1
|
Bae S, Kang SI, Ko HC, Park J, Jun W. Anti-Obesity Effect of Jeju Roasted Citrus Peel Extract in High-Fat Diet-Induced Obese Mice and 3T3-L1 Adipocytes Via Lipid Metabolism Regulation. J Med Food 2024; 27:369-378. [PMID: 38489599 DOI: 10.1089/jmf.2023.k.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Lipid accumulation in adipocytes occurs through multifactorial effects such as overnutrition due to unbalanced eating habits, reduced physical activity, and genetic factors. In addition, obesity can be intensified by the dis-regulation of various metabolic systems such as differentiation, lipogenesis, lipolysis, and energy metabolism of adipocytes. In this study, the Jeju roasted peel extract from Citrus unshiu S.Markov. (JRC), which is discarded as opposed to the pulp of C. unshiu S.Markov., is commonly consumed to ameliorate obesity. To investigate the anti-obesity effect of JRC, these studies were conducted on differentiated 3T3-L1 cells and in high-fat diet-induced mice, and related methods were used to confirm whether it decreased lipid accumulation in adipocytes. The mechanism of inhibiting obesity by JRC was confirmed through mRNA expression studies. JRC suppressed lipid accumulation in adipocytes and adipose tissue, and significantly improved enzymes such as alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase and serum lipid profiles. In addition, it effectively modulated the expression of genes related to lipid and energy metabolism in adipose tissue. As a result, these findings suggest that JRC could be a therapeutic regulator of body fat accumulation by significantly alleviating the dis-regulation of intracellular lipid metabolism in adipocytes and by enhancement of energy metabolism (Approval No. CNU IACUC-YB-2023-98).
Collapse
Affiliation(s)
- Subin Bae
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
| | - Seong-Il Kang
- Planning Management and Research Development, Jeju Institute of Korean Medicine, Jeju, Korea
| | - Hee Chul Ko
- Planning Management and Research Development, Jeju Institute of Korean Medicine, Jeju, Korea
| | - Jeongjin Park
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
- Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| | - Woojin Jun
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
- Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| |
Collapse
|
2
|
Osadnik K, Osadnik T, Gierlotka M, Windak A, Tomasik T, Mastej M, Kuras A, Jóźwiak K, Penson PE, Lip GYH, Mikhailidis DP, Toth PP, Catapano AL, Ray KK, Howard G, Tomaszewski M, Charchar FJ, Sattar N, Williams B, MacDonald TM, Banach M, Jóźwiak J. Metabolic syndrome is associated with similar long-term prognosis in those living with and without obesity: an analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 studies. Eur J Prev Cardiol 2023; 30:1195-1204. [PMID: 37039119 DOI: 10.1093/eurjpc/zwad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
AIMS We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. METHODS AND RESULTS The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006, and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS, and obese patients with MetS. Differences in all-cause mortality were analysed using Kaplan-Meier and Cox regression analyses. A total of 45 615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14 202 (31%) by NCEP/ATP III criteria and 17 216 (37.7%) by JIS criteria. Follow-up was available for 44 620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese {hazard ratio, HR: 1.88 [95% confidence interval (CI) 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively} and non-obese individuals [HR: 2.11 (95% CI 1.85-2.40) and 1.7 (95% CI 1.56-1.85) according to NCEP/ATP III and JIS criteria, respectively]. Obese patients without MetS had a higher mortality risk than non-obese patients without MetS [HR: 1.16 (95% CI 1.10-1.23) and HR: 1.22 (95% CI 1.15-1.30), respectively in subgroups with NCEP/ATP III and JIS criteria applied]. CONCLUSIONS MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS, obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised.
Collapse
Affiliation(s)
- Kamila Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland, Jordana 38 st., 41-808 Zabrze, Poland
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland, Jordana 38 st., 41-808 Zabrze, Poland
| | - Marek Gierlotka
- Department of Cardiology, Institute of Medical Sciences, University of Opole, Al. W. Witosa 26, 45-401 Opole, Poland
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Bochenska 4 Street, 31-061 Krakow, Poland
| | - Tomasz Tomasik
- Department of Family Medicine, Jagiellonian University Medical College, Bochenska 4 Street, 31-061 Krakow, Poland
| | - Mirosław Mastej
- Mastej Medical Center, Staszica 17A St., 38-200 Jasło, Poland
| | - Agnieszka Kuras
- Multiprofile Medical Simulation Center, University of Opole, Oleska 48 St., 45-052 Opole, Poland
| | - Kacper Jóźwiak
- Faculty of Health Sciences, Jagiellonian University Collegium Medicum, ul/street: Piotra Michałowskiego 12, 31-126 Kraków, Poland
| | - Peter E Penson
- Clinical Pharmacy & Therapeutics Research Group, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, James Parsons Building, Byrom Street, Liverpool L3 3AF, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Brownlow Hill, Liverpool L69 7TX, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, 6 West Derby St., Liverpool L7 8TX, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond St., London NW3 2QG, UK
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- CGH Medical Center, Department of Preventive Cardiology, 101 East Miller Road, Sterling, IL 61081, USA
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via G. Balzaretti 9, 10136 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, Via Milanese, 300, 20099 Milan, Italy
| | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, 320 St Dunstan's Road (Reynolds Building) Imperial College London, London W68RP, UK
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, 1665 University Blvd, AL 35294-0022, USA
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester, 46 Grafton St., Manchester M13 9NT, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Nelson St, Manchester M13 9NQ, UK
| | - Fadi J Charchar
- Health Innovation and Transformation Centre, Federation University Australia, University Drive, Ballarat, Victoria 3350, Australia
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Bryan Williams
- NIHR University College London Biomedical Research Centre, University College London and University College London Hospitals NHS Foundation Trust, 149 Tottenham Court Road, London W1T 7DN, UK
| | - Thomas M MacDonald
- MEMO Research, School of Medicine, University of Dundee, Ninewells Hospital & Medical School, Ninewells Avenue, Dundee DD1 9SY, UK
| | - Maciej Banach
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Rzgowska 281/289, 93-338 Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland
| | - Jacek Jóźwiak
- Department of Family Medicine and Public Health, University of Opole, Oleska 48 Street, 45-052 Opole, Poland
| |
Collapse
|
3
|
Liu H, Chen S, Ji H, Dai Z. Effects of time-restricted feeding and walking exercise on the physical health of female college students with hidden obesity: a randomized trial. Front Public Health 2023; 11:1020887. [PMID: 37275490 PMCID: PMC10235762 DOI: 10.3389/fpubh.2023.1020887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose Time-restricted feeding (TRF) is an emerging dietary pattern with many potential effects. This study focused on the effects of TRF and walking on the physical health of female college students with hidden obesity. Methods A total of 77 female college students with hidden obesity, aged 18-22 years, were randomly assigned to a control group (CON, N = 19), time-restricted feeding group (TRF, N = 19), exercise group (EXE, N = 20), and TRF combined with exercise group (TRF + EXE, N = 19). The interventions lasted for 8 weeks. Tests assessing body shape, body composition, bone mineral density, blood lipid levels, and blood pressure were performed before and after the intervention. Results (1) Intragroup comparison before and after the intervention revealed that the TRF, EXE, and TRF + EXE groups had significantly reduced body weight (p < 0.01), body mass index (BMI) (p < 0.05), and lean tissue mass (LTM) (p < 0.01) but increased total cholesterol (TC) levels (p < 0.05) after the intervention. Body fat percentage (BF%) increased considerably in the EXE and TRF + EXE groups (p < 0.01). (2) Post-intervention comparisons of body weight, BMI, LTM, adipose tissue mass (ATM), total bone mineral density (TBMD), blood lipid levels, and blood pressure between the intervention groups (TRF, EXE, and TRF + EXE) and the CON group showed no significant differences (p > 0.05). (3) A comparison of the changes between the groups before and after the intervention showed significant decreases in body weight in the TRF and TRF + EXE groups (p < 0.05) and in both BMI and LTM in the TRF, EXE, and TRF + EXE groups (p < 0.05) compared to those in the CON group. The BF% change in the EXE and TRF + EXE groups were significantly greater than that in the TRF group (p < 0.01). Conclusion TRF effectively decreased body weight and BMI in female college students with hidden obesity. However, increased blood lipid levels and decreased LTM levels were also observed. The effects of TRF combined with exercise were not superior to those of TRF or walking alone in terms of body weight, body mass index, body composition, TBMD, or blood lipid levels. Therefore, TRF cannot be considered the best option for fat reduction in female college students with hidden obesity.
Collapse
Affiliation(s)
- Haitao Liu
- College of Physical Education, Henan University, Kaifeng, China
- Research Center for Sports Reform and Development, Henan University, Kaifeng, China
- Institute of Physical Fitness and Health, Henan University, Kaifeng, China
| | - Shiying Chen
- College of Physical Education, Henan University, Kaifeng, China
| | - Haoyuan Ji
- College of Physical Education, Henan University, Kaifeng, China
| | - Zuanqin Dai
- College of Physical Education, Henan University, Kaifeng, China
| |
Collapse
|
4
|
Kucukdag HN, Sonmez CI. The Relationship of Body Fat Ratio to Anthropometric and Metabolic Parameters in Normal Weight and Overweight Women; The Concept of Normal Weight Obesity. EURASIAN JOURNAL OF FAMILY MEDICINE 2023. [DOI: 10.33880/ejfm.2023120104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Aim: We aimed to underline the importance of “normal weight obesity concept”, prevent the overlooking of Normal Weight Obesity patients, administrate their treatments and explain them the risks regarding their future lives along with making emphasis on the necessity of change in polyclinical practices about the subject.
Methods: We selected 200 female patients that were either normal or overweighted for this study. Patients have been divided into 4 groups with respect to their body mass index and body fat percent values. Differences of bioelectrical impedance analysis measurements between the groups, relation of the anthropometric and metabolic parameters and those parameters’ inner correlations have been inspected.
Results: Serum levels of fasting plasma glucose, insulin, HOMA-IR, total cholesterol, LDL, triglyceride and TSH were higher in “Normal Weight Obesity” subjects than “Normal Weight Lean” subjects. The mean LDL levels were found to be higher in the Normal Weight Obesity group compared to the other groups and it was found to be statistically significant. Body fat percent was positively correlated to insulin, HOMA-IR, visceral fat rating, waist – hip circumferences, waist to height – hip to height ratios.
Conclusion: The importance of measurement of body fat percent and not to overlook the Normal Weight Obesity patients should be emphasized once more. Therefore, in the primary care, during public screening and polyclinical assessment states, patients should be checked for obesity with not only measuring their weights and heights, but also detection of their detailed body composition.
