but also (and probably more strongly) in normal-weight individuals.
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Affiliation(s)
- Magda Gasull
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Conxa Castell
- Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Natàlia Pallarès
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carme Miret
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Pumarega
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
| | - María Téllez-Plaza
- Institute for Biomedical Research, Hospital Clinic de Valencia
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tomàs López
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Albert Goday
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - Miquel Porta
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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10
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Slagter SN, Corpeleijn E, van der Klauw MM, Sijtsma A, Swart-Busscher LG, Perenboom CWM, de Vries JHM, Feskens EJM, Wolffenbuttel BHR, Kromhout D, van Vliet-Ostaptchouk JV. Dietary patterns and physical activity in the metabolically (un)healthy obese: the Dutch Lifelines cohort study. Nutr J 2018; 17:18. [PMID: 29433580 PMCID: PMC5809859 DOI: 10.1186/s12937-018-0319-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Diversity in the reported prevalence of metabolically healthy obesity (MHO), suggests that modifiable factors may be at play. We evaluated differences in dietary patterns and physical activity between MHO and metabolically unhealthy obesity (MUO). METHODS Cross-sectional data of 9270 obese individuals (30-69 years) of the Lifelines Cohort Study was used. MHO was defined as obesity and no metabolic syndrome risk factors and no cardiovascular disease history. MUO was defined as obesity and ≥2 metabolic syndrome risk factors. Sex-specific associations of dietary patterns (identified by principal component analysis) and physical activity with MHO were assessed by multivariable logistic regression (reference group: MUO). Analyses were adjusted for multiple covariates. RESULTS Among 3442 men and 5828 women, 10.2% and 24.4% had MHO and 56.9% and 35.3% MUO, respectively. We generated four obesity-specific dietary patterns. Two were related to MHO, and in women only. In the highest quartile (Q) of 'bread, potatoes and sweet snacks' pattern, odds ratio (OR) (95% CI) for MHO was 0.52 (0.39-0.70). For the healthier pattern 'fruit, vegetables and fish', an OR of 1.36 (1.09-1.71) in Q3 and 1.55 (1.21-1.97) in Q4 was found for MHO. For physical activity, there was a positive association between moderate physical activity and vigorous physical activity in the highest tertile and MHO in women and men, respectively (OR 1.19 (1.01-1.41) and OR 2.02 (1.50-2.71)). CONCLUSION The healthier diet -characterized by 'fruit, vegetables and fish'- and moderate physical activity in women, and vigorous physical activity in men may be related to MHO. The (refined) carbohydrate-rich 'bread, potatoes and sweet snacks' dietary pattern was found to counteract MHO in women.
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Affiliation(s)
- Sandra N. Slagter
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Melanie M. van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Anna Sijtsma
- Lifelines Cohort Study, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Linda G. Swart-Busscher
- Department of Paramedical Sciences, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Corine W. M. Perenboom
- Division of Human Nutrition, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Jeanne H. M. de Vries
- Division of Human Nutrition, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition, Wageningen University, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Bruce H. R. Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Daan Kromhout
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Jana V. van Vliet-Ostaptchouk
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, 9700 RB Groningen, The Netherlands
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11
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Pinart M, Nimptsch K, Bouwman J, Dragsted LO, Yang C, De Cock N, Lachat C, Perozzi G, Canali R, Lombardo R, D'Archivio M, Guillaume M, Donneau AF, Jeran S, Linseisen J, Kleiser C, Nöthlings U, Barbaresko J, Boeing H, Stelmach-Mardas M, Heuer T, Laird E, Walton J, Gasparini P, Robino A, Castaño L, Rojo-Martínez G, Merino J, Masana L, Standl M, Schulz H, Biagi E, Nurk E, Matthys C, Gobbetti M, de Angelis M, Windler E, Zyriax BC, Tafforeau J, Pischon T. Joint Data Analysis in Nutritional Epidemiology: Identification of Observational Studies and Minimal Requirements. J Nutr 2018; 148:285-297. [PMID: 29490094 DOI: 10.1093/jn/nxx037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023] Open
