Determination of Peak Aerobic Capacity in Normal Weight Obesity and Metabolically Healthy Obesity

Abstract Objectives The true cardiometabolic risk of the novel body composition phenotypes normal-weight obesity (NWO) and metabolically healthy obesity (MHO) remains controversial. Cardiorespiratory fitness, as measured by peak oxygen uptake during exercise (VO2peak), is inversely correlated with CVD and mortality. The objective of this project was to determine VO2peak in NWO and MHO relative to appropriate positive and negative control groups. Methods For this cross-sectional study, participants aged 18–50 years were recruited into one of four groups based on BMI, body composition, and metabolic risk factors: NWO (normal BMI with high body fat percentage (BF%)); MHO (obese BMI, high BF%, and up to one of the diagnostic criteria for metabolic syndrome (MetS) as defined by the International Diabetes Federation); MetS (obese BMI, high BF%, and at least three of the diagnostic criteria for MetS); and healthy controls (HC; normal BMI, BF%, and metabolic markers). Participants engaged in a maximal exercise test on a cycle ergometer to determine VO2peak and a DEXA scan to assess BF%. Data were analyzed using one-way ANOVA. Results A total of 35 participants completed this study (HC: n = 10; NWO: n = 8; MHO: n = 10; MetS: n = 7). VO2peak was greater in HC (44.2 ± 11.0 ml/kg/min) compared to NWO (28.6 ± 5.1 ml/kg/min; P = 0.002), MHO (25.4 ± 6.7 ml/kg/min; P < 0.0001) and MetS (24.3 ± 8.8 ml/kg/min; P = 0.0002). VO2peak was similar among NWO, MHO, and MetS (p's ≥ 0.76). BF% was lower in HC (23.4 ± 5.5%) compared to NWO (32.6 ± 3.8%; P = 0.0099), MHO (41.9 ± 6.0%; P < 0.0001) and MetS (32.5 ± 6.1%; P = 0.016). BF% was also greater in MHO compared to NWO (P = 0.0085) and MetS (P = 0.0115). There was no significant difference in BF% between NWO and MetS (P > 0.9999). Across groups, there was a strong inverse correlation between BF% and VO2peak (r = −0.83). Conclusions VO2peak did not significantly differ among all three at-risk groups (NWO, MHO, and MetS), and all were lower than HC. BF% also did not significantly differ between NWO and MetS groups, and BF% was actually greater in MHO compared to MetS and NWO. NWO and MHO, despite normal BMI and metabolic markers, respectively, have a VO2peak more similar to MetS than HC, suggesting increased cardiometabolic risk. Funding Sources American Society for Nutrition Mars. Inc Predoctoral Fellowship.

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Association of Metabolically Healthy and Unhealthy Obesity Phenotype with Markers Related to Obesity, Diabetes among Young, Healthy Adult Men. Analysis of MAGNETIC Study

Life ◽

10.3390/life11121350 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1350

Author(s):

Mateusz Lejawa ◽

Kamila Osadnik ◽

Zenon Czuba ◽

Tadeusz Osadnik ◽

Natalia Pawlas

Keyword(s):

Plasminogen Activator Inhibitor ◽

Normal Weight ◽

Obese Patients ◽

Metabolically Healthy Obesity ◽

Plasminogen Activator Inhibitor 1 ◽

Metabolic Markers ◽

Adult Men ◽

Metabolically Healthy Obese ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

Adipose tissue secretes many regulatory factors called adipokines. Adipokines affect the metabolism of lipids and carbohydrates. They also influence the regulation of the immune system and inflammation. The current study aimed to evaluate the association between markers related to obesity, diabesity and adipokines and metabolically healthy and unhealthy obesity in young men. The study included 98 healthy participants. We divided participants into three subgroups based on body mass index and metabolic health definition: 49 metabolically healthy normal-weight patients, 27 metabolically healthy obese patients and 22 metabolically unhealthy obese patients. The 14 metabolic markers selected were measured in serum or plasma. The analysis showed associations between markers related to obesity, diabesity and adipokines in metabolically healthy and unhealthy obese participants. The decreased level of adipsin (p < 0.05) was only associated with metabolically healthy obesity, not with metabolically unhealthy obesity. The decreased level of ghrelin (p < 0.001) and increased level of plasminogen activator inhibitor-1 (p < 0.01) were only associated with metabolically unhealthy obesity, not with metabolically healthy obesity. The decreased level of adiponectin and increased levels of leptin, c-peptide, insulin and angiopoietin-like 3 protein were associated with metabolically healthy and unhealthy obesity. In conclusion, our data show that metabolically healthy obesity was more similar to metabolically unhealthy obesity in terms of the analyzed markers related to obesity and diabesity.