Keywords: obesity, body fat distribution, waist to height ratio
Collapse
|
5
|
Anderson KC, Hirsch KR, Peterjohn AM, Blue MNM, Pihoker AA, Ward DS, Ondrak KS, Smith-Ryan AE. Characterization and prevalence of obesity among normal weight college students. Int J Adolesc Med Health 2023; 35:81-88. [PMID: 33155992 DOI: 10.1515/ijamh-2020-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/06/2020] [Indexed: 11/15/2022]
Abstract
Normal weight obesity (NWO) describes individuals who have a normal weight body mass index (BMI), but have an unhealthy amount of body fat. Based on the life-long habits that develop during college, exploring NWO among a college-aged population may be essential in identifying and preventing obesity that develops in early adulthood. This study aimed to characterize NWO among young adults with normal weight BMI. 94 college students (Mean ± SD: Age: 19.6 ± 1.5 yrs; BMI: 21.9 ± 1.8 kg/m2) enrolled during the Fall semester (Aug-Oct) were assessed for body composition by dual energy X-ray absorptiometry to determine body fat percentage, fat mass, lean mass and trunk fat; lifestyle habits were characterized from validated questionnaires. Mean arterial pressure and metabolic biomarkers [total cholesterol, high density lipoproteins, non-high density lipoproteins, and glucose] were evaluated for cardiometabolic health. NWO was defined using data from the National Health and Nutrition Examination Survey (NHANES) for body fat percentage. Data was analyzed by group (NWO vs NWL) and sex. with independent t-tests to investigate continuous data, and chi-square test of independence for categorical data. Rates of NWO for the total sample were 13.8%. Males (n=30) had a higher rate of NWO (26.7%) compared to females (n=64; 7.8%). NWO individuals had higher fat mass (p=0.024), trunk fat (p<0.001), and larger waist to hip ratio (p<0.001) than normal weight lean. NWO also engaged in less vigorous physical activity (p=0.043). The occurrence of NWO among otherwise healthy college students is evident. Identification of these individuals may be an effective component for obesity prevention and treatment. Determining feasible methods to measure body fat in this population is essential, as BMI may mask obesity in a young adult population.
Collapse
Affiliation(s)
- Kara C Anderson
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Austin M Peterjohn
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Alexis A Pihoker
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Dianne S Ward
- Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kristin S Ondrak
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
6
|
Are Women with Normal-Weight Obesity at Higher Risk for Cardiometabolic Disorders? Biomedicines 2023; 11:biomedicines11020341. [PMID: 36830878 PMCID: PMC9953250 DOI: 10.3390/biomedicines11020341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the cardiometabolic abnormalities in women with normal-weight obesity (NWO) in comparison with lean, overweight, and obese women. METHODS This cross-sectional study evaluated the assessment of cardiometabolic abnormalities of women with NWO compared to lean, overweight, and obese women. NWO was defined as a BMI < 25 kg.m-2 and a BFP higher than 30%. Anthropometric variables, cardiometabolic abnormality markers (fasting blood glucose (FBG), blood pressure (BP), lipid profile, insulin resistance, and high-sensitivity C-reactive protein (hs-CRP)), and liver enzymes were also examined. RESULTS Significant differences were observed in HDL concentrations between NWO, lean, and obese participants (p < 0.05). There were no significant differences in FBG, insulin resistance, liver enzymes, or cholesterol between groups (p > 0.05). The prevalence of the abnormal metabolic phenotype was higher in NWO compared to the lean group (4.0% and 24.1%, respectively; p < 0.05). Women with type 2 and 3 obesity had abnormal metabolic profiles (60.9% and 73.9%, respectively) compared to NWO participants (p < 0.01). The NWO group had a significantly higher incidence of cardiometabolic abnormalities compared to the lean participants (p < 0.05), while the type 2 and 3 obese individuals had significantly higher incidences compared to the NWO group (p < 0.001 and p < 0.001, respectively). CONCLUSIONS Individuals with NWO had a significantly higher incidence of cardiometabolic abnormalities when compared to lean participants. These abnormalities strongly relate to BFP and waist circumferences.
Collapse
|
7
|
Mohammadian Khonsari N, Baygi F, Tabatabaei-Malazy O, Mohammadpoor Nami S, Ehsani A, Asadi S, Qorbani M. Association of normal weight obesity phenotype with inflammatory markers: A systematic review and meta-analysis. Front Immunol 2023; 14:1044178. [PMID: 36923417 PMCID: PMC10010388 DOI: 10.3389/fimmu.2023.1044178] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
Background Individuals with normal weight could suffer from obesity based on their body fat percentage (also known as normal weight obesity (NWO)), thus being at risk of significant morbidity and mortality compared to the general population. It seems that inflammatory pathways and chronic inflammation are significant contributors to the pathogenicity of NWO. This study aimed to assess and pool the association of proinflammatory and anti-inflammatory cytokines with NWO. Methods In this systematic review and meta-analysis, online international databases (PubMed, Scopus, EMBASE, Web of Science, and Google Scholar) were searched until August 2022. All observational studies with an English full text comparing the mean levels of proinflammatory and anti-inflammatory cytokines (e.g., C-reactive protein (CRP), various types of interleukins (IL) s, tumor necrosis factor-alpha (TNF)) and white blood cell (WBC) count, in subjects with NWO and "normal weight non-obese (NWNO)" were included. Two researchers independently screened, reviewed and assessed the quality of included studies. The remaining articles' data were extracted post-screening. The heterogeneity between studies was assessed using the I2 and Cochran's Q tests. A random effect model meta-analysis was used to pool the standardized mean difference (SMD) as an effect size. Results From the initial 559 studies, 21 and 19 were included in the qualitative and quantitative synthesis, respectively. In the systematic review, 8 studies reported a significant association between various proinflammatory cytokines (CRP, IL6, IL1β, and TNFα) and NWO. According to random-effect meta-analysis, the association between NWO with CRP (SMD: 0.60, 95% CI: 0.30, 0.91) and IL6 (SMD: 0.90, 95%CI: 0.14, 1.66) was statistically significant. Moreover, the mean level of TNFα in subjects with NWO and NWNO did not differ significantly (SMD: 0.67, 95% CI: -0.36, 1.70). Conclusion The findings of this study show that NWO was associated with high levels of CRP and IL6. Therefore, inflammatory pathways may play a role in the pathogenicity of NWO.
Collapse
Affiliation(s)
| | - Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ozra Tabatabaei-Malazy
- Endocrinology and Metabolism Population Sciences Institute, Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadpoor Nami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Ehsani
- Department of Pediatric, Iran University of Medical Sciences, Tehran, Iran
| | - Sasan Asadi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| |
Collapse
|
8
|
Lu Y, Wiltshire HD, Baker JS, Wang Q, Ying S. Associations between dairy consumption, physical activity, and blood pressure in Chinese young women. Front Nutr 2023; 10:1013503. [PMID: 37113293 PMCID: PMC10126246 DOI: 10.3389/fnut.2023.1013503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/13/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction The prevalence of hypertension (HTN) has been increasing in young adults. A healthy dietary pattern and increasing physical activity (PA) are commonly recommended as lifestyle modifications needed to manage blood pressure (BP). However, little is known about the relationship between dairy intake, PA, and BP in Chinese young women. The aim of this study was to examine whether BP was associated with dairy intake, moderate-to-vigorous intensity physical activity (MVPA) and total physical activity (TPA) in a sample of Chinese young women. Methods A total of 122 women (20.4 ± 1.4) who had complete data sets from the Physical Fitness in Campus (PFIC) study were included in this cross-sectional analysis. Data related to dairy intake and PA was collected using a food frequency questionnaire and an accelerometer. BP was measured following standardized procedures. The association between BP with dairy intake and PA was examined using multivariable linear regression models. Results After controlling for potential covariables, we observed a significant and independent relationship only between systolic BP with dairy intake [standardized beta (b) = -0.275, p < 0.001], MVPA (b = -0.167, p = 0.027), and TPA (b = -0.233, p = 0.002). Furthermore, we found a decrease of 5.82 ± 2.94, 1.13 ± 1.01, and 1.10 ± 0.60 mm Hg in systolic BP for daily additional servings of dairy, 10 min of MVPA, and 100 counts per minute of TPA, respectively. Conclusion Our results suggested that the higher amount of dairy consumption or PA was associated with lower level of SBP in Chinese young women.
Collapse
Affiliation(s)
- Yining Lu
- Faculty of Sport Science, Ningbo University, Ningbo, China
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Huw D. Wiltshire
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Julien S. Baker
- Centre for Population Health and Medical Informatics, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Qiaojun Wang
- Faculty of Sport Science, Ningbo University, Ningbo, China
- *Correspondence: Qiaojun Wang,
| | - Shanshan Ying
- Faculty of Sport Science, Ningbo University, Ningbo, China
| |
Collapse
|
9
|
Wentzel A, Patterson AC, Duhuze Karera MG, Waldman ZC, Schenk BR, DuBose CW, Sumner AE, Horlyck-Romanovsky MF. Non-invasive type 2 diabetes risk scores do not identify diabetes when the cause is β-cell failure: The Africans in America study. Front Public Health 2022; 10:941086. [PMID: 36211668 PMCID: PMC9537602 DOI: 10.3389/fpubh.2022.941086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023] Open
Abstract
Background Emerging data suggests that in sub-Saharan Africa β-cell-failure in the absence of obesity is a frequent cause of type 2 diabetes (diabetes). Traditional diabetes risk scores assume that obesity-linked insulin resistance is the primary cause of diabetes. Hence, it is unknown whether diabetes risk scores detect undiagnosed diabetes when the cause is β-cell-failure. Aims In 528 African-born Blacks living in the United States [age 38 ± 10 (Mean ± SE); 64% male; BMI 28 ± 5 kg/m2] we determined the: (1) prevalence of previously undiagnosed diabetes, (2) prevalence of diabetes due to β-cell-failure vs. insulin resistance; and (3) the ability of six diabetes risk scores [Cambridge, Finnish Diabetes Risk Score (FINDRISC), Kuwaiti, Omani, Rotterdam, and SUNSET] to detect previously undiagnosed diabetes due to either β-cell-failure or insulin resistance. Methods Diabetes was diagnosed by glucose criteria of the OGTT and/or HbA1c ≥ 6.5%. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤ 2.04). Diabetes due to β-cell-failure required diagnosis of diabetes in the absence of insulin resistance. Demographics, body mass index (BMI), waist circumference, visceral adipose tissue (VAT), family medical history, smoking status, blood pressure, antihypertensive medication, and blood lipid profiles were obtained. Area under the Receiver Operator Characteristics Curve (AROC) estimated sensitivity and specificity of each continuous score. AROC criteria were: Outstanding: >0.90; Excellent: 0.80-0.89; Acceptable: 0.70-0.79; Poor: 0.50-0.69; and No Discrimination: 0.50. Results Prevalence of diabetes was 9% (46/528). Of the diabetes cases, β-cell-failure occurred in 43% (20/46) and insulin resistance in 57% (26/46). The β-cell-failure group had lower BMI (27 ± 4 vs. 31 ± 5 kg/m2 P < 0.001), lower waist circumference (91 ± 10 vs. 101 ± 10cm P < 0.001) and lower VAT (119 ± 65 vs. 183 ± 63 cm3, P < 0.001). Scores had indiscriminate or poor detection of diabetes due to β-cell-failure (FINDRISC AROC = 0.49 to Cambridge AROC = 0.62). Scores showed poor to excellent detection of diabetes due to insulin resistance, (Cambridge AROC = 0.69, to Kuwaiti AROC = 0.81). Conclusions At a prevalence of 43%, β-cell-failure accounted for nearly half of the cases of diabetes. All six diabetes risk scores failed to detect previously undiagnosed diabetes due to β-cell-failure while effectively identifying diabetes when the etiology was insulin resistance. Diabetes risk scores which correctly classify diabetes due to β-cell-failure are urgently needed.
