Do lifestyle factors and quality of life differ in people with metabolically healthy and unhealthy obesity?

The association between the lifestyle risk score and metabolically healthy and unhealthy obesity phenotype in Iranian women with overweight and obesity: a cross-sectional study

Background

The evidence shows that all women with obesity do not develop metabolic complications thus, they may be metabolically healthy. The lifestyle factors in combination may influence obesity phenotypes including metabolically healthy and unhealthy obesity. While previous studies examined associations between single lifestyle factors and obesity phenotype, no previous study has examined associations between lifestyle risk score (LRS) and obesity phenotypes. This study for the first time created the LRS which is a combination of lifestyle factors and investigated the LRS in relation to various obesity phenotypes among women with overweight and obesity.

Methods

This cross-sectional study analyzed 278 women referred to health centers of the Tehran University of Medical Sciences. A multistage sampling method was used to recruit the participants. The LRS was created based on diet, physical activity (PA), sleep, obesity, and sociodemographic characteristics. A binary logistic regression analysis was used to evaluate the association between obesity phenotypes and LRS.

Results

Women with higher LRS had higher body mass index (BMI) and high-sensitivity C-reactive protein (hs-CRP) while had lower high-density lipoprotein cholesterol (HDL-C), PA, education levels, sleep quality, vegetables, grains and legumes intake. Furthermore, women with higher LRS were more likely to experience metabolically unhealthy obesity (MUO).

Conclusion

This study found significant associations between higher LRS and an increased likelihood of MUO. Further prospective studies are needed to advance our understanding of the relationship between lifestyle and obesity.

The effect of circadian timing program for evening-chronotype individuals with obesity on obesity management and sleep quality: A randomized controlled trial

OBJECTIVES

The study aimed to investigate the effect of the circadian timing program (SİZAP) developed for evening-chronotype individuals with obesity on obesity management and sleep quality.

METHODS

This single-site, randomized controlled trial with an experimental research design was registered in ClinicalTrials.gov. It was reported in accordance with the "Consolidated Standards of Reporting Trials" (CONSORT) randomized controlled trial guidelines. The study sample consisted of 38 evening-chronotype individuals with first-degree obesity, with 19 individuals in each study group. The intervention group's sleep hygiene training was conducted and their lifestyle changes were ensured through SİZAP. The control group followed their normal daily lifestyle. No intervention was made in terms of the dietary practices of both groups. Study data were collected using the personal information form, the anthropometric measurement form, the Horne and Ostberg Morning and Evening Questionnaire (MEQ), the Impact of weight on quality of life-lite (IWQOL-lite), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the sleep diary, and the data tracked via the website and smart bracelets.

RESULTS

It was determined that the participants in the SİZAP group had a statistically significant decrease in the anthropometric measurements and daytime sleepiness (p < 0.05). The sleep quality scores and the scores of the bodily functions sub-dimension of the quality of life scale were significantly better in the intervention group than in the control group (p < 0.05).

CONCLUSION

It was found that SİZAP is effective in obesity management in evening-chronotype individuals and increases weight loss success and sleep quality.

Obesity, cardiovascular risk, and lifestyle: cross-sectional and prospective analyses in a nationwide Spanish cohort

AIMS

To assess whether overweight and obesity are independently associated with cardiometabolic health [as categorized based on the presence/absence of cardiovascular disease (CVD) risk factors (diabetes, hypercholesterolaemia, or hypertension)], and the role of lifestyle on this association.

METHODS AND RESULTS

A nationwide cohort of Spanish adults (18-64 years) was studied using a cross-sectional design and prospective observational design. Lifestyle-related factors (physical activity, sleeping characteristics, alcohol drinking, and smoking) were registered, and participants were classified as having an 'unhealthy' or 'healthy' cardiometabolic status attending to the presence or absence, respectively, of ≥1 CVD risk factor. A number of 596 111 participants (44 ± 9 years, 67% male) were studied at baseline, with prospective analyses in a subcohort [n = 302 061; median follow-up, 2 years (range, 2 to 5)]. Compared to normal weight, overweight and obesity were associated with a higher prevalence [odds ratio, 1.67 (95% confidence interval, 1.61-1.67) and 2.70 (2.69-2.78), respectively] and incidence [1.62 (1.59-1.67) and 2.70 (2.63-2.78)] of an unhealthy cardiometabolic status. Meeting physical activity guidelines reduced the odds of an unhealthy cardiometabolic status at baseline [0.87 (0.85-0.88)] among individuals with overweight/obesity, as well as of transitioning from a healthy status to an unhealthy status during the follow-up [0.87 (0.84-0.94)]. No significant associations were found for the remainder of lifestyle factors.

CONCLUSION

Overweight and obesity are independently associated with an unhealthy cardiometabolic status. Regular physical activity attenuates not only the prevalence but also the incidence of CVD risk factors.

Obesity and the risk of cardiometabolic diseases

The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.