The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness
Francisco B. Ortega,Duck-chul Lee,Peter T. Katzmarzyk,Jonatan R. Ruiz,Jonatan R. Ruiz,Xuemei Sui,Timothy S. Church,Steven N. Blair +7 more
TLDR
Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.Abstract:
Current knowledge on the prognosis of metabolically healthy but obese phenotype is limited due to the exclusive use of the body mass index to define obesity and the lack of information on cardiorespiratory fitness. We aimed to test the following hypotheses: (i) metabolically healthy but obese individuals have a higher fitness level than their meta- bolically abnormal and obese peers; (ii) after accounting for fitness, metabolically healthy but obese phenotype is a benign condition, in terms of cardiovascular disease and mortality. Methods and results Fitness was assessed by a maximal exercise test on a treadmill and body fat per cent (BF%) by hydrostatic weighing or skinfolds (obesity ¼ BF% ≥25 or ≥30%, men or women, respectively) in 43 265 adults (24.3% women). Metabolically healthy was considered if meeting 0 or 1 of the criteria for metabolic syndrome. Metabolically healthy but obese participants (46% of the obese subsample) had a better fitness than metabolically abnormal obese participants (P , 0.001). When adjusting for fitness and other confounders, metabolically healthy but obese individuals had lower risk (30-50%, estimated by hazard ratios) of all-cause mortality, non-fatal and fatal cardiovascular disease, and cancer mortality than their metabolically unhealthy obese peers; while no significant differences were observed between metabolically healthy but obese and metabolically healthy normal-fat participants. Conclusions (i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.read more
Citations
More filters
Journal ArticleDOI
Are Metabolically Healthy Overweight and Obesity Benign Conditions?: A Systematic Review and Meta-analysis
TL;DR: In this article, the authors focused on a unique subgroup of overweight and obese individuals who have normal metabolic features despite increased adiposity, but it remains unclear whether metabolic phenotype modifies the morbidity and mortality associated with higher body mass index (BMI).
Journal ArticleDOI
Obesity and Cardiovascular Disease
TL;DR: A scientifically based harmonized definition of MHO is proposed, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis.
Journal ArticleDOI
Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications
TL;DR: The observational studies that gave rise to the idea of metabolically healthy obesity are described and the key parameters that can help to distinguish it from the general form of obesity are discussed.
Journal ArticleDOI
Exercise is the Real Polypill
TL;DR: In this article, a review summarizes the current body of knowledge on the main biological mediators (ingredients) of the preventive/therapeutic effects of regular exercise, and summarizes their roles.
Journal ArticleDOI
Obesity and Cardiovascular Diseases: Implications Regarding Fitness, Fatness, and Severity in the Obesity Paradox
Carl J. Lavie,Carl J. Lavie,Paul A. McAuley,Timothy S. Church,Richard V. Milani,Steven N. Blair +5 more
TL;DR: The obesity paradox in CV diseases is reviewed, where overweight and at least mildly obese patients with most CV diseases seem to have a better prognosis than do their leaner counterparts, and the potential value of purposeful weight loss and increased physical activity to affect levels of fitness is reviewed.
References
More filters
Journal ArticleDOI
Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity
K. G. M. M. Alberti,Robert H. Eckel,Scott M. Grundy,Paul Zimmet,James I. Cleeman,Karen A. Donato,Jean Charles Fruchart,W. Philip T. James,Catherine M. Loria,Sidney C. Smith +9 more
TL;DR: It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool, and a single set of cut points would be used for all components except waist circumference, for which further work is required.
Book
ACSM's guidelines for exercise testing and prescription
TL;DR: In this paper, the authors discuss the benefits and risks associated with physical activity and propose a general principles of exercise prescription for healthy populations with special consideration and environmental consideration, as well as a prescription for patients with chronic diseases and health conditions.
Journal ArticleDOI
Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy Men and Women
Steven N. Blair,Harold W. Kohl,Ralph S. Paffenbarger,Debra G. Clark,Kenneth H. Cooper,Larry W. Gibbons +5 more
TL;DR: Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer, and lower mortality rates in higher fitness categories also were seen for cardiovascular Disease and cancer of combined sites.
Journal ArticleDOI
Generalized equations for predicting body density of men
Andrew S. Jackson,M L Pollock +1 more
TL;DR: The regression equations were shown to be valid for adult men varying in age and fatness, in combination with age, waist and forearm circumference.
Journal ArticleDOI
Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women: A Meta-analysis
Satoru Kodama,Kazumi Saito,Shiro Tanaka,Miho Maki,Yoko Yachi,Mihoko Asumi,Ayumi Sugawara,Kumiko Totsuka,Hitoshi Shimano,Yasuo Ohashi,Nobuhiro Yamada,Hirohito Sone +11 more
TL;DR: In this article, a systematic literature search was conducted for observational cohort studies using MEDLINE (1966 to December 31, 2008) and EMBASE (1980 to December 30, 2008), which reported associations of baseline cardiorespiratory fitness with CHD events, CVD events, or all-cause mortality in healthy participants.