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Association between being metabolically healthy/unhealthy and metabolic syndrome in Iranian adults

PLoS ONE ◽

10.1371/journal.pone.0262246 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262246

Author(s):

Ozra Tabatabaei-Malazy ◽

Sahar Saeedi Moghaddam ◽

Masoud Masinaei ◽

Nazila Rezaei ◽

Sahar Mohammadi Fateh ◽

...

Keyword(s):

Metabolic Syndrome ◽

Public Awareness ◽

Normal Weight ◽

Healthy Lifestyles ◽

Adult Treatment Panel ◽

Metabolically Healthy Obesity ◽

Anthropometric Data ◽

Metabolic Markers ◽

Obese Subjects ◽

Metabolically Healthy

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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Relationship between Eating Patterns and Body Composition among Young Females in Qatar

University of the Future: Re-Imagining Research and Higher Education ◽

10.29117/quarfe.2020.0219 ◽

2020 ◽

Author(s):

Fatma Elsayed ◽

Aram Alhammadi ◽

Alanood Alahmad ◽

Zahra Babiker ◽

Abdelhamid Kerkadi

Keyword(s):

Body Composition ◽

Dietary Patterns ◽

Fast Food ◽

Dietary Habits ◽

Communicable Disease ◽

Normal Weight ◽

Female Students ◽

Eating Patterns ◽

Young Females ◽

Significant Difference

The prevalence of obesity has been increased in Qatar, with the transition from healthy to unhealthy dietary habits. Behavioral factors that are associated with obesity are, long-term imbalanced energy intake, high screen time, skipping breakfast and physical inactivity. Changes in body composition and percent body fat (PBF) increase the risk of non-communicable disease. This study is the first study conducted in Qatar to investigate the relationship between dietary patterns and body composition among young females at Qatar University. This cross-sectional study consisted of 766 healthy female students Qatari and non-Qatari aged from 18-26 years randomly selected from different colleges at Qatar University. A validate questionnaire was used in order to collect data about healthy and unhealthy dietary patterns. Anthropometric measurements involved body weight, height, waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and body composition using “Seca285”, “Seca203” and “InbodyBiospace 720”. Dietary patterns were identified by using factor loading. Linear regression was used to estimate confidence intervals and regression coefficient. More than half of the participants had a normal weight (65.1%), whereas 22.8 % and 12.0% were overweight and obese, respectively. Fat mass, BMI and PBF were slightly increased with age, but there was no significant difference. Factor analysis identified two dietary patterns: unhealthy patterns and healthy patterns. The frequent intake of vegetables and fruits was significant among high PBF female students (p=0.045 and p=0.001, respectively). The frequent intake of fast food was higher for overweight female students but there was no significant difference (p=0.289), whereas, the frequent intake of sweetened beverages was associated with higher significant rate of normal weight among female students (p = 0.009). No significant relation was found between dietary patterns, BMI and PBF. In conclusion, body composition is not significantly associated with healthy and unhealthy eating patterns among young females.