Abstract
Background Joint data analysis from multiple nutrition studies may improve the ability to answer complex questions regarding the role of nutritional status and diet in health and disease. Objective The objective was to identify nutritional observational studies from partners participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) Consortium, as well as minimal requirements for joint data analysis. Methods A predefined template containing information on study design, exposure measurements (dietary intake, alcohol and tobacco consumption, physical activity, sedentary behavior, anthropometric measures, and sociodemographic and health status), main health-related outcomes, and laboratory measurements (traditional and omics biomarkers) was developed and circulated to those European research groups participating in the ENPADASI under the strategic research area of "diet-related chronic diseases." Information about raw data disposition and metadata sharing was requested. A set of minimal requirements was abstracted from the gathered information. Results Studies (12 cohort, 12 cross-sectional, and 2 case-control) were identified. Two studies recruited children only and the rest recruited adults. All studies included dietary intake data. Twenty studies collected blood samples. Data on traditional biomarkers were available for 20 studies, of which 17 measured lipoproteins, glucose, and insulin and 13 measured inflammatory biomarkers. Metabolomics, proteomics, and genomics or transcriptomics data were available in 5, 3, and 12 studies, respectively. Although the study authors were willing to share metadata, most refused, were hesitant, or had legal or ethical issues related to sharing raw data. Forty-one descriptors of minimal requirements for the study data were identified to facilitate data integration. Conclusions Combining study data sets will enable sufficiently powered, refined investigations to increase the knowledge and understanding of the relation between food, nutrition, and human health. Furthermore, the minimal requirements for study data may encourage more efficient secondary usage of existing data and provide sufficient information for researchers to draft future multicenter research proposals in nutrition.
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Affiliation(s)
- Mariona Pinart
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jildau Bouwman
- TNO, Microbiology and Systems Biology Group, Zeist, Netherlands
| | - Lars O Dragsted
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Chen Yang
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Nathalie De Cock
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | | | | | - Rosario Lombardo
- The Microsoft Research-University of Trento Centre for Computational and Systems Biology (COSBI), Trentino, Italy
| | - Massimo D'Archivio
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Stephanie Jeran
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jakob Linseisen
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany.,Ludwig-Maximilians-Universität (LMU) München, Medical Faculty, Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Chair of Epidemiology at University Centre for Health Care Sciences at the Augsburg Clinic (UNIKA-T Augsburg), Ausburg, Germany
| | - Christina Kleiser
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Janett Barbaresko
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Thorsten Heuer
- Department of Nutritional Behavior, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Eamon Laird
- Centre for Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Luis Castaño
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Rare Diseases Networking Biomedical Research Centre (CIBERER), BioCruces-Hospital Universitario Cruces-The University of the Basque Country (Basque: Euskal Herriko Unibertsitatea/Spanish: Universidad del País Vasco (UPV/EHU)), Barakaldo, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Unidad de Gestión Clínica (UGC) Endocrinology and Nutrition. Hospital Regional Universitario de Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jordi Merino
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain.,Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Luis Masana
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain
| | - Marie Standl
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Holger Schulz
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Elena Biagi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Christophe Matthys
- Department of Clinical and Experimental Medicine, The Katholieke Universiteit Leuven (KU Leuven) and Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Marco Gobbetti