Collapse
Affiliation(s)
- Annemarie Wentzel
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States,Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa,South African Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa,*Correspondence: Annemarie Wentzel
| | - Arielle C. Patterson
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - M. Grace Duhuze Karera
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States,National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States,Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda
| | - Zoe C. Waldman
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Blayne R. Schenk
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Christopher W. DuBose
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States,National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Margrethe F. Horlyck-Romanovsky
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States,Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, New York, NY, United States,Margrethe F. Horlyck-Romanovsky
| |
Collapse
|
10
|
Postprandial triglycerides, endothelial function, and inflammatory cytokines as potential candidates for early risk detection in normal-weight obesity. Obes Res Clin Pract 2022; 16:386-392. [PMID: 36127280 DOI: 10.1016/j.orcp.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022]
Abstract
PROBLEM Normal-weight obesity (NWO) is associated with increased cardiovascular disease (CVD) risk. However, NWO's clinical presentation is often unremarkable based on common risk factors. We examined whether CVD risk factors not routinely measured clinically including postprandial triglycerides, flow-mediated dilation (FMD), and inflammatory cytokines would be abnormal in NWO, consistent with their future risk. METHODS Individuals were recruited into 3 groups (n = 10/ group): controls (Con), NWO, and metabolic syndrome (MetS). Con was defined as a normal body mass index (BMI), < 25% (M) or < 35% (F) body fat, and < 1 International Diabetes Federation (IDF) criteria. NWO were above this body fat cutoff while maintaining a normal BMI and MetS was defined per the IDF. Participants underwent an abbreviated fat tolerance test (i.e., difference in fasting and 4 h triglycerides following a high-fat meal [9 kcal/kg; 73% fat)] and fasting and postprandial lipid and glucose metrics, as well as FMD were measured. A T cell cytokine bioplex was also performed using fasting serum. RESULTS NWO and MetS had similar body fat% and both were higher than Con (p < 0.0001). Despite having similar fasting triglycerides to Con, NWO had 4-hour triglycerides 66% greater than Con, but 46% lower than MetS (p < 0.01). FMD decreased in all groups after the high-fat meal (p < 0.0001). MetS displayed lower fasting FMD than Con, and NWO was similar to both groups (p < 0.05). No group differences were observed with postprandial FMD and the majority of fasting cytokines assessed. However, MetS exhibited higher fasting TNF-α than Con (p < 0.05), and NWO was similar to both groups. CONCLUSIONS Overall, NWO was associated with higher postprandial triglycerides than Con, but displayed little evidence of impaired vascular health or inflammation.
Collapse
|
11
|
Quesada O, Lauzon M, Buttle R, Wei J, Suppogu N, Kelsey SF, Reis SE, Shaw LJ, Sopko G, Handberg E, Pepine CJ, Bairey Merz CN. Body weight and physical fitness in women with ischaemic heart disease: does physical fitness contribute to our understanding of the obesity paradox in women? Eur J Prev Cardiol 2022; 29:1608-1614. [PMID: 35244151 PMCID: PMC9440958 DOI: 10.1093/eurjpc/zwac046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022]
Abstract
AIMS Body mass index (BMI) defined obesity is paradoxically associated with lower all-cause mortality in patients with known cardiovascular disease. This study aims to determine the role of physical fitness in the obesity paradox in women with ischaemic heart disease (IHD). METHODS AND RESULTS Women undergoing invasive coronary angiography with signs/symptoms of IHD in the Women's Ischemia Syndrome Evaluation (WISE) prospective cohort (enrolled 1997-2001) were analysed. This study investigated the longer-term risk of major adverse cardiovascular events (MACE) and all-cause mortality associated with BMI and physical fitness measured by Duke Activity Status Index (DASI). Overweight was defined as BMl ≥25 to 30 kg/m2, obese as BMI ≥30 kg/m2, unfit as DASI scores <25, equivalent to ≤7 metabolic equivalents. Among 899 women, 18.6% were normal BMI-fit, 11.4% overweight-fit, 10.4% obese-fit, 15.3% normal BMI-unfit, 23.8% overweight-unfit, and 30.4% obese-unfit. In adjusted models compared to normal BMI-fit, normal BMI-unfit women had higher MACE risk [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.17-2.32; P = 0.004]; whereas obese-fit and overweight-fit women had lower risk of mortality (HR 0.60, 95% CI 0.40-0.89; P = 0.012 and HR 0.62, 95% CI 0.41-0.92; P = 0.018, respectively). CONCLUSION To address the paradox of body weight and outcomes in women, we report for the first time that among women with signs/symptoms of IHD overweight-fit and obese-fit were at lower risk of long-term all-cause mortality; whereas normal BMI-unfit were at higher risk of MACE. Physical fitness may contribute to the obesity paradox in women, warranting future studies to better understand associations between body weight, body composition, and physical fitness to improve cardiovascular outcomes in women.
Collapse
Affiliation(s)
- Odayme Quesada
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
- Women’s Heart Center, The Christ Hospital Heart and Vascular Institute, 2139 Auburn Ave, Cincinnati, OH 45219, USA
| | - Marie Lauzon
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
| | - Rae Buttle
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
| | - Janet Wei
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
| | - Nissi Suppogu
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
| | - Sheryl F. Kelsey
- Department of Medicine, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
| | - Steven E. Reis
- Department of Medicine, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
| | - Leslee J. Shaw
- Department of Medicine, Division of Cardiology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA 30322, USA
| | - George Sopko
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eileen Handberg
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, 1329 SW 16th Street, Gainesville, FL 32610, USA
| | - Carl J. Pepine
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, 1329 SW 16th Street, Gainesville, FL 32610, USA
| | - C. Noel Bairey Merz
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA 90048, USA
| |
Collapse
|
12
|
Rakhmat II, Putra ICS, Wibowo A, Henrina J, Nugraha GI, Ghozali M, Syamsunarno MRAA, Pranata R, Akbar MR, Achmad TH. Cardiometabolic risk factors in adults with normal weight obesity: A systematic review and meta-analysis. Clin Obes 2022; 12:e12523. [PMID: 35412026 DOI: 10.1111/cob.12523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 12/29/2022]
Abstract
Normal weight obesity (NWO) is a new emerging phenotype of obesity, defined as a normal body mass index with a high body fat percentage. While several studies have described the impact of NWO on cardiometabolic risk factors, the association between them remains uncertain. This meta-analysis systematically evaluated cardiometabolic risk factors in adults with NWO compared to adults with normal weight lean (NWL). A systematic literature search was performed from the inception until September 21, 2021 in order to comprehensively search for all observational studies that had three important variables, including adults (age ≥18 years old), NWO and cardiometabolic risk factors including metabolic syndrome, hypertension, diabetes mellitus, dyslipidaemia or all laboratory findings related to cardiometabolic risk factors. Twenty-four cross-sectional studies with a total of 75 201 subjects are included in the qualitative and quantitative analysis. Overall, older age and female sex are more likely in NWO population. Compared to NWL, NWO is significantly associated with cardiometabolic risk factors, including metabolic syndrome (OR = 2.24 [1.74, 2.89]; p < .001; I2 = 76%, Pheterogeneity < 0.001), hypertension (OR = 1.60[1.36, 1.89]; p < .001; I2 = 76%, Pheterogeneity < 0.001), diabetes mellitus (OR = 1.72[1.54, 1.92]; p < .001; I2 = 47%, Pheterogeneity < 0.001), dyslipidaemia (OR = 1.50 [1.03, 2.18]; p = .03; I2 = 94%, Pheterogeneity < 0.001) and other laboratory findings, except for C-reactive protein in both sexes group; and adiponectin levels in female group. Our meta-analysis showed that NWO was associated with cardiometabolic risk factors. Thus, the traditional definition of obesity using the BMI criteria should be challenged, as those with NWO might still be exposed to a heightened risk of cardiometabolic disorders. Nonetheless, further prospective cohort studies are needed better to understand this syndrome.
Collapse
Affiliation(s)
- Iis Inayati Rakhmat
- Department of Biochemistry, Faculty of Medicine, Jenderal Achmad Yani University, Kota Cimahi, Jawa Barat, Indonesia
| | - Iwan Cahyo Santosa Putra
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Arief Wibowo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - Joshua Henrina
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Gaga Irawan Nugraha
- Department of Basic Medical Science, Faculty of Medicine, Padjajadran University, Bandung, Indonesia
| | - Mohammad Ghozali
- Department of Basic Medical Science, Faculty of Medicine, Padjajadran University, Bandung, Indonesia
| | - Mas Rizky A A Syamsunarno
- Department of Basic Medical Science, Faculty of Medicine, Padjajadran University, Bandung, Indonesia
| | - Raymond Pranata
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
| | - Tri Hanggono Achmad
- Department of Basic Medical Science, Faculty of Medicine, Padjajadran University, Bandung, Indonesia
| |
Collapse
|
13
|
Prevalence of central obesity according to different definitions in normal weight adults of two cross-sectional studies in Panama. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100215. [PMID: 36777687 PMCID: PMC9904116 DOI: 10.1016/j.lana.2022.100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Methods Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Findings Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. Interpretation NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Funding Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.
Collapse
|
14
|
Mohammadian Khonsari N, Khashayar P, Shahrestanaki E, Kelishadi R, Mohammadpoor Nami S, Heidari-Beni M, Esmaeili Abdar Z, Tabatabaei-Malazy O, Qorbani M. Normal Weight Obesity and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:857930. [PMID: 35399938 PMCID: PMC8987277 DOI: 10.3389/fendo.2022.857930] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/14/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity is one of the most significant causes of morbidity and mortality worldwide. Current studies suggest a new type of obesity, normal weight obesity (NWO), which is defined as having a normal body mass index (BMI), but a high-fat percentage increases the risk of cardiometabolic risk factors (CMRFs). This systematic review and meta-analysis aimed to pool the association between NWO with CMRFs. METHODS A systematic search of the literature in all available electronic databases, including Scopus, Web of Science, EMBASE, and PubMed, was performed until October 2021. All English studies that assessed the association of NWOs [compared to normal weight non-obese (NWNO)] and the CMRFs were included. Two investigators extracted data and performed a quality assessment. The heterogeneity between studies was assessed with I-squared and Cochran's Q tests. Odds ratio (OR) was used as an effect size to pool the association of NWO with CMRFs. RESULTS Twenty-five articles that met the inclusion criteria entered the study. The total number of participants was 177,792, with an age range of 13 to 75 years. Most studies were conducted on the general population (adults) and were from China. The result of fixed-effect model meta-analysis indicated an increased odds of hyperglycemia (OR:1.50, 95%:1.23, 1.76), high TG (OR:1.90, 95% CH:1.44, 2.35), low HDL (OR: 1.28, 95% CI:1.06, 1.49) and diabetes (OR:1.39, 95% CI:1.30, 1.49). Moreover, the random effect meta-analysis showed that NWO increased the odds of dyslipidemia (OR:1.83, 95% CI:1.61, 20.4), HTN (OR:1.40, 95% CI:1.28, 1.51) and metabolic syndrome (OR:1.92, 95% CI:1.58, 2.26). Moreover, the mean of all CMRFs except plasma glucose in NWO subjects was statistically higher than NWNO subjects (p-value<0.05). CONCLUSION The present study showed that NWO increased the odds of CMRFs. These findings indicate the inadequacy of the BMI measurement and the need for body fat assessment for a better obesity risk assessment.
