ArticlePloS one2013
Defining metabolically healthy obesity: role of dietary and lifestyle factors.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 2 of them syntheses that pooled it.
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106 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk of hypertension among different metabolic phenotypes: a systematic review and meta-analysis of prospective cohort studies.Journal of human hypertension · 2019Pooled it
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- Effectiveness of vitamin D therapy in improving metabolomic biomarkers in obesity phenotypes: Two randomized clinical trials.International journal of obesity (2005) · 2018Trial
- Beyond the BMI Paradox: Unraveling the Cellular and Molecular Determinants of Metabolic Health in Obesity.Biomolecules · 2025Review
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- Understanding the role of metabolic syndrome in prostate cancer risk: A UK Biobank prospective cohort study.Scientific reports · 2025Article
- 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.Frontiers in public health · 2025Article
- Identification of metabolism related biomarkers in obesity based on adipose bioinformatics and machine learning.Journal of translational medicine · 2024Article
- Plant-based diet adherence is associated with metabolic health status in adults living with and without obesity.European journal of nutrition · 2024Article
- Follistatin as a Potential Biomarker for Identifying Metabolically Healthy and Unhealthy Obesity: A Cross-Sectional Study.Journal of personalized medicine · 2024Article
- Review
- Association of priori-defined DASH dietary pattern with metabolic health status among Iranian adolescents with overweight and obesity.Scientific reports · 2024Article
- Trends and characteristics of the metabolically healthy obese phenotype in an Arab population.Frontiers in public health · 2024Article
- The relation between dietary phytochemical index and metabolic health status in overweight and obese adolescents.Scientific reports · 2023Article
- Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolically unhealthy overweight/obesity phenotypes among Iranian women: a cross sectional study.BMC endocrine disorders · 2023Article
- The association between egg consumption and metabolic health status in overweight and obese adolescents.Scientific reports · 2023Article
- Untargeted Metabolomics Based on Liquid Chromatography-Mass Spectrometry for the Analysis of Plasma and Erythrocyte Samples in Childhood Obesity.Methods in molecular biology (Clifton, N.J.) · 2023Article
- Visceral Adiposity Index and Lipid Accumulation Product as Effective Markers of Different Obesity Phenotypes in Korean Adults: A Cross-Sectional Analysis.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Body Mass Trajectory Affects the Long-Term Occurrence of Metabolic Syndrome in Adult Patients with Severe Obesity.Children (Basel, Switzerland) · 2022Article
46 more citing papers are in PubMed but not listed here.
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Abstract
backgroundThere 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.
methodCross-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.
resultsThe 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).
conclusionA 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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