- Faculty of Science and Technology, Free University of Bozen, Bolzano, Italy
| | - Maria de Angelis
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Eberhard Windler
- Preventive Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jean Tafforeau
- Scientific Institute of Public Health, Brussels, Belgium
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany.,MDC/BIH Biobank, Max Delbrück Center for Molecular Medicine and Berlin Institute of Health, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
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12
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Wakabayashi I. Inverse association between excessive alcohol drinking and cardiometabolically healthy status in middle-aged men with and without overweight and obesity. Diabetes Metab Syndr 2018; 12:31-37. [PMID: 28882469 DOI: 10.1016/j.dsx.2017.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 08/20/2017] [Indexed: 11/18/2022]
Abstract
AIMS The aim of this study was to clarify the relationship between drinking and metabolically healthy status in men with normal weight, overweight and obesity. METHODS The subjects were Japanese men aged from 35 to 60 years (n=31781) and they were divided by daily amount of drinking (g ethanol) into light (< 22), moderate (≥22 and <44), heavy (≥44 and <66) and very heavy (≥66) drinkers. Metabolically healthy subjects were defined as those without hypertension, dyslipidemia and diabetes. RESULTS The percentage of metabolically healthy subjects was much lower in the overweight (BMI≥25 and <30) and obese (BMI≥30) groups than in the normal weight group (BMI≥18.5 and <25) and was much lower in the obese group than in the overweight group. In each of the normal weight and overweight groups, percentages of metabolically healthy subjects were significantly lower in heavy and very heavy drinkers than in nondrinkers and were marginally significantly higher in light drinkers than in nondrinkers. The above associations between drinking and metabolically healthy status were confirmed by logistic regression analysis. In the obese group, the percentage of metabolically healthy subjects was significantly lower in regular drinkers (including all drinker categories) than in nondrinkers, and metabolically healthy subjects were rare (0.56%) among regular drinkers. CONCLUSIONS Regardless of absence and presence of overweight or obesity, excessive alcohol drinking is inversely associated with metabolically healthy status and should be avoided for prevention of cardiovascular disease.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.
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13
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Beccarelli LM, Scherr RE, Newman JW, Borkowska AG, Gray IJ, Linnell JD, Keen CL, Young HM. Associations Among Fatty Acids, Desaturase and Elongase, and Insulin Resistance in Children. J Am Coll Nutr 2017; 37:44-50. [PMID: 29043930 DOI: 10.1080/07315724.2017.1347908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Fatty acid profiles and desaturase (SCD-16, SCD018, D5D, D6D) and elongase (ELOVL6) enzyme activity have been associated with adiposity and metabolic disease. While this has been studied in adults, few studies have included children. The objective of this study was to evaluate these markers in children and identify relationships with markers of metabolic health. It was hypothesized that these lipid markers would be correlated to adiposity and metabolic disease. METHODS This study was a cross-sectional analysis of fourth- and fifth-grade children (n = 86, aged 9-12) participating in a comprehensive nutrition program. Any student enrolled in the program was eligible for inclusion in this study. Fasting plasma was collected and analyzed for total fatty acids, glucose, insulin, and full lipid panels. Insulin resistance was estimated using calculated homeostatic model assessment for insulin resistance (HOMA-IR) values. RESULTS There were no differences in lipid markers, glucose, insulin, or HOMA-IR among children classified as normal weight, overweight, or obese. SCD-16, D5D, and ELOVL6 activity was significantly correlated to HOMA-IR values (r = 0.39, p = 0.001; r = -0.33, p = 0.006; r = -0.37, p = 0.005, respectively). In regression analysis, body mass index for age percentile, D6D activity, ELOVL6 activity, and systolic blood pressure were the most significant predictors of HOMA-IR values (adjusted r2 = 0.39, p ≤ 0.001). CONCLUSIONS There was no relationship between these lipid markers and adiposity in this population; however, there were correlations with HOMA-IR. Regardless of adiposity, there may be underlying changes in fatty acid and lipid metabolism associated with the development of metabolic diseases.