Collapse
Affiliation(s)
| | - Patricia Khashayar
- Center for Microsystems Technology, Imec & Ghent University, Zwijnaarde-Gent, Belgium
| | - Ehsan Shahrestanaki
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Mohammadpoor Nami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Motahar Heidari-Beni
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Esmaeili Abdar
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Qorbani, ; Ozra Tabatabaei-Malazy,
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Mostafa Qorbani, ; Ozra Tabatabaei-Malazy,
| |
Collapse
|
15
|
Cota BC, Priore SE, Ribeiro SAV, Juvanhol LL, de Faria ER, de Faria FR, Pereira PF. Cardiometabolic risk in adolescents with normal weight obesity. Eur J Clin Nutr 2021; 76:863-870. [PMID: 34711932 DOI: 10.1038/s41430-021-01037-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were carried out on the topic with adolescents. OBJECTIVE To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents. SUBJECTS/METHODS Cross-sectional study, with 506 normal weight adolescents aged 10-19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype. RESULTS NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27-1.47), WHR (OR = 25.89;95%CI = 10.43-64.26) and android fat (OR = 1.49;95%CI = 1.36-1.63); insulin resistance (OR = 4.09;95%CI = 1.72-9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50-9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21-15.08); uric acid (OR = 1.81;95%CI = 1.29-2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47-7.81), total cholesterol (OR = 2.77;95%CI = 1.22-6.29), and in at least one (OR = 1.87;95%CI = 1.04-3.37) or two (OR = 6.61;95%CI = 1.45-30.19) components of MS. CONCLUSION NWO is associated with the presence of cardiometabolic risk factors in adolescents.
Collapse
Affiliation(s)
- Bruna Clemente Cota
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil.
| | - Silvia Eloiza Priore
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
| | | | - Leidjaira Lopes Juvanhol
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
| | | | - Franciane Rocha de Faria
- Instituto de Ciências Exatas e Naturais, Universidade Federal de Rondonópolis, Rondonópolis, Mato Grosso, Brazil
| | - Patrícia Feliciano Pereira
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais (MG), Brazil
| |
Collapse
|
16
|
Osuna-Padilla IA, Rodríguez-Moguel NC, Aguilar-Vargas A, Rodríguez-Aguirre E, Briceño O, Ávila-Ríos S. Normal weight obesity is associated with hypercholesterolemia and low muscle mass in persons living with HIV on antiretroviral treatment. Nutrition 2021; 94:111515. [PMID: 34844155 DOI: 10.1016/j.nut.2021.111515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/22/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Normal weight obesity (NWO) is defined as a condition of normal body weight, but with high body fat percentage. Clinical and immunologic implications of NWO in persons living with HIV (PLHIV) remain unknown. The aim of this study was to examine NWO prevalence and its associations with metabolic and immunologic measurements in a cohort of PLHIV on antiretroviral treatment (ART). METHODS We enrolled 73 adult PLHIV on ART. Body composition was assessed by dual-energy x-ray absorptiometry. NWO was defined as body mass index 18.5 to 24.9 kg/m2 and body fat ≥25%. We determined triacylglycerols, total cholesterol, high-density lipoprotein, low-density lipoprotein, blood glucose, blood pressure, bone mineral density, inflammatory cytokines (interleukin [IL]-1β, tumor necrosis factor-α and IL-6) and CD4+ and CD8+ T-cell activation. RESULTS The prevalence of NWO was 49% (36 of 73). Participants with NWO showed lower CD4+ T-cell percentage (25 versus 27%, P = 0.03), lower CD4/CD8 ratio (0.62 versus 0.82, P = 0.02), lower muscle mass (6.84 versus 7.11 kg/m2, P = 0.01) and higher prevalence of hypercholesterolemia (26% versus 6%, P = 0.03) than individuals with normal body composition. No differences in inflammation/activation markers were observed between groups (P > 0.05 in all cases). CONCLUSION NWO was frequent in a cohort of Mexican PLHIV on ART and was associated with lower muscle mass, hypercholesterolemia, lower CD4+ T-cell percentage, and lower CD4/CD8 ratio. The incorporation of body fat measurements in the regular physical examination of PLHIV could contribute to early identification of the NWO condition and lead to better management of possible long-term morbidity.
Collapse
Affiliation(s)
- Ivan A Osuna-Padilla
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Nadia C Rodríguez-Moguel
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Adriana Aguilar-Vargas
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Edna Rodríguez-Aguirre
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Olivia Briceño
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| |
Collapse
|
17
|
Lee G, Choi S, Park SM. Association of waist circumference with muscle and fat mass in adults with a normal body mass index. Nutr Res Pract 2021; 15:604-612. [PMID: 34603608 PMCID: PMC8446684 DOI: 10.4162/nrp.2021.15.5.604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/OBJECTIVES We aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently. SUBJECTS/METHODS We analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates. RESULTS We observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5–18.3), 21.0 (20.6–21.5), 22.1 (21.5–22.8), and 25.1 (24.2–26.1) in men and 29.7 (29.4–30.0), 32.0 (31.6–32.3), 32.9 (32.4–33.4), and 34.7 (33.2–36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m2) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51–7.59), 7.62 (7.56–7.68), 7.65 (7.56–7.74), and 7.22 (7.04–7.41) in men and 5.83 (5.80–5.85), 5.96 (5.92–6.00), 6.03 (5.96–6.10), and 5.88 (5.73–6.03). CONCLUSIONS There was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.
Collapse
Affiliation(s)
- Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| |
Collapse
|
18
|
Normal weight obesity and unaddressed cardiometabolic health risk-a narrative review. Int J Obes (Lond) 2021; 45:2141-2155. [PMID: 34007010 DOI: 10.1038/s41366-021-00858-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023]
Abstract
Normal weight obesity (NWO) is defined as having a normal body mass index (BMI), but a high body fat mass. There is growing interest in individuals with NWO, which is an underdiagnosed and understudied group, because of their increased risk for cardiometabolic morbidity and mortality. In this review, we summarized the definition, prevalence, etiology, pathophysiology, and cardiovascular outcomes seen in NWO. We have also summarized the available literature on interventions for NWO. There is a wide variation in the body fat percent cutoffs used to diagnose excess body fat. Hence, the prevalence rates of NWO vary between different populations and studies. It is estimated that about 30 million Americans have NWO and the worldwide prevalence ranges from 4.5% to 22%. Genetics, diet, and physical activity are related to NWO. However, etiological factors are not clear. Changes in body composition, inflammation, oxidative stress are present in NWO in comparison to normal weight lean (NWL) who have a normal BMI and normal body fat amount. Furthermore, cardiometabolic changes are observed and some are subclinical. Thus, screening for NWO will enhance the primary prevention of cardiovascular disease. Due to the use of various body fat percent cutoffs and methods to measure body fat, it is challenging to compare between studies. Researchers working in this field should ideally work towards developing standard body fat percent cutoffs for diagnosing NWO. There are many gaps in the literature on NWO unlike for overt obesity and future studies should explore the etiology, molecular mechanisms, and adipose tissue changes of NWO as well as conduct well planned and executed randomized controlled trials testing dietary, physical, and behavioral interventions for NWO in both males and females of different racial and age groups.
Collapse
|
19
|
Insufficient Physical Fitness and Deficits in Basic Eating Habits in Normal-Weight Obese Children Are Apparent from Pre-School Age or Sooner. Nutrients 2021; 13:nu13103464. [PMID: 34684465 PMCID: PMC8538680 DOI: 10.3390/nu13103464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022] Open
Abstract
Normal-weight obesity appears to be an extended diagnosis/syndrome associated with insufficient physical fitness levels and inadequate eating habits at least from school years. However, its relation to long term health parameters in pre-school children remains unknown, even though pre-school age is crucial for the determining healthy lifelong habits. Therefore, the aim of the current study was to investigate the differences in physical fitness level and basic eating habits between normal-weight obese, normal-weight non-obese, and overweight and obese preschoolers. The research sample consisted of 188 preschoolers aged 4.0–6.9 years (Mage = 5.52 ± 0.8 year), normal-weight obese = 25; normal-weight non-obese = 143, overweight and obese = 20. Body composition was measured using bio-impedance InBody230. Six tests assessed the physical fitness level: sit-ups; standing long jump; shuttle running 4 × 5 meters; throwing with a tennis ball; multistage fitness tests; sit and reach. A four-item eating habits questionnaire for parents focusing on breakfast regularity, consumption of sweet foods and drinks, selection of food and attitude towards eating was used. A non-parametric analysis of variance and Fisher’s exact test along with suitable effect sizes were used for data processing of physical fitness tests and the basic eating habits questionnaire, respectively. Normal-weight obese children performed significantly worse (from p = 0.03 to p < 0.001, ES ω2-G = low to medium) in muscular fitness, cardiorespiratory fitness and running agility compared to normal-weight non-obese counterparts and did not significantly differ in the majority of physical fitness performance tests from overweight and obese peers. In basic eating habits, normal-weight obese boys preferred significantly more sweet foods and drinks (p = 0.003 ES = 0.35, large), while normal-weight obese girls had significantly more negative attitude towards eating (p = 0.002 ES = 0.33, large) in comparison to their normal-weight non-obese peers. Normal-weight obesity seems to develop from early childhood and is associated with low physical fitness and deficits in eating habits which might inhibit the natural necessity for physically active life from pre-school age or sooner.