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Metabolically healthy obesity and metabolically obese normal weight: a review

Journal of Physiology and Biochemistry ◽

10.1007/s13105-020-00781-x ◽

2021 ◽

Vol 77 (1) ◽

pp. 175-189 ◽

Cited By ~ 1

Author(s):

Saioa Gómez-Zorita ◽

Maite Queralt ◽

Maria Angeles Vicente ◽

Marcela González ◽

María P. Portillo

Keyword(s):

Normal Weight ◽

Metabolically Healthy Obesity ◽

Metabolically Obese Normal Weight ◽

Metabolically Healthy

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Abstract 075: Differences In Body Composition At Baseline And In Response To Exercise Training By Metabolic Health And Weight Status

Circulation ◽

10.1161/circ.143.suppl_1.075 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Alexis Jones ◽

Jacob L Barber ◽

James S Skinner ◽

Claude Bouchard ◽

Mark A Sarzynski

Keyword(s):

Body Composition ◽

Exercise Training ◽

Visceral Fat ◽

Weight Status ◽

Normal Weight ◽

Metabolic Health ◽

Fat Free Mass ◽

Obese Adults ◽

Change Models ◽

Metabolically Healthy

Background: Body composition is known to differ across metabolic health and weight phenotypes. Regular exercise improves body composition, yet little is known about differences in exercise response across metabolic health and weight phenotypes. Methods: Normal weight (n=376) and overweight/obese (OWOB) adults (n=456) from the HERITAGE Family Study (56% female, 38% Black) completed a 20-week endurance training program. Four groups based on baseline BMI and metabolic risk were created: metabolically healthy normal weight, MHNW; metabolically unhealthy normal weight, MUNW; metabolically healthy OWOB, MHO; and metabolically unhealthy OWOB, MUO. Unhealthy was defined as having ≥2 metabolic syndrome components. General linear models tested for differences in baseline and change in measures of body composition (fat mass [FM], fat-free mass [FFM], % body fat [%BF], visceral fat) after adjusting for age, sex, and ethnicity (and baseline value in change models). Results: Table 1 shows adjusted mean baseline and change in body composition values by group. Baseline body composition tended to track with weight status, with NW adults having lower FM, %BF, and visceral fat compared to obese adults (p<0.05), regardless of metabolic health. However, the MHO group had lower baseline values of these traits compared to MUO (p<0.05). Body composition measures significantly improved with exercise training in all groups, however, the magnitude of change differed between groups. For example, both NW groups had larger decreases in %BF compared to the obese groups, with MUNW showing the largest decrease. Conversely, MHNW showed the largest decrease in visceral fat, which was greater than both obese groups, but change in visceral fat was similar between MHO and MUNW. Conclusions: Normal weight adults tended to have better body composition profiles at baseline and larger improvements with exercise compared to obese adults, regardless of metabolic health. Within weight groups, body composition improved regardless of metabolic health status.

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Characteristics of Physical Fitness and Cardiometabolic Risk in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s280350 ◽

2020 ◽

Vol Volume 13 ◽

pp. 4157-4167

Author(s):

Qianqian Tian ◽

Hui Wang ◽

Keneilwe Kenny Kaudimba ◽

Shanshan Guo ◽

Haixin Zhang ◽

...

Keyword(s):

University Students ◽

Physical Fitness ◽

Cardiometabolic Risk ◽

Cross Sectional Study ◽

Normal Weight ◽

Sectional Study ◽

Cross Sectional ◽

Chinese University ◽

Normal Weight Obesity ◽

Chinese University Students

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Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults

Nutrients ◽

10.3390/nu12041106 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1106 ◽

Cited By ~ 3

Author(s):

María Correa-Rodríguez ◽

Katherine González-Ruíz ◽

David Rincón-Pabón ◽

Mikel Izquierdo ◽

Antonio García-Hermoso ◽

...

Keyword(s):

Blood Pressure ◽

Young Adults ◽

Body Mass ◽

Abdominal Obesity ◽

Cardiometabolic Risk ◽

Large Population ◽

Normal Weight ◽

Increased Risk ◽

Low Hdl ◽

Normal Weight Obesity

Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m2. The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.