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Affiliation(s)
- Lori M Beccarelli
- a University of California Davis, Nutrition , Davis , California , USA
| | | | - John W Newman
- b United States Department of Agriculture ARS, Western Human Nutrition Research Center , Davis , California , USA
| | - Alison G Borkowska
- c Pennsylvania State University, Nutritional Sciences , University Park , Pennsylvania , USA
| | - Ira J Gray
- b United States Department of Agriculture ARS, Western Human Nutrition Research Center , Davis , California , USA
| | - Jessica D Linnell
- d Oregon State Extension Service, Family and Community Health Tillamook and Lincoln Counties , Tillamook , Oregon , USA
| | - Carl L Keen
- a University of California Davis, Nutrition , Davis , California , USA
| | - Heather M Young
- e University of California Davis Health System, Betty Irene Moore School of Nursing , Sacramento , California , USA
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14
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Roos V, Elmståhl S, Ingelsson E, Sundström J, Ärnlöv J, Lind L. Alterations in Multiple Lifestyle Factors in Subjects with the Metabolic Syndrome Independently of Obesity. Metab Syndr Relat Disord 2017; 15:118-123. [PMID: 28339343 DOI: 10.1089/met.2016.0120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vendela Roos
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
| | - Sölve Elmståhl
- 2 Division of Geriatric Medicine, Department of Health Sciences, Lund University, Malmö University Hospital , Malmö, Sweden
| | - Erik Ingelsson
- 3 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, California
- 4 Molecular Epidemiology and Science for Life Laboratory, Department of Medical Sciences, Uppsala University , Uppsala, Sweden
| | - Johan Sundström
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
- 5 Uppsala Clinical Research Center (UCR) , Uppsala, Sweden
| | - Johan Ärnlöv
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
- 6 School of Health and Social Studies, Dalarna University , Falun, Sweden
| | - Lars Lind
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
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15
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The mountainous Cretan dietary patterns and their relationship with cardiovascular risk factors: the Hellenic Isolated Cohorts MANOLIS study. Public Health Nutr 2016; 20:1063-1074. [PMID: 27989266 DOI: 10.1017/s1368980016003207] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We carried out de novo recruitment of a population-based cohort (MANOLIS study) and describe the specific population, which displays interesting characteristics in terms of diet and health in old age, through deep phenotyping. DESIGN Cross-sectional study where anthropometric, biochemical and clinical measurements were taken in addition to interview-based completion of an extensive questionnaire on health and lifestyle parameters. Dietary patterns were derived through principal component analysis based on a validated FFQ. SETTING Geographically isolated Mylopotamos villages on Mount Idi, Crete, Greece. SUBJECTS Adults (n 1553). RESULTS Mean age of the participants was 61·6 years and 55·8 % were women. Of the population, 82·7 % were overweight or obese with a significantly different prevalence between overweight men and women (43·4 v. 34·7 %, P=0·002). The majority (70·6 %) of participants were married, while a larger proportion of women were widowed than men (27·8 v. 3·5 %, P<0·001). Smoking was more prevalent in men (38·7 v. 8·2 %, P<0·001), as 88·8% of women had never smoked. Four dietary patterns emerged as characteristic of the population; these were termed 'local', 'high fat and sugar, 'Greek café/tavern' and 'olive oil, fruits and vegetables'. Individuals more adherent to the local dietary pattern presented higher blood glucose (β=4·026, P<0·001). Similarly, individuals with higher compliance with the Greek café/tavern pattern had higher waist-to-hip ratio (β=0·012, P<0·001), blood pressure (β=1·015, P=0·005) and cholesterol (β=5·398, P<0·001). CONCLUSIONS Profiling of the MANOLIS elderly population identifies unique unhealthy dietary patterns that are associated with cardiometabolic indices.
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16
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Roos V, Elmståhl S, Ingelsson E, Sundström J, Ärnlöv J, Lind L. Metabolic Syndrome Development During Aging with Special Reference to Obesity Without the Metabolic Syndrome. Metab Syndr Relat Disord 2016; 15:36-43. [PMID: 27754771 DOI: 10.1089/met.2016.0082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obesity and its associated metabolic complications continue to increase worldwide. We investigated the development of metabolic syndrome (MetS) during aging in relation to body mass index (BMI) and exercise habits. We assigned special emphasis to the metabolic stability in individuals with obesity, but without MetS, a condition often referred to as metabolically healthy obesity. MATERIALS AND METHODS Cross-sectional analysis was carried out in a sample of 19,129 men and women aged 45-75 years from the EpiHealth study. In addition, longitudinal analyses were carried out in the ULSAM study (2322 men at baseline followed from age 50 to age 77) and in the PIVUS study (1016 men and women at baseline followed from age 70 to age 80). Participants were categorized into six groups according to BMI category (normal weight/BMI <25 kg/m2, overweight/BMI 25-30 kg/m2, and obesity/BMI >30 kg/m2) and MetS status (+/-, National Cholesterol Education Program criteria). RESULTS MetS prevalence and number of MetS components increased with age in all three samples. The PIVUS study showed that high baseline BMI, low baseline physical activity, and increasing BMI during follow-up were related to increasing MetS prevalence and increasing numbers of MetS components during follow-up. One-third to half of individuals initially belonging to the obesity without MetS category acquired MetS during aging. CONCLUSIONS MetS prevalence increased during aging, especially in individuals with high BMI, low level of physical activity, and weight gain. Obesity without MetS was not a stable condition over time as many of those individuals gained metabolic disturbances during aging.