Collapse
|
20
|
Brown AF, Alfiero CJ, Brooks SJ, Kviatkovsky SA, Smith-Ryan AE, Ormsbee MJ. Prevalence of Normal Weight Obesity and Health Risk Factors for the Female Collegiate Dancer. J Strength Cond Res 2021; 35:2321-2326. [PMID: 34398079 DOI: 10.1519/jsc.0000000000004064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Brown, AF, Alfiero, CJ, Brooks, SJ, Kviatkovsky, SA, Smith-Ryan, AE, and Ormsbee, MJ. Prevalence of normal weight obesity and health risk factors for the female collegiate dancer. J Strength Cond Res 35(8): 2321-2326, 2021-The purpose of this study was to investigate the prevalence of normal weight obesity (NWO) and evaluate the relationship between NWO and health risk factors in a collegiate dancer population. Reanalysis of data of female dancers (N = 42) from 2 larger studies was used to assess prevalence and health risk factors of NWO. Dancers completed a dual-energy x-ray absorptiometry scan to assess fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT) and a 3-day food record. Normal weight obesity was defined as a body mass index (BMI) of 18.5-24.9 kg·m-2 and body fat (BF) ≥30%. Twenty-five (60%) dancers were classified as normal weight lean (NWL), and 17 dancers (40%) were classified as NWO. Significant differences were observed for BMI (NWL: 21.1 ± 1.7, NWO: 23.1 ± 1.6, p < 0.001), LM (NWL: 71.0 ± 2.9%, NWO: 62.5 ± 2.7%, p < 0.001), %BF (NWL: 24.8 ± 3.1%, NWO: 33.9 ± 2.6%, p < 0.001), and VAT (NWL: 130.6 ± 43.0 g, NWO: 232.3 ± 70.8 g, p < 0.001) between NWL and NWO. A significant difference was observed for carbohydrate intake (NWL: 4.7 ± 1.8 g·kg-1, NWO: 3.7 ± 1.0 g·kg-1, p = 0.020) between groups. Significant positive correlations with FM were observed between carbohydrate (kcal, p = 0.048), fat (kcal, p = 0.018; g·kg-1, p = 0.040), and total calories (p = 0.019) in NWO. Normal weight obesity in collegiate dancers may be more prevalent than previously perceived and may be significantly related to important health risk factors. The current study demonstrates the need for body composition assessments and emphasizing on promoting overall health in collegiate dancers.
Collapse
Affiliation(s)
- Ann F Brown
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Christopher J Alfiero
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Samantha J Brooks
- Department of Movement Sciences, Human Performance Laboratory, University of Idaho, Moscow, Idaho
| | - Shiloah A Kviatkovsky
- Department of Nutrition, Food & Exercise Sciences, Institute of Sport Sciences & Medicine, Florida State University, Tallahassee, Florida
| | - Abbie E Smith-Ryan
- Department of Exercise & Sport Science, Applied Physiology Laboratory, University of North Carolina Chapel Hill, Chapel Hill, North Carolina; and
| | - Michael J Ormsbee
- Department of Nutrition, Food & Exercise Sciences, Institute of Sport Sciences & Medicine, Florida State University, Tallahassee, Florida.,Discipline of Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
21
|
Bellissimo MP, Hsu E, Hao L, Easley K, Martin GS, Ziegler TR, Alvarez JA. Relationships between plasma apelin and adiponectin with normal weight obesity, body composition, and cardiorespiratory fitness in working adults. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2021; 24:100257. [PMID: 34178605 PMCID: PMC8213890 DOI: 10.1016/j.jcte.2021.100257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022]
Abstract
Background A significant proportion of adults have normal weight obesity (NWO), defined as a normal body mass index (BMI) but disproportionately high body fat percentage. Individuals with NWO may have increased risk of cardiometabolic disorders and lower exercise tolerance, but it is unclear if this obesity phenotype is linked with dysregulated production of adipokines or myokines such as adiponectin and apelin, respectively. Methods This cross-sectional, secondary analysis included 177 working adults (mean age 49.6 ± 9.9 yrs, 64% female). Plasma high-molecular weight adiponectin and apelin levels were measured by ELISA. Body composition and fat distribution were assessed using dual energy X-ray absorptiometry. Exercise tolerance (VO2 maximum) was determined by treadmill testing. NWO was defined as a BMI <25 kg/m2 and body fat >30% for women or >23% for men. Participants were categorized as lean, NWO, or overweight-obese. Results A total of 14.7% of subjects were categorized as lean, 23.7% as having NWO, and 61.6% as having overweight-obesity. Plasma adiponectin levels were elevated in the overweight-obesity group (P < 0.05) compared to the lean and NWO groups, which did not differ from each other (P > 0.05). Adiponectin concentrations were inversely associated with BMI, fat mass, fat mass percent, visceral fat, and trunk to leg fat ratio and positively associated with leg fat mass (all P < 0.001). Plasma apelin levels were similar between the three body composition groups (P < 0.05) and were not significantly associated with any body composition indices. Apelin concentrations were inversely related to VO2 maximum (β = −0.03 ± 0.01, p = 0.002). Conclusion Plasma adiponectin and apelin levels did not distinguish between lean and NWO groups. Positive relationships with leg fat mass and adiponectin suggest the importance of assessing body composition and fat distribution when studying adipokines and cardiometabolic disorders. Further investigations are needed to understand relationships between exercise, body composition, and apelin secretion.
Collapse
Affiliation(s)
- Moriah P Bellissimo
- Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Emory Hsu
- Santa Clara Valley Medical Center, San Jose, CA, USA.,Stanford School of Medicine, Palo Alto, CA, USA
| | - Li Hao
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Kirk Easley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Greg S Martin
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Thomas R Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Emory Center for Clinical and Molecular Nutrition, Emory University, Atlanta, GA, USA.,Section of Endocrinology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Jessica A Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Emory Center for Clinical and Molecular Nutrition, Emory University, Atlanta, GA, USA
| |
Collapse
|
22
|
Liu B, Giffney HE, Arthur RS, Rohan TE, Dannenberg AJ. Cancer Risk in Normal Weight Individuals with Metabolic Obesity: A Narrative Review. Cancer Prev Res (Phila) 2021; 14:509-520. [PMID: 33563604 PMCID: PMC8102335 DOI: 10.1158/1940-6207.capr-20-0633] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 11/16/2022]
Abstract
Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.
Collapse
Affiliation(s)
- Bethina Liu
- MD Program, Weill Cornell Medicine, New York, New York
| | | | | | | | | |
Collapse
|
23
|
Normal weight obesity and the risk of diabetes in Chinese people: a 9-year population-based cohort study. Sci Rep 2021; 11:6090. [PMID: 33731778 PMCID: PMC7969601 DOI: 10.1038/s41598-021-85573-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/03/2021] [Indexed: 11/20/2022] Open
Abstract
We evaluated the risk of developing diabetes in Chinese individuals with normal weight obesity (NWO). This 9-year population-based cohort study was based on the China National Diabetes and Metabolic Disorders Survey. A total of 1128 subjects without diabetes were included. Body fat percentage (BF%) was assessed by electrical bioimpedance. NWO was defined as subjects with a normal BMI (< 24 kg/m2) and an excess BF% (≥ 24% in men; ≥ 33% in women). Of 1128 individuals, 528 individuals were normal weight non-obese (NWNO), 118 (10.5%) were normal weight obese (NWO), 63 were overweight non-obese (OWNO), and 419 were overweight obese (OWO). During a follow-up of 9.0 years (interquartile range: 8.9–9.3), 113 (10.0%) individuals developed diabetes. The incidence rates of diabetes in NWNO, NWO, OWNO and OWO people were 5.69 (27 cases), 11.30 (12 cases), 3.53 (2 cases) and 19.09 (72 cases) per 1000 person-years, respectively. Cox regression analyses indicated multivariate-adjusted hazard ratios of diabetes in NWO, OWNO and OWO people were 2.110 (95% CI 1.026–4.337, p = 0.025), 0.441 (95% CI 0.101–1.928, p = 0.232) and 3.465 (95% CI 2.163–5.551, p < 0.001), respectively, relative to NWNO people. Chinese people with NWO are at increased risk of developing diabetes. We strongly suggest the incorporation of BF% measurement into the regular physical examination in Chinese medical practice.
Collapse
|
24
|
Gómez-Zorita S, Queralt M, Vicente MA, González M, Portillo MP. Metabolically healthy obesity and metabolically obese normal weight: a review. J Physiol Biochem 2021; 77:175-189. [PMID: 33704694 DOI: 10.1007/s13105-020-00781-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023]
Abstract
Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.
Collapse
Affiliation(s)
- Saioa Gómez-Zorita
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain. .,BIOARABA Health Research Institute, Vitoria, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain.
| | - Maite Queralt
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain
| | - Maria Angeles Vicente
- BIOARABA Health Research Institute, Vitoria, Spain.,Alava University Hospital (Osakidetza), Vitoria, Spain
| | - Marcela González
- Nutrition and Food Science Department, Faculty of Biochemistry and Biological Sciences, National University of Litoral and National Scientific and Technical Research Council (CONICET), 3000, Santa Fe, Argentina
| | - María P Portillo
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain.,BIOARABA Health Research Institute, Vitoria, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain
| |
Collapse
|
25
|
Bennouar S, Bachir Cherif A, Temmar M, Fauvel JP, Bouafia MT, Abdi S. Combined effect of obesity and metabolic profile on glomerular dysfunction in hypertensive subjects. Nephrology (Carlton) 2021; 26:578-585. [PMID: 33634933 DOI: 10.1111/nep.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/07/2021] [Accepted: 02/19/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study is to explore the individual and combined effects of obesity and metabolic profile on the impairment of glomerular function among hypertensive subjects. METHODS This is a cross-sectional study enrolling 499 hypertensive subjects. Based on body mass index values and metabolic profile, they were assigned to one of four metabolic phenotype groups: MHNO: metabolically healthy non-obese, MHO: metabolically healthy but obese, MUHNO: metabolically unhealthy but non-obese, and MUHO: metabolically unhealthy and obese. The effect of the interaction between obesity and metabolic profile was tested on an additive scale, for both microalbuminuria and reduced estimated glomerular filtration rate (eGFR). RESULTS After adjustment for confounding factors, the highest risk of both microalbuminuria and decreased eGFR was found among patients of the MUHO group (OR = 6.0 [2.13], p < 0.0001, OR = 5.4 [1.26], p = 0.03, respectively). Analysis of the additive interaction indicates that 51% and 53% of the risk of microalbuminuria and its combination with low eGFR respectively is explained by the co-occurrence of obesity and metabolic disorder. The mechanism of this interaction is synergistic (synergy index = 2.6, [1.5.3]). CONCLUSION The decline of glomerular function in hypertensive subjects is significantly exacerbated by the interaction between obesity and metabolic disorders. The management of such high-risk subjects requires, in addition to the therapeutic regimen, an adequate dietary and physical program in order to preserve glomerular function.