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THE CHARACTERISTICS OF SECRETION OF ADIPONECTIN AND ITS RELATIONSHIP WITH PARTICULAR INDICESOF METABOLISM IN MALES OF ABLE-BODIED AGE IN CASE OF OBESITY

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2017-23-6-312-315 ◽

2017 ◽

Vol 23 (6) ◽

pp. 312-315

Author(s):

Olga V. Karataeva

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Low Density Lipoproteins ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Metabolically Healthy Obesity ◽

Significant Difference ◽

Fasting Glycaemia ◽

Metabolically Healthy ◽

Degree Of Severity

The sampling consisted of 79 examined males of able-bodied age. The arterial hypertension stage I and II was established in 58% of them; obesity of various degree of severity was diagnosed in 63% of them; metabolic syndrome according criteria ATP-III was noted in 46.8% of examined patients. The general clinical and anthropometric examination was carried out. The laboratory analyses included estimation of lipidogram, fasting glycaemia and also hormones adiponectin and insulin with following calculation of index of insulin resistance HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). The study was organized to investigate effecting of obesity on secretion of adiponectin and its relationship with indices of lipidogram and level of insulin resistance. The comparative analysis of groups with and absence of obesity established no significant difference in level of adiponectin and indices of lipidogram. the significant differences were established in the levels of basal insulin hence in value of index NOMA-IR that points to hyperinsulinemia and expressed insulin resistance in patients with obesity. The patients were separated in two groups depending on presence of manifestations of metabolic syndrome: with metabolically healthy obesity and metabolically complicated obesity. The analysis established a significant decreasing of level of adiponectin in the group of metabolically complicated obesity accompanied by insulin resistance, dyslipidemia and increased level of glycaemia. The study established no effect of degree of obesity on decreasing of level of adiponectin. The significant differences between levels of adiponectin in comparison between group without obesity and group of metabolically healthy obesity. The correlation analysis in group with obesity demonstrated back-coupling between level of adiponectin and content of total cholesterol, low density lipoproteins and coefficient of atherogenicity. The comparison of groups according median of adiponectin established significant differences in rate of development of metabolic syndrome and value of coefficient of atherogenicity.

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The association between body composition and metabolically unhealthy profile of adults with normal weight in Northwest China

PLoS ONE ◽

10.1371/journal.pone.0248782 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248782

Author(s):

Ling Fan ◽

Jiangwei Qiu ◽

Yu Zhao ◽

Ting Yin ◽

Xiaoxia Li ◽

...

Keyword(s):

Body Composition ◽

Bioelectrical Impedance ◽

Northwest China ◽

Normal Weight ◽

Chinese Adults ◽

Ningxia Hui Autonomous Region ◽

Fat Level ◽

Males And Females ◽

Metabolically Healthy ◽

Insight Into

Objective Related evidences of metabolically unhealthy profile of adults with normal weight are not well characterized in the Chinese population. This is because they cannot be effectively identified by regular measurements (such as body mass index [BMI]). To overcome this gap in literature, this study aimed at investigating the association between body composition and metabolically unhealthy profile in Chinese adults with normal weight. Methods A total of 5427 individuals with normal-weight were recruited from 15820 people living in Ningxia Hui Autonomous Region in Northwest China. Normal-weight was defined as a BMI of 18.5–23.9 kg/m2. Metabolically unhealthy profile was assessed by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Metabolically unhealthy normal-weight (MUHNW) profile was defined in individuals who had normal weight and at least two cardiometabolic risk factors. Generalized linear model was used to investigate the association between body composition measured by bioelectrical impedance and metabolically unhealthy profile in adults with normal-weight. Results The percentage of metabolically unhealthy profile was 35.86% in adults with normal weight. Different MUHNW distributions were found between males and females depending on age. The percentage of the MUHNW profile significantly increased in women after the age of 55, contrary to men. The association between body composition and MUHNW was affected by age and sex. The increased adiposity indices (fat mass index [FMI], visceral fat level [VFL], waist circumference [WCF]), and reduced skeletal muscle mass ratio [SMR] showed significant differences between MUHNW and metabolically healthy with normal weight (MHNW) (p < 0.05). Conclusion The distribution of MUHNW differed between ages and sexes. FMI, VFL, WCF and SMR could be responsible for the MUHNW adults, providing a new insight into the potential metabolic risks for the adults with normal weight in China. This directs us in the management of the MUHNW for their early prevention.

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