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Affiliation(s)
- Vendela Roos
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
| | - Sölve Elmståhl
- 2 Division of Geriatric Medicine, Department of Health Sciences, Lund University, Malmö University Hospital , Malmö, Sweden
| | - Erik Ingelsson
- 3 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine , Stanford, California.,4 Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University , Uppsala, Sweden
| | - Johan Sundström
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden .,5 Uppsala Clinical Research Center (UCR) , Uppsala, Sweden
| | - Johan Ärnlöv
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden .,6 School of Health and Social Studies, Dalarna University , Falun, Sweden
| | - Lars Lind
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
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17
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Andreeva-Gateva PA, Konsulova P, Orbetzova M, Georgieva-Nikolova R, Tafradjiiska-Hadjiolova R, Angelova V, Voynikov Y, Nikolova I, Simova I. Differentiation of obese patients at moderate or higher Findrisc score based on their atherogenic index. Postgrad Med 2016; 128:790-796. [PMID: 27700189 DOI: 10.1080/00325481.2016.1240590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to reveal different subgroups of patients with at least moderate risk of developing diabetes in the next 10 years, based on clustering of cardiovascular risk factors. METHODS We performed a one-center cross-sectional study of adult patients (n = 109, median age 45 years) with Findrisc score of above 11 out of 26 maximum. We included in the cluster analysis anthropometrics, lipid and carbohydrate parameters obtained in oral glucose tolerance test (OGTT), insulin, C-peptide, creatinine, C-reactive protein, liver enzymes, beta-cell function, insulin sensitivity and insulin resistance (HOMA calculations). We also evaluated the atherogenic index of plasma (AIP). RESULTS We identified three metabolic phenotypes of patients with at least moderate Findrisc score-one 'male' (cluster AM, n = 24), and two 'female' phenotypes (cluster AW, n = 9 and cluster BW, n = 76). Men were almost homogenous for their metabolic phenotype, with lower fat percentage than women (p < .05). Most of the women (cluster BW, n = 76) presented with better metabolic pattern i.e. lower insulin resistance, lower C-reactive protein, lower degree of obesity and visceral fat rating (p < .05), despite the higher fat percentage (p < .05). Some of the women, however, (cluster AW, n = 9) presented with parameters very similar to that of men (cluster AM) and significantly higher than in cluster BW. Despite the lack of significant differences in lipid parameters among clusters, AIP was significantly lower in cluster BW (p < .05). CONCLUSION Most of the women presented with clearly less unfavorable atherogenic risk than men. Two different phenotypes of obese women with at least moderate Findrisc score were revealed, and the level of inflammation seems to be the main discriminant factor. Larger prospective studies are required to elucidate whether those are really two different pathogenically phenotypes or if they belong to the same phenotype's continuum.
