Defining metabolically healthy obesity: role of dietary and lifestyle factors.

BACKGROUND:There is a current lack of consensus on defining metabolically healthy obesity (MHO). Limited data on dietary and lifestyle factors and MHO exist. The aim of this study is to compare the prevalence, dietary factors and lifestyle behaviours of metabolically healthy and unhealthy obese and...

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Main Authors: Catherine M Phillips, Christina Dillon, Janas M Harrington, Vera J C McCarthy, Patricia M Kearney, Anthony P Fitzgerald, Ivan J Perry
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3798285?pdf=render
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author Catherine M Phillips
Christina Dillon
Janas M Harrington
Vera J C McCarthy
Patricia M Kearney
Anthony P Fitzgerald
Ivan J Perry
author_facet Catherine M Phillips
Christina Dillon
Janas M Harrington
Vera J C McCarthy
Patricia M Kearney
Anthony P Fitzgerald
Ivan J Perry
author_sort Catherine M Phillips
collection DOAJ
description BACKGROUND:There is a current lack of consensus on defining metabolically healthy obesity (MHO). Limited data on dietary and lifestyle factors and MHO exist. The aim of this study is to compare the prevalence, dietary factors and lifestyle behaviours of metabolically healthy and unhealthy obese and non-obese subjects according to different metabolic health criteria. METHOD:Cross-sectional sample of 1,008 men and 1,039 women aged 45-74 years participated in the study. Participants were classified as obese (BMI ≥ 30 kg/m(2)) and non-obese (BMI < 30 kg/m(2)). Metabolic health status was defined using five existing MH definitions based on a range of cardiometabolic abnormalities. Dietary composition and quality, food pyramid servings, physical activity, alcohol and smoking behaviours were examined. RESULTS:The prevalence of MHO varied considerably between definitions (2.2% to 11.9%), was higher among females and generally increased with age. Agreement between MHO classifications was poor. Among the obese, prevalence of MH was 6.8% to 36.6%. Among the non-obese, prevalence of metabolically unhealthy subjects was 21.8% to 87%. Calorie intake, dietary macronutrient composition, physical activity, alcohol and smoking behaviours were similar between the metabolically healthy and unhealthy regardless of BMI. Greater compliance with food pyramid recommendations and higher dietary quality were positively associated with metabolic health in obese (OR 1.45-1.53 unadjusted model) and non-obese subjects (OR 1.37-1.39 unadjusted model), respectively. Physical activity was associated with MHO defined by insulin resistance (OR 1.87, 95% CI 1.19-2.92, p = 0.006). CONCLUSION:A standard MHO definition is required. Moderate and high levels of physical activity and compliance with food pyramid recommendations increase the likelihood of MHO. Stratification of obese individuals based on their metabolic health phenotype may be important in ascertaining the appropriate therapeutic or intervention strategy.
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spelling doaj.art-64761b9758b9457896a6102cf6126acf2022-12-21T22:33:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7618810.1371/journal.pone.0076188Defining metabolically healthy obesity: role of dietary and lifestyle factors.Catherine M PhillipsChristina DillonJanas M HarringtonVera J C McCarthyPatricia M KearneyAnthony P FitzgeraldIvan J PerryBACKGROUND:There is a current lack of consensus on defining metabolically healthy obesity (MHO). Limited data on dietary and lifestyle factors and MHO exist. The aim of this study is to compare the prevalence, dietary factors and lifestyle behaviours of metabolically healthy and unhealthy obese and non-obese subjects according to different metabolic health criteria. METHOD:Cross-sectional sample of 1,008 men and 1,039 women aged 45-74 years participated in the study. Participants were classified as obese (BMI ≥ 30 kg/m(2)) and non-obese (BMI < 30 kg/m(2)). Metabolic health status was defined using five existing MH definitions based on a range of cardiometabolic abnormalities. Dietary composition and quality, food pyramid servings, physical activity, alcohol and smoking behaviours were examined. RESULTS:The prevalence of MHO varied considerably between definitions (2.2% to 11.9%), was higher among females and generally increased with age. Agreement between MHO classifications was poor. Among the obese, prevalence of MH was 6.8% to 36.6%. Among the non-obese, prevalence of metabolically unhealthy subjects was 21.8% to 87%. Calorie intake, dietary macronutrient composition, physical activity, alcohol and smoking behaviours were similar between the metabolically healthy and unhealthy regardless of BMI. Greater compliance with food pyramid recommendations and higher dietary quality were positively associated with metabolic health in obese (OR 1.45-1.53 unadjusted model) and non-obese subjects (OR 1.37-1.39 unadjusted model), respectively. Physical activity was associated with MHO defined by insulin resistance (OR 1.87, 95% CI 1.19-2.92, p = 0.006). CONCLUSION:A standard MHO definition is required. Moderate and high levels of physical activity and compliance with food pyramid recommendations increase the likelihood of MHO. Stratification of obese individuals based on their metabolic health phenotype may be important in ascertaining the appropriate therapeutic or intervention strategy.http://europepmc.org/articles/PMC3798285?pdf=render
spellingShingle Catherine M Phillips
Christina Dillon
Janas M Harrington
Vera J C McCarthy
Patricia M Kearney
Anthony P Fitzgerald
Ivan J Perry
Defining metabolically healthy obesity: role of dietary and lifestyle factors.
PLoS ONE
title Defining metabolically healthy obesity: role of dietary and lifestyle factors.
title_full Defining metabolically healthy obesity: role of dietary and lifestyle factors.
title_fullStr Defining metabolically healthy obesity: role of dietary and lifestyle factors.
title_full_unstemmed Defining metabolically healthy obesity: role of dietary and lifestyle factors.
title_short Defining metabolically healthy obesity: role of dietary and lifestyle factors.
title_sort defining metabolically healthy obesity role of dietary and lifestyle factors
url http://europepmc.org/articles/PMC3798285?pdf=render
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