Collapse
Affiliation(s)
- Salam Bennouar
- Central Laboratory of Clinical Biology, University Hospital Center of Blida, Blida, Algeria
| | - Abdelghani Bachir Cherif
- Department of Internal Medicine and Cardiology, University Hospital Center of Blida, Blida, Algeria
| | - Mohamed Temmar
- Department of Internal Medicine and Cardiology, University Hospital Center of Blida, Blida, Algeria
| | - Jean-Pierre Fauvel
- Department of Nephrology-Hypertension, Claude Bernard University, Lyon, France
| | - Mohamed Tahar Bouafia
- Department of Internal Medicine and Cardiology, University Hospital Center of Blida, Blida, Algeria
| | - Samia Abdi
- Central Laboratory of Clinical Biology, University Hospital Center of Blida, Blida, Algeria
| |
Collapse
|
26
|
Coelho CCNDS, Bragança MLBM, de Oliveira BR, Bettiol H, Barbieri MA, Cardoso VC, Silva AAMD. Incidence of metabolic syndrome in adults with healthy weight, normal weight obesity, and overweight/obesity. Nutrition 2020; 85:111134. [PMID: 33578242 DOI: 10.1016/j.nut.2020.111134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to estimate the incidence of metabolic syndrome (MetS) in individuals with a healthy weight (HWI), normal weight obesity (NWO), or overweight/obesity (OWO). METHODS In all, 787 adults belonging to a 1978/1979 birth cohort from Ribeirão Preto were placed into one of three groups: HWI (body mass index [BMI] ≥18.5 and <25 kg/m2 + ∑skinfolds ≤90th percentile); NWO (BMI ≥18.5 and <25 kg/m2 +∑skinfolds >90th percentile); and OWO (BMI ≥25 kg/m2 +∑skinfolds >90th percentile). Those diagnosed with MetS at the 23 to 25 y of age were excluded according to Joint Interim Statement criteria. The incidence of MetS and its components in individuals 37 to 39 y of age was evaluated by Poisson regression with robust estimation of variance, which was adjusted for family income; physical activity level; and daily intake of calories, lipids, and added sugar. RESULTS MetS was detected in 279 adults at 37 to 39 y of age. NWO and OWO individuals showed higher risk ratios (RRs) for the development of MetS (RR,1.87; 95% confidence interval [CI], 1.36-2.57; RR, 1.61; 95% CI, 1.29-2.03), increased blood glucose levels (RR, 1.77; 95% CI, 1.12-2.79; RR, 1.51; 95% CI, 1.12-2.04), and increased waist circumferences (RR, 1.46; 95% CI, 1.32-1.61; RR, 1.50; 95% CI, 1.38-1.62). There was a higher risk for increased blood pressure (RR, 1.72; 95% CI, 1.35-2.19) among OWO individuals, but not among those with NWO. CONCLUSION Individuals with NWO have a risk ratio for MetS similar to individuals with OWO. This demonstrates the need to assess body fat percentages, even in BMI-designated normal weight individuals, both for prevention and management of obesity.
Collapse
Affiliation(s)
| | | | - Bianca Rodrigues de Oliveira
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| |
Collapse
|
27
|
Bellissimo MP, Bettermann EL, Tran PH, Crain BH, Ferranti EP, Binongo JN, Hartman TJ, Jones DP, Ziegler TR, Alvarez JA. Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults. J Acad Nutr Diet 2020; 120:1963-1973.e2. [PMID: 33011149 PMCID: PMC7686254 DOI: 10.1016/j.jand.2020.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 06/27/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown. OBJECTIVE The objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as lean, NWO, and overweight-obese. Secondary objectives of the study were to compare clinical biomarkers and food groups and macronutrient intakes between the three groups, and to test for associations between body composition components with diet quality scores and physical fitness levels. DESIGN This is a secondary data analysis from a cross-sectional study that included metropolitan university and health care system employees. Body composition was measured by dual energy x-ray absorptiometry. Individuals with a body mass index <25 kg/m2 and body fat >23% for men and >30% for women were classified as having NWO. Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score were calculated from Block food frequency questionnaires. Physical fitness was assessed by measuring maximal oxygen uptake (VO2 maximum) during treadmill testing. PARTICIPANTS/SETTING This study included 693 adults (65% women, mean age 48.9 ± 11.5 years) enrolled between 2007 and 2013 in Atlanta, GA. MAIN OUTCOME MEASURES The main outcome measures were Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Mediterranean Diet Score diet quality scores and maximal oxygen uptake. STATISTICAL ANALYSES Multiple linear regression analyses with post hoc comparisons were used to investigate group differences in fitness, diet quality, and biomarkers. Regression analyses were also used to examine relationships between diet quality scores and fitness with body composition. RESULTS VO2 maximum was significantly lower in the NWO compared with the lean group (36.2 ± 0.8 mL/min/kg vs 40.2 ± 1.0 mL/min/kg; P < 0.05). Individuals with NWO reported similar diet quality to lean individuals and more favorable Alternate Healthy Eating Index and Dietary Approaches to Stop Hypertension scores than individuals with overweight-obesity (P < 0.05). Diet quality scores and physical fitness levels were inversely associated with percent body fat and visceral adipose tissue (P < 0.05), regardless of weight status. Individuals with NWO exhibited higher fasting blood insulin concentrations, insulin resistance, low-density lipoprotein cholesterol, and triglyceride levels, and significantly lower high-density lipoprotein cholesterol levels than lean individuals (P < 0.05). CONCLUSIONS Physical fitness was significantly decreased in individuals with NWO compared with lean individuals. Higher diet quality was associated with decreased total and visceral fat but did not distinguish individuals with NWO from lean individuals.
Collapse
Affiliation(s)
- Moriah P. Bellissimo
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University; Atlanta, GA, USA
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
| | - Erika L. Bettermann
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Phong H. Tran
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Benjamin H. Crain
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Erin P. Ferranti
- Nell Hodgson School of Nursing, Emory University; Atlanta, GA, USA
| | - Jose N. Binongo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Dean P. Jones
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Thomas R. Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Section of Endocrinology, Atlanta Veterans Affairs Medical Center; Decatur, GA, USA
| | - Jessica A. Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
| |
Collapse
|
28
|
Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review. Public Health Nutr 2020; 24:870-881. [PMID: 33256881 DOI: 10.1017/s1368980020004863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. DESIGN The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. SETTING School, university and population. PARTICIPANTS Adolescents between 10 and 19 years old. RESULTS A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. CONCLUSIONS The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).
Collapse
|
29
|
Taheri E, Hosseini S, Qorbani M, Mirmiran P. Association of adipocytokines with lipid and glycemic profiles in women with normal weight obesity. BMC Endocr Disord 2020; 20:171. [PMID: 33198735 PMCID: PMC7670687 DOI: 10.1186/s12902-020-00648-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/31/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Individuals with normal weight obesity (NWO) are predisposed to having cardiometabolic disorders. This study aims to investigate the circulating levels of vaspin, leptin and their association with glycemic and lipid profiles in women with NWO. METHODS Forty women with body mass index (BMI) = 18.5-24.9 kg/m2 and fat mass (FM) ≥ 30% were assigned in the NWO group. Thirty age-matched women with identical BMI range, and FM < 30% (normal weight non-obese; NWNO) were considered as a control group. In addition to anthropometric measurements, glycemic and lipid profiles and circulating levels of leptin and vaspin were measured. RESULTS The mean ± standard deviation (SD) age of participants was 28.76 ± 4.76 years in the NWO group and 29.23 ± 4.50 years in the control group. The NWO group had the higher mean serum levels of insulin (9.02 ± 4.75 vs. 6.24 ± 2.51, P = 0.009), leptin (17.31 ± 8.10 vs. 9.94 ± 4.30, P < 0.001) and homeostatic model assessment of insulin resistance (HOMA-IR) (33.77 ± 20.71 vs. 23.48 ± 10.03, P = 0.009) compared to the NWNO group. The serum level of vaspin was higher in the NWO group compared to the control group (34.82 pg/ml vs. 27.72 pg/ml, respectively, P = 0.12). In NWO group, the serum levels of leptin had positive correlation with FBS (r = 0.45, P = 0.02), insulin (r = 0.51, P = 0.008), and HOMA-IR (r = 0.46, P = 0.02) and vaspin concentration was associated with insulin (r = 0.36, P = 0.02) and HOMA-IR (r = 0.30, P = 0.06), positively. CONCLUSION It is concluded that the concentration of insulin and HOMA-IR index were significantly higher in women with NWO compared to NWNO. Higher concentrations of leptin and vaspin in the NWO group were associated with glycemic profile.
Collapse
Affiliation(s)
- Ehsaneh Taheri
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, 19839-63113, Iran.
| | - Saeed Hosseini
- Department of Clinical Nutrition, School of Nutritional Scientists and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
30
|
Tian Q, Wang H, Kaudimba KK, Guo S, Zhang H, Gao S, Wang R, Luan X, Lee JKW, Chen P, Liu T, Wang R. Characteristics of Physical Fitness and Cardiometabolic Risk in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4157-4167. [PMID: 33177856 PMCID: PMC7649220 DOI: 10.2147/dmso.s280350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To (i) describe the characteristics of physical fitness and cardiometabolic risk in Chinese university students with normal-weight obesity (NWO); (ii) assess the association between NWO with physical fitness and cardiometabolic risk. METHODS A total of 249 participants from the 2018 Shanghai University of Sport Alumni Health Cohort Study in China formed the study cohort. NWO was defined as normal body mass index (17.9-23.9 kg/m2 for males; 17.2-23.9 kg/m2 for females) but with excess body-fat percentage (≥20% for males; ≥30% for females). Body composition was assessed by dual-energy X-ray absorptiometry. Physical-fitness scores were calculated from a battery of sex-specific tests. Cardiometabolic risk was calculated using a continuous clustered risk (MetS) score. RESULTS We found that 16.7% of male and 45.3% of female university students were classified as having NWO. Participants with NWO showed worse cardiorespiratory fitness than those with normal weight (NW) (male NWO (37±8) vs male NW (41±6) mL/kg/min, p<0.01; female NWO (31±4) vs female NW (33±6) mL/kg/min, p<0.01). NWO was associated negatively with the fitness score (OR = 0.853; 95% CI = 0.793-0.917) and was associated positively with the MetS score (1.280; 1.162-1.410). CONCLUSION University students with NWO were characterized by higher cardiometabolic risk and lower levels of physical fitness. Our findings implied that university students with NWO should be mindful of the potential hidden health risks of excess body fat and participate in exercise to enhance physical fitness.