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Affiliation(s)
- Pavlina A Andreeva-Gateva
- a Department of Pharmacology and Toxicology, Medical Faculty , Medical University of Sofia , Sofia , Bulgaria.,b Department of Internal Medicine, Pharmacology and Clinical Pharmacology, Pediatrics, Epidemiology, Infectious Diseases and Dermatology, Medical Faculty , University of Sofia 'St Kliment Ohridski,' , Sofia , Bulgaria
| | - Petya Konsulova
- c Department of Endocrinology, Medical Faculty , Medical University of Plovdiv , Plovdiv , Bulgaria
| | - Maria Orbetzova
- c Department of Endocrinology, Medical Faculty , Medical University of Plovdiv , Plovdiv , Bulgaria
| | - Radka Georgieva-Nikolova
- d Department of Medical Chemistry and Biochemistry, Medical Faculty , Medical University of Sofia , Sofia , Bulgaria
| | | | - Violina Angelova
- f Department of Chemistry, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria
| | - Yulian Voynikov
- f Department of Chemistry, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria
| | - Irina Nikolova
- g Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria
| | - Iscra Simova
- h Pre-admission Ward , Specialized Hospital of Infections and Parasitic Diseases 'Prof. Ivan Kirov ,' Sofia , Bulgaria
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Park YMM, Steck SE, Fung TT, Zhang J, Hazlett LJ, Han K, Lee SH, Kwon HS, Merchant AT. Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) style diet, and metabolic health in U.S. adults. Clin Nutr 2016; 36:1301-1309. [PMID: 27665232 DOI: 10.1016/j.clnu.2016.08.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/09/2016] [Accepted: 08/24/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS There is sparse evidence on the relationship between the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) style diet, and metabolic health, especially comparing cardiometabolic phenotypes among in normal weight and obese populations. We aimed to investigate the association of the Mediterranean diet scores (MDS) and DASH index with metabolically healthy obese (MHO) and metabolically obese normal weight (MONW) phenotypes in a representative U.S. POPULATION METHODS MDS and DASH index were calculated using dietary data from 2767 adults aged 20-90 years without any prior diagnosis of cancer or cardiovascular disease from the National Health and Nutrition Examination Survey III, 1988-1994. MHO and MONW individuals were identified using fasting glucose, insulin resistance, blood pressure, triglycerides, C-reactive protein, and high-density lipoprotein-cholesterol. RESULTS Higher MDS was associated with higher odds of MHO phenotype (odds ratio (OR)T3 vs T1, 2.57 [95% confidence interval (CI), 1.04-6.35]; P trend = 0.04), and higher DASH index was associated with lower odds of MONW phenotype (ORT3 vs T1, 0.59 [95% CI, 0.38-0.93]; P trend = 0.03) only in the younger age group (<45 years for men or premenopausal women). No significant associations of MDS and DASH index with MHO and MONW phenotypes were observed in the older age group (≥45 years for men or postmenopausal women). CONCLUSIONS Adherence to Mediterranean diet or DASH style diet was favorably associated with MHO and MONW phenotypes only in the younger age group, suggesting that potential dietary intervention to prevent cardiometabolic disease differ by age group.
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Affiliation(s)
- Yong-Moon Mark Park
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Teresa T Fung
- Department of Nutrition, Simmons College, Boston, MA, USA; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Linda J Hazlett
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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Diniz MDFHS, Beleigoli AMR, Ribeiro ALP, Vidigal PG, Bensenor IM, Lotufo PA, Duncan BB, Schmidt MI, Barreto SM. Factors associated with metabolically healthy status in obesity, overweight, and normal weight at baseline of ELSA-Brasil. Medicine (Baltimore) 2016; 95:e4010. [PMID: 27399079 PMCID: PMC5058808 DOI: 10.1097/md.0000000000004010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/22/2016] [Accepted: 05/25/2016] [Indexed: 12/13/2022] Open
Abstract
The primary aim of this study was to evaluate metabolically healthy status (MHS) among participants in obesity, overweight, and normal weight groups and characteristics associated with this phenotype using baseline data of Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The secondary aim was to investigate agreement among 4 different MHS criteria. This cross-sectional study included 14,545 participants aged 35 to 74 years with a small majority (54.1%) being women. Of all participants, 22.7% (n = 3298) were obese, 40.8% (n = 5934) were overweight, and 37.5% (n = 5313) were of normal weight.Socio-demographic, behavioral, and anthropometric factors related to MHS were ascertained. Logistic regression models estimated the odds of associations. We used 4 different criteria separately and in combination to define MHS: the National Health and Nutrition Examination Survey (NHANES), the National Cholesterol Education Program (NCEP-ATPIII), the International Diabetes Federation (IDF) and comorbidities, and the agreement between them were evaluated by Cohen-kappa coefficient.MHS was present among 12.0% (n = 396) of obese, 25.5% (n = 1514) of overweight, and 48.6% (n = 2582) of normal weight participants according to the combination of the 4 criteria. The agreement between all the 4 MHS criteria was strong (kappa 0.73 P < 0.001). In final logistic models, MHS was associated with lower age, female sex, lower body mass index (BMI), and weight change from age 20 within all BMI categories.This study showed that, despite differences in prevalence among the 4 criteria, MHS was associated with common characteristics at every BMI category.
