Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype
Abstract Background The terms metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) categorize subjects with obesity based on the presence or absence of cardio-metabolic risk factors. Detecting MUO phenotype is crucial due to the high risk of cardio-metabolic complications, r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12967-023-04546-0 |
| _version_ | 1797556778901176320 |
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| author | Luigi Barrea Ludovica Verde Daniel Simancas-Racines Ana Karina Zambrano Evelyn Frias-Toral Annamaria Colao Silvia Savastano Giovanna Muscogiuri |
| author_facet | Luigi Barrea Ludovica Verde Daniel Simancas-Racines Ana Karina Zambrano Evelyn Frias-Toral Annamaria Colao Silvia Savastano Giovanna Muscogiuri |
| author_sort | Luigi Barrea |
| collection | DOAJ |
| description | Abstract Background The terms metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) categorize subjects with obesity based on the presence or absence of cardio-metabolic risk factors. Detecting MUO phenotype is crucial due to the high risk of cardio-metabolic complications, requiring tailored and intensive follow-up. However, diagnosing MUO is time-consuming and costly. Thus, we aimed to investigate the role of Mediterranean diet (MD) in determining MHO/MUO phenotypes and whether adherence to MD could serve as an additional screening tool for MUO phenotype. Methods The study population of this cross-sectional observational study consisted of 275 subjects with obesity. We assessed their lifestyle habits (physical activity and smoking habits), anthropometric measurements (weight, height, waist circumference, body mass index), blood pressure, metabolic parameters, inflammatory marker (high sensitivity C reactive protein levels), adherence to MD (by PREvención con DIetaMEDiterránea (PREDIMED) questionnaire), and MHO/MUO phenotypes. Results The study included 275 individuals with obesity (256F/19M; 34.0 ± 10.5 years; BMI 38.3 ± 5.95 kg/m2). Among them, 114 (41.5%) exhibited MHO phenotype, while 161 (58.5%) had MUO phenotype. MHO phenotype exhibited favorable anthropometric and cardio-metabolic profiles, characterized by lower waist circumference (p < 0.001), BMI (p < 0.001), insulin resistance (p < 0.001), blood pressure (p < 0.001), inflammation (p < 0.001), and lipid levels (p < 0.001) compared to MUO phenotype. Notably, we found that MHO phenotype had higher adherence to MD (p < 0.001) and consumed more extra virgin olive oil (EVOO) (p < 0.001), vegetables (p < 0.001), fruits (p < 0.001), legumes (p = 0.001), fish (p < 0.001), wine (p = 0.008), and nuts (p = 0.001), while reporting lower intake of red/processed meats (p < 0.001), butter, cream, margarine (p = 0.008), soda drinks (p = 0.006), and commercial sweets (p = 0.002) compared to MUO phenotype. Adherence to MD (p < 0.001) and EVOO (p = 0.015) intake were identified as influential factors in determining the presence of MUO/MHO phenotypes. Furthermore, a PREDIMED score < 5 proved to be the most sensitive and specific cut-point value for predicting the presence of MUO phenotype (p < 0.001). Conclusion High adherence to MD was associated with MHO phenotype. Moreover, we suggest that a specific cut-off of the PREDIMED score could be an indicator to discriminate patients with MUO/MHO phenotypes and therefore help in identifying patients at higher cardiovascular risk who will require specific dietary intervention. |
| first_indexed | 2024-03-10T17:07:48Z |
| format | Article |
| id | doaj.art-5532c2c80db4481da38788f4ce6595ab |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-03-10T17:07:48Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-5532c2c80db4481da38788f4ce6595ab2023-11-20T10:44:55ZengBMCJournal of Translational Medicine1479-58762023-09-0121111310.1186/s12967-023-04546-0Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotypeLuigi Barrea0Ludovica Verde1Daniel Simancas-Racines2Ana Karina Zambrano3Evelyn Frias-Toral4Annamaria Colao5Silvia Savastano6Giovanna Muscogiuri7Dipartimento di Scienze Umanistiche, Centro Direzionale, Università Telematica PegasoCentro Italiano Per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università degli Studi di Napoli Federico IICentro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica EquinoccialCentro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica EquinoccialSchool of Medicine, Universidad Católica Santiago de GuayaquilCentro Italiano Per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università degli Studi di Napoli Federico IICentro Italiano Per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università degli Studi di Napoli Federico IICentro Italiano Per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università degli Studi di Napoli Federico IIAbstract Background The terms metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) categorize subjects with obesity based on the presence or absence of cardio-metabolic risk factors. Detecting MUO phenotype is crucial due to the high risk of cardio-metabolic complications, requiring tailored and intensive follow-up. However, diagnosing MUO is time-consuming and costly. Thus, we aimed to investigate the role of Mediterranean diet (MD) in determining MHO/MUO phenotypes and whether adherence to MD could serve as an additional screening tool for MUO phenotype. Methods The study population of this cross-sectional observational study consisted of 275 subjects with obesity. We assessed their lifestyle habits (physical activity and smoking habits), anthropometric measurements (weight, height, waist circumference, body mass index), blood pressure, metabolic parameters, inflammatory marker (high sensitivity C reactive protein levels), adherence to MD (by PREvención con DIetaMEDiterránea (PREDIMED) questionnaire), and MHO/MUO phenotypes. Results The study included 275 individuals with obesity (256F/19M; 34.0 ± 10.5 years; BMI 38.3 ± 5.95 kg/m2). Among them, 114 (41.5%) exhibited MHO phenotype, while 161 (58.5%) had MUO phenotype. MHO phenotype exhibited favorable anthropometric and cardio-metabolic profiles, characterized by lower waist circumference (p < 0.001), BMI (p < 0.001), insulin resistance (p < 0.001), blood pressure (p < 0.001), inflammation (p < 0.001), and lipid levels (p < 0.001) compared to MUO phenotype. Notably, we found that MHO phenotype had higher adherence to MD (p < 0.001) and consumed more extra virgin olive oil (EVOO) (p < 0.001), vegetables (p < 0.001), fruits (p < 0.001), legumes (p = 0.001), fish (p < 0.001), wine (p = 0.008), and nuts (p = 0.001), while reporting lower intake of red/processed meats (p < 0.001), butter, cream, margarine (p = 0.008), soda drinks (p = 0.006), and commercial sweets (p = 0.002) compared to MUO phenotype. Adherence to MD (p < 0.001) and EVOO (p = 0.015) intake were identified as influential factors in determining the presence of MUO/MHO phenotypes. Furthermore, a PREDIMED score < 5 proved to be the most sensitive and specific cut-point value for predicting the presence of MUO phenotype (p < 0.001). Conclusion High adherence to MD was associated with MHO phenotype. Moreover, we suggest that a specific cut-off of the PREDIMED score could be an indicator to discriminate patients with MUO/MHO phenotypes and therefore help in identifying patients at higher cardiovascular risk who will require specific dietary intervention.https://doi.org/10.1186/s12967-023-04546-0Mediterranean dietPREDIMEDMetabolically healthy obesityMHOMetabolically unhealthy obesityMUO |
| spellingShingle | Luigi Barrea Ludovica Verde Daniel Simancas-Racines Ana Karina Zambrano Evelyn Frias-Toral Annamaria Colao Silvia Savastano Giovanna Muscogiuri Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype Journal of Translational Medicine Mediterranean diet PREDIMED Metabolically healthy obesity MHO Metabolically unhealthy obesity MUO |
| title | Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype |
| title_full | Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype |
| title_fullStr | Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype |
| title_full_unstemmed | Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype |
| title_short | Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype |
| title_sort | adherence to the mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity muo phenotype |
| topic | Mediterranean diet PREDIMED Metabolically healthy obesity MHO Metabolically unhealthy obesity MUO |
| url | https://doi.org/10.1186/s12967-023-04546-0 |
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