Collapse
Affiliation(s)
- Qianqian Tian
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Hui Wang
- State Key Laboratory of Genetic Engineering, Department of Endocrinology and Metabolism, Institute of Metabolism and Integrative Biology, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | | | - Shanshan Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Haixin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Song Gao
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Ruwen Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Xin Luan
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Jason Kai Wei Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Global Asia Institute, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
| | - Peijie Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Tiemin Liu
- State Key Laboratory of Genetic Engineering, Department of Endocrinology and Metabolism, Institute of Metabolism and Integrative Biology, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of China
| |
Collapse
|
31
|
Prevalence of normal weight obesity and its associated cardio-metabolic risk factors - Results from the baseline data of the Kerala Diabetes Prevention Program (KDPP). PLoS One 2020; 15:e0237974. [PMID: 32841271 PMCID: PMC7446975 DOI: 10.1371/journal.pone.0237974] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023] Open
Abstract
Background Cardiometabolic disorders are frequently observed among those who have obesity as measured by body mass index (BMI). However, there is limited data available on the cardiometabolic profile of those who are non-obese by BMI but with a high body fat percentage (BFP), a phenotype frequently observed in the Indian population. We examined the prevalence of individuals with normal weight obesity (NWO) and the cardiometabolic profile of NWO individuals at high risk for type 2 diabetes(T2D) in a south Asian population. Material and methods In the Kerala Diabetes Prevention Program, individuals aged between 30 to 60 years were screened using the Indian Diabetes Risk Score(IDRS) in 60 rural communities in the Indian state of Kerala. We used data from the baseline survey of this trial for this analysis which included 1147 eligible high diabetes risk individuals(IDRS >60). NWO was defined as BMI within the normal range and a high BFP (as per Asia-pacific ethnicity based cut-off); Non-obese (NO) as normal BMI and BFP and overtly obese (OB) as BMI ≥25 kg/m2 irrespective of the BFP. Data on demographic, clinical and biochemical characteristics were collected using standardized questionnaires and protocols. Body fat percentage was assessed using TANITA body composition analyser (model SC330), based on bioelectrical impedance. Results The mean age of participants was 47.3 ± 7.5 years and 46% were women. The proportion with NWO was 32% (n = 364; 95% CI: 29.1 to 34.5%), NO was 17% (n = 200) and OB was 51% (n = 583). Among those with NWO, 19.7% had T2D, compared to 18.7% of those who were OB (p value = 0.45) and 8% with NO (p value = 0.003). Among those with NWO, mean systolic and diastolic blood pressure were 129 ± 20; 78 ± 12 mmHg, compared to 127 ± 17; 78±11 mmHg among those with OB (p value = 0.12;0.94) and 120 ± 16; 71±10 mmHg among with NO (p value<0.001; 0.001), respectively. A similar pattern of association was observed for LDL cholesterol and triglycerides. After adjusting for other risk factors, the odds of having diabetes (OR:2.72[95% CI:1.46–5.08]) and dyslipidemia (2.37[1.55–3.64]) was significantly more in individuals with NWO as compared to non-obese individuals. Conclusions Almost one-third of this South Asian population, at high risk for T2D, had normal weight obesity. The significantly higher cardiometabolic risk associated with increased adiposity even in lower BMI individuals has important implications for recognition in clinical practice.
Collapse
|
32
|
Kapoor N, Lotfaliany M, Sathish T, Thankappan KR, Tapp RJ, Thomas N, Furler J, Oldenburg B. Effect of a Peer-led Lifestyle Intervention on Individuals With Normal Weight Obesity: Insights From the Kerala Diabetes Prevention Program. Clin Ther 2020; 42:1618-1624. [PMID: 32718783 DOI: 10.1016/j.clinthera.2020.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/22/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Normal weight obesity (NWO) is a unique phenotype of obesity associated with high cardiovascular mortality. There is limited literature on assessing the effect of therapeutic interventions on the cardiometabolic health of these individuals. We studied the effect of a peer-led lifestyle intervention on key cardiometabolic parameters (blood glucose, blood pressure, and plasma lipids) in individuals with NWO. METHODS This study is a secondary data analysis of the Kerala Diabetes Prevention Program, a cluster-randomized controlled study that involves a peer-led, real-life lifestyle intervention for individuals from the community between the ages of 30 and 60 years with a high diabetes risk. Participants underwent a rigorous cardiometabolic evaluation at baseline and at 2-year follow-up. FINDINGS A total of 292 recruited individuals with NWO were randomized into the intervention (n = 159) and control (n = 133) arms. At 2 years of follow-up, there was minimal but statistically significant improvement in systolic blood pressure and serum HDL level in the intervention arm, but no statistical difference was seen in other lipid and glycemic parameters. IMPLICATIONS This study provides early evidence of the effect of a lifestyle intervention in a cohort of individuals with NWO. Only systolic blood pressure and serum HDL level had a mild favorable change in the intervention arm when compared with the control arm.
Collapse
Affiliation(s)
- Nitin Kapoor
- Department of Endocrinology, Diabetes, and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India; Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Science, The University of Melbourne, Melbourne, Australia.
| | - Mojtaba Lotfaliany
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Science, The University of Melbourne, Melbourne, Australia
| | - Thirunavukkarasu Sathish
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Science, The University of Melbourne, Melbourne, Australia; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kavumpurathu R Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India; Department of Public Health and Community Medicine, Central University, Kasaragod, Kerala, India
| | - Robyn J Tapp
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Science, The University of Melbourne, Melbourne, Australia; The School of Biomedical Engineering and Imaging Sciences, Kings College London, London, United Kingdom; Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, United Kingdom
| | - Nihal Thomas
- Department of Endocrinology, Diabetes, and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - John Furler
- Department of General Practice, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Australia
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry, and Health Science, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
33
|
Marzullo P, Di Renzo L, Pugliese G, De Siena M, Barrea L, Muscogiuri G, Colao A, Savastano S. From obesity through gut microbiota to cardiovascular diseases: a dangerous journey. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2020; 10:35-49. [PMID: 32714511 PMCID: PMC7371682 DOI: 10.1038/s41367-020-0017-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The co-existence of humans and gut microbiota started millions of years ago. Until now, a balance gradually developed between gut bacteria and their hosts. It is now recognized that gut microbiota are key to form adequate immune and metabolic functions and, more in general, for the maintenance of good health. Gut microbiota are established before birth under the influence of maternal nutrition and metabolic status, which can impact the future metabolic risk of the offspring in terms of obesity, diabetes, and cardiometabolic disorders during the lifespan. Obesity and diabetes are prone to disrupt the gut microbiota and alter the gut barrier permeability, leading to metabolic endotoxaemia with its detrimental consequences on health. Specific bacterial sequences are now viewed as peculiar signatures of the metabolic syndrome across life stages in each individual, and are linked to pathogenesis of cardiovascular diseases (CVDs) via metabolic products (metabolites) and immune modulation. These mechanisms have been linked, in association with abnormalities in microbial richness and diversity, to an increased risk of developing arterial hypertension, systemic inflammation, nonalcoholic fatty liver disease, coronary artery disease, chronic kidney disease, and heart failure. Emerging strategies for the manipulation of intestinal microbiota represent a promising therapeutic option for the prevention and treatment of CVD especially in individuals prone to CV events.
Collapse
Affiliation(s)
- Paolo Marzullo
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
- Division of General Medicine, IRCCS Istituto Auxologico Italiano, 28923 Piancavallo, Verbania Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00136 Rome, Italy
| | - Gabriella Pugliese
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
| | - Martina De Siena
- Division of Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luigi Barrea
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
| | - Annamaria Colao
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
| | - Silvia Savastano
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
| | - on behalf of Obesity Programs of nutrition, Education, Research and Assessment (OPERA) Group
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
- Division of General Medicine, IRCCS Istituto Auxologico Italiano, 28923 Piancavallo, Verbania Italy
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00136 Rome, Italy
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131 Naples, Italy
- Division of Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy
| |
Collapse
|
34
|
Lee G, Chang J, Hwang SS, Son JS, Park SM. Development and validation of prediction equations for the assessment of muscle or fat mass using anthropometric measurements, serum creatinine level, and lifestyle factors among Korean adults. Nutr Res Pract 2020; 15:95-105. [PMID: 33542795 PMCID: PMC7838475 DOI: 10.4162/nrp.2021.15.1.95] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/06/2020] [Accepted: 06/01/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008–2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland–Altman plot and intraclass correlation coefficient (ICC). RESULTS The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS All equations had low bias, moderate agreement based on the Bland–Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.
Collapse
Affiliation(s)
- Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| |
Collapse
|
35
|
The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial. Br J Nutr 2020; 124:1044-1051. [PMID: 32513334 DOI: 10.1017/s0007114520002019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Normal-weight obesity (NWO) syndrome is associated with metabolic diseases. The present study aimed to investigate the effects of 12 weeks of a high-protein (HP) v. a standard protein (SP) diet on appetite, anthropometry and body composition in NWO women. In this clinical trial, fifty NWO women were randomly allocated to HP (n 25) or SP (n 25) diet groups. Women in the HP and SP groups consumed 25 and 15 % of their total energy intake from protein for 12 weeks. Weight, fat mass (FM), lean body mass (LBM), waist circumference (WC) and appetite were evaluated at baseline and following their 3-month intervention. After 12 weeks, the LBM was higher in HP compared with no significant changes in the SP group (mean between-group difference = 1·5 kg; 95 % CI 3·1, 0·01; effect size (d) = 0·4). Furthermore, the HP group had lower FM (mean between-group difference -1·1 kg; 95 % CI 1, -3·3; d = -0·2), body fat percentage (BFP) (mean between-group difference -2 %; 95 % CI 0·7, -5·2; d = -0·3) and WC (mean between-group difference -1·4 cm; 95 % CI 0·6, -3·6; d = -0·2) at the end of the study in comparison with the SP group. In both groups, weight and appetite were unchanged over time without significant differences between groups. Twelve weeks of euenergetic diets with different dietary protein contents resulted in no significant weight loss in women with NWO. However, an HP diet significantly improved body composition (LBM, FM, BFP and WC) in this population.
Collapse
|
36
|
Correa-Rodríguez M, González-Ruíz K, Rincón-Pabón D, Izquierdo M, García-Hermoso A, Agostinis-Sobrinho C, Sánchez-Capacho N, Roa-Cubaque MA, Ramírez-Vélez R. Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults. Nutrients 2020; 12:E1106. [PMID: 32316150 PMCID: PMC7230158 DOI: 10.3390/nu12041106] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- María Correa-Rodríguez
- Faculty of Health, Department of Nursing, University of Granada, Av. Ilustración, 60, 18016 Granada, Spain;
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia;
| | - David Rincón-Pabón
- ZIPATEFI (Zona de Investigaciones de Posgrados, Terapia Respiratoria y Fisioterapia de Areandina), Fundación Universitaria del Área Andina, Pereira 110231, Colombia;
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio García-Hermoso
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago 7500618, Chile
| | | | - Nohora Sánchez-Capacho
- Facultad de Ciencias de la Salud- Universidad de Boyacá, Tunja 150003, Colombia; (N.S.-C.); (M.A.R.-C.)
| | | | - Robinson Ramírez-Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
37
|
Avolio E, Gualtieri P, Romano L, Pecorella C, Ferraro S, Palma G, Di Renzo L, De Lorenzo A. Obesity and Body Composition in Man and Woman: Associated Diseases and the New Role of Gut Microbiota. Curr Med Chem 2020; 27:216-229. [PMID: 30914014 DOI: 10.2174/0929867326666190326113607] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/18/2018] [Accepted: 02/19/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is now recognized as a worldwide health issue and has reached epidemic proportions, affecting both developed and developing countries. The World Obesity Federation stated that "Obesity is a chronic relapsing disease process": as a result, obesity has been recognized internationally as a chronic disease. The primary cause of the metabolic syndrome and increase of the cardiovascular risk have been identified in "sick fat", a condition then defined as adiposopathy. Heart attacks, strokes and renal failures are pathologies that have mid-risk factors such as dyslipidemia, hypertension and diabetes, which in turn are caused by obesity, whose primary risk factor is represented by the diet. The aim of the present review is to consider the importance of body composition, together with chronic inflammation and a new gut microbiota data that may turn out to be crucial elements of some target treatment of human obesity. METHODS In this review, we performed research using PubMed database reviewing the evidence in the literature of evidence information regarding the link between obesity and body composition in the development of metabolic disease via inflammation markers and in particular, the new role exerted by gut microbiota. RESULTS Several papers were evaluated searching for differences in fat mass and disease risk. We also identified the same papers dealing with differences in body composition and metabolic syndrome. Our attention focuses also on a new frontier of gut microbiota composition in the body weight decrease and anti-inflammatory effects. CONCLUSION To the saving of lean mass, for the prevention of cardiometabolic diseases, also considering the relationship with obesity, it is necessary to reduce the inflammatory state, acting on the gut-microbiota and on the intestinal permeability. To improve the health of the intestinal flora, we propose a 4P medicine and treatment with probiotics, prebiotics, postbiotics, and polyphenols.