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Affiliation(s)
- Maria de Fátima Haueisen Sander Diniz
- School of Medicine & Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG Hospital Universitário, University of São Paulo, São Paulo, SP Postgraduate Program in Epidemiology, School of Medicine, and Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Physical Activity and Sedentary Behavior in Metabolically Healthy versus Unhealthy Obese and Non-Obese Individuals - The Maastricht Study. PLoS One 2016; 11:e0154358. [PMID: 27138596 PMCID: PMC4854448 DOI: 10.1371/journal.pone.0154358] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 04/12/2016] [Indexed: 01/12/2023] Open
Abstract
Background Both obesity and the metabolic syndrome are associated with increased risk of cardiovascular diseases and type 2 diabetes. Although both frequently occur together in the same individual, obesity and the metabolic syndrome can also develop independently from each other. The (patho)physiology of “metabolically healthy obese” (i.e. obese without metabolic syndrome) and “metabolically unhealthy non-obese” phenotypes (i.e. non-obese with metabolic syndrome) is not fully understood, but physical activity and sedentary behavior may play a role. Objective To examine objectively measured physical activity and sedentary behavior across four groups: I) “metabolically healthy obese” (MHO); II) “metabolically unhealthy obese” (MUO); III)”metabolically healthy non-obese” (MHNO); and IV) “metabolically unhealthy non-obese” (MUNO). Methods Data were available from 2,449 men and women aged 40–75 years who participated in The Maastricht Study from 2010 to 2013. Participants were classified into the four groups according to obesity (BMI≥30kg/m2) and metabolic syndrome (ATPIII definition). Daily activity was measured for 7 days with the activPAL physical activity monitor and classified as time spent sitting, standing, and stepping. Results In our study population, 562 individuals were obese. 19.4% of the obese individuals and 72.7% of the non-obese individuals was metabolically healthy. After adjustments for age, sex, educational level, smoking, alcohol use, waking time, T2DM, history of CVD and mobility limitation, MHO (n = 107) spent, per day, more time stepping (118.2 versus 105.2 min; p<0.01) and less time sedentary (563.5 versus 593.0 min., p = 0.02) than MUO (n = 440). In parallel, MHNO (n = 1384) spent more time stepping (125.0 versus 115.4 min; p<0.01) and less time sedentary (553.3 versus 576.6 min., p<0.01) than MUNO (n = 518). Conclusion Overall, the metabolically healthy groups were less sedentary and more physically active than the metabolically unhealthy groups. Therefore, physical activity and sedentary time may partly explain the presence of the metabolic syndrome in obese as well as non-obese individuals.
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Camhi SM, Whitney Evans E, Hayman LL, Lichtenstein AH, Must A. Healthy eating index and metabolically healthy obesity in U.S. adolescents and adults. Prev Med 2015; 77:23-7. [PMID: 25937589 DOI: 10.1016/j.ypmed.2015.04.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/16/2015] [Accepted: 04/27/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether dietary quality differs between metabolically-healthy-obese (MHO) and metabolically-abnormal-obesity (MAO) in a nationally representative sample. METHODS National Health and Nutrition Examination Survey (NHANES) data (2007-2008; 2009-2010) were used to identify obese adolescents (≥95th body mass index (BMI) %tile) and adults (≥30kg/m(2)). MHO was defined as <2 abnormal cardiometabolic risk factors (elevated blood pressure, triglycerides, glucose, low high density lipoprotein cholesterol (HDL-C); or on medications). Healthy Eating Index 2005 (HEI-2005) scores were calculated from 24-hour recall data. General linear regression models determined whether HEI-2005 scores differed between MHO and MAO after controlling for age, race, gender, NHANES wave, BMI, physical activity and health status by age group (12-18; 19-44; 45-85years). RESULTS Compared with MAO, MHO adolescents (n=133) had higher total HEI-2005 score, higher milk scores, and higher scores from calories from solid fats, alcohol beverages and added sugars. MHO women 19-44years (n=240) had higher total HEI-2005, higher whole fruit, higher whole grain and higher meat and bean scores compared with MAO. No significant differences were observed between MHO and MAO for HEI-2005 total scores in men 19-44years, or adults 45-85years. CONCLUSION MHO adolescents and women 19-44years have better dietary compliance to the U.S. guidelines when compared with MAO, suggesting potential intervention targets to improve cardiometabolic risk within obesity.
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Affiliation(s)
- Sarah M Camhi
- Exercise and Health Sciences Department, University of Massachusetts, Boston, MA, USA.
| | - E Whitney Evans
- Weight Control and Diabetes Research Center, Brown Medical School/Miriam Hospital, Providence, RI, USA
| | - Laura L Hayman
- Office of the Vice-Provost for Research, University of Massachusetts, Boston, MA, USA
| | - Alice H Lichtenstein
- JM USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Aviva Must
- Department of Public Health Community Medicine, Tufts University School of Medicine, Boston, MA, USA
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Fung MDT, Canning KL, Mirdamadi P, Ardern CI, Kuk JL. Lifestyle and weight predictors of a healthy overweight profile over a 20-year follow-up. Obesity (Silver Spring) 2015; 23:1320-5. [PMID: 26010328 PMCID: PMC5055396 DOI: 10.1002/oby.21087] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/19/2015] [Accepted: 02/20/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine whether changes in modifiable risk factors [physical activity, cardiorespiratory fitness (CRF), body weight, and diet composition] are associated with the transition to metabolically healthy overweight/obese (MHOW) versus metabolically abnormal overweight/obese. METHODS Analysis included 1,358 adults [aged 25.0 (3.5) years] from the CARDIA study who were healthy at baseline and had overweight/obesity at follow-up. Participants with zero or one of the following six risk factors were classified as MHOW: elevated triglycerides, LDL, blood pressure, fasting glucose, and HOMA-insulin resistance and low HDL. RESULTS Over the 20-year follow-up, the sample gained weight (BMI 24.5 to 31.1 kg/m(2) ), and the prevalence of MHOW was 47% at follow-up. After adjusting for changes in CRF, diet, and weight change, physical activity and macronutrient intake were not independently associated with MHOW (P > 0.05), while changes in CRF [fit-unfit: RR (95%) = 0.58, 0.52-0.66; unfit-unfit: RR = 0.67, 0.58-0.76, versus fit-fit] and weight [gain: RR (95%) = 0.54, 0.43-0.67; cycle: RR = 0.74, 0.57-0.94, versus stable] were independently associated with MHOW. CONCLUSIONS Focusing on high CRF and strategies to limit weight gain may be important for individuals with overweight and obesity in early to mid-adulthood to maintain a metabolically healthy profile.
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Affiliation(s)
- Michael D T Fung
- School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Karissa L Canning
- School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Paul Mirdamadi
- School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Chris I Ardern
- School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Jennifer L Kuk
- School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
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Moy FM, Loh DA. Cardiometabolic risks profile of normal weight obese and multi-ethnic women in a developing country. Maturitas 2015; 81:389-93. [PMID: 25987469 DOI: 10.1016/j.maturitas.2015.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/17/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours. METHODS This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration. MAIN OUTCOME MEASURE Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviours. RESULTS A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3-22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73-4.04), hypertriglyceridemia (2.51, 1.47-4.29) and hypertension (1.63, 1.15-2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0-9.8). None of the lifestyle behaviours were significantly associated with NWO. CONCLUSIONS Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks.
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Affiliation(s)
- Foong Ming Moy
- Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 50603, Malaysia.
| | - Debbie Ann Loh
- Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur 50603, Malaysia
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