Collapse
Affiliation(s)
- Ennio Avolio
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Health Center srl, via Sabotino 56, 87100 Cosenza, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Romano
- School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy
| | | | - Simona Ferraro
- School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Palma
- S.S.D. Sperimentazione Animale, Istituto Nazionale Tumori-IRCCS-"Fondazione G. Pascale", 80131 Naples, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
38
|
Čuta M, Bařicová K, Černý D, Sochor O. Normal-weight obesity frequency in the Central European urban adult female population of Brno, Czech Republic. Cent Eur J Public Health 2019; 27:131-134. [PMID: 31241288 DOI: 10.21101/cejph.a5133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/24/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The universally recognized indicator of nutritional status, BMI, has some shortcomings, especially in detecting overweight and obesity. A relatively recently introduced normal weight obesity (NWO) describes a phenomenon when individuals are found to have normal weight as indicated by BMI but have an elevated percentage of body fat. Normal weight obese individuals face a higher risk of developing metabolic syndrome, cardiometabolic dysfunction and have higher mortality. No studies have been previously performed which would map NWO in Brno, Czech Republic. METHODS In a sample of 100 women from Brno, we assessed the percentage of normal weight obese individuals using bioelectric impedance analysis (BIA) - three different analyzers were utilized: Tanita BC-545 personal digital scale, InBody 230 and BodyStat 1500MDD. Also, a caliperation method was used to estimate body fat percentage. Various body fat percentage cut-off points were used according to different authors. RESULTS When the 30% body fat (BF) cut-off was used, up to 14% of the women in our sample were found to be normal weight obese. When the sum of skinfolds or the 35% BF cut-off point are selected as a criterion for identifying normal weight obesity (NOW), only 1 of 100 examined women was identified as normal weight obese; at the 35% BF cut-off, BodyStat analyzer categorized no women as normal weight obese. Also, when the 30% BF or 66th percentile BF cut-off points were utilized, BodyStat identified pronouncedly fewer women from our sample to be normal-weight obese than the two other analyzers. CONCLUSIONS On a pilot sample of Czech women, we demonstrated that depending on the selected cut-off (there is no clear agreement on cut-off points in literature), up to 14% of the examined women were found to be normal weight obese.
Collapse
Affiliation(s)
- Martin Čuta
- Department of Anthropology, Faculty of Science, Masaryk University, Brno, Czech Republic.,International Clinical Research Centre, St. Anne᾿s University Hospital Brno, Brno, Czech Republic
| | - Klára Bařicová
- Department of Anthropology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Dominik Černý
- Department of Anthropology, Faculty of Science, Masaryk University, Brno, Czech Republic.,International Clinical Research Centre, St. Anne᾿s University Hospital Brno, Brno, Czech Republic
| | - Ondřej Sochor
- International Clinical Research Centre, St. Anne᾿s University Hospital Brno, Brno, Czech Republic
| |
Collapse
|
39
|
Kapoor N, Furler J, Paul TV, Thomas N, Oldenburg B. Normal Weight Obesity: An Underrecognized Problem in Individuals of South Asian Descent. Clin Ther 2019; 41:1638-1642. [PMID: 31270012 DOI: 10.1016/j.clinthera.2019.05.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 01/23/2023]
Abstract
PURPOSE Obesity has attained pandemic proportions across the world, and its prevalence in developing countries is also on the rise. Nevertheless, there is still a large gap in understanding the reasons behind a disproportionately high prevalence of diabetes as opposed to a lesser degree of obesity seen in individuals of South Asian origin. This research letter highlights the importance of identifying individuals with normal weight obesity, which may partially bridge this knowledge gap. METHODS We reviewed recently published evidence on normal weight obesity. FINDINGS Normal weight obesity is a common public health problem and may be prevalent in up to one-third of individuals of certain Asian ethnicities. Literature is emerging on its pathophysiology and association with metabolic diseases, such as type 2 diabetes mellitus, hypertension, and dyslipidemia. More recently, normal weight obesity was also identified as an independent strong predictor of cardiovascular mortality. However, evidence is particularly lacking on its appropriate management. IMPLICATIONS Normal weight obesity is an underrecognized yet widely prevalent problem in individuals of Asian descent. Further research on pathogenic mechanisms, diagnostic modalities, and therapeutic options in individuals with normal weight obesity is needed to appropriately manage this condition.
Collapse
Affiliation(s)
- Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India; Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Australia.
| | - John Furler
- Department of General Practice, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Australia
| | - Thomas V Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
40
|
Jung WS, Hwang H, Kim J, Park HY, Lim K. Comparison of excess post-exercise oxygen consumption of different exercises in normal weight obesity women. J Exerc Nutrition Biochem 2019; 23:22-27. [PMID: 31337202 PMCID: PMC6651661 DOI: 10.20463/jenb.2019.0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/27/2019] [Indexed: 11/22/2022] Open
Abstract
[Purpose] The purpose of this study was to compare the excess post-exercise oxygen consumption (EPOC) between different types of exercises in women with normal weight obesity (NWO). [Methods] Nine university students with NWO having body mass index <25 kg/m2 and body fat percentage >30% participated in the study. First, continuous exercise (CEx) on an ergometer for 30 minutes at 60% of maximal oxygen consumption (VO2max) and interval exercise (IEx) at 80% VO2max for 2 minutes were performed. This was followed by exercise performed at 40% VO2max for 1 minute and at 80% VO2max for 3 minutes, performed 6 times repeatedly for a total of 26 minutes. The accumulation of short duration exercise (AEx) was performed for 3-bouts of 10 minutes each at 60% VO2max. [Results] The major findings were as follows: energy consumption during the exercises showed no significant difference between CEx, IEx, and AEx; EPOC was higher in IEx and AEx as compared to CEx for all dependent variables (e.g. total oxygen consumption, total calorie, summation of heart rate, and EPOC duration); and the lipid profile showed no significant difference. [Conclusion] Our study confirmed that when homogenizing the energy expenditure for various exercises in NWO individuals, EPOC was higher in IEx and AEx than in CEx. Therefore, IEx and AEx can be considered as effective exercise methods for increasing energy expenditure in NWO females.
Collapse
|
41
|
Cline MG, Witzel AL, Moyers TD, Kirk CA. Body composition of lean outdoor intact cats vs lean indoor neutered cats using dual-energy x-ray absorptiometry. J Feline Med Surg 2019; 21:459-464. [PMID: 29911463 PMCID: PMC10814548 DOI: 10.1177/1098612x18780872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The objectives for this study were to compare the body composition of adult indoor neutered domestic cats with outdoor intact cats with an ideal body condition score using dual-energy x-ray absorptiometry, and to report the body composition findings of free-roaming cats, as this has not been previously reported. Most domestic house cats differ from free-roaming cats as they are confined indoors and neutered. Indoor neutered cats have reduced activity and hormonal alterations that may result in lower muscle mass and higher body fat percentages vs outdoor intact cats, despite similar body condition scores. METHODS Twenty-one outdoor intact cats (10 male, 11 female) were selected from a trap-neuter-return program and 16 indoor neutered domestic cats (10 male, six female) were client-owned. Inclusion criteria included an estimated age between 1 and 6 years, complete blood count, biochemistry panel, urinalysis, total thyroxine, feline leukemia virus/feline immunodeficiency virus screening and a body condition score of 4-5/9. RESULTS Indoor neutered cats had a higher body fat percentage (22.1% [range 17.3-28.2%]) than outdoor intact cats (17.3% [range 10.0-33.6%]; P = 0.002). Indoor neutered male cats had a higher body fat percentage ( P <0.001) than outdoor intact cats. No difference in body fat percentage was observed in female cats ( P = 0.159). Indoor neutered domestic cats had a higher bone mineral density than outdoor intact cats ( P = 0.023). CONCLUSIONS AND RELEVANCE The results of this study suggest indoor confinement and neutering increase body fat percentage and bone mineral density in cats with an ideal body condition score.
Collapse
Affiliation(s)
- Martha G Cline
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Angela L Witzel
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Tamberlyn D Moyers
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Claudia A Kirk
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| |
Collapse
|
42
|
De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? J Transl Med 2019; 17:169. [PMID: 31118060 PMCID: PMC6530037 DOI: 10.1186/s12967-019-1919-y] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/10/2019] [Indexed: 12/15/2022] Open
Abstract
Obesity must be considered a real pathology. In the world wide, obesity represent one of the major public health issue associated with increased morbidity and mortality. Overweight or obesity, in fact, significantly increases the risk of contracting diseases, such as: arterial hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, cerebral vasculopathy, gallbladder lithiasis, arthropathy, ovarian polycytosis, sleep apnea syndrome, and some neoplasms. Despite numerous informative campaigns, unfortunately, the fight against obesity does not seem to work: in the last years, the prevalence continued to increase. The progressive and rapid increase in the incidence of obesity, which has characterized most of the economically advanced countries in the last decade, has been the main stimulus for the research of the mechanisms underlying this pathology and the related disorders. The aims of this review is to provide a revision of the literature in order to define obesity as diseases, secondly to highlight the limits and the inaccuracy of common tools used for the diagnosis of obesity, and as a third thing to strengthen the concept of the complexity of obesity as a disease among political health care providers. Obesity may be viewed as a multifactorial pathology and chronic low-grade inflammatory disease. In fact, people affected by obesity have greater risk of developing comorbility and morbility, respect to healthy. Hence, the absolute therapeutic benefit is directly proportional to the basic risk. So, internationally interest on early diagnosis of obesity is growing to avoid under- and overdiagnosis consequences. Therefore, the consequences are an aggravation of the disease and an increase in obesity related pathology like diabetes, cardiovascular disease, and cancer. The most widely used parameter for diagnosis, body mass index (BMI) is not suitable for assessing the body fat. In fact, several studies demonstrate that BMI alone cannot define obesity, which consists not so much in weight gain as in excess fat mass. The use of suitable tools for the assessment of fat mass percentage combined with clinical and genetic analysis allowed to identify different phenotypes of obesity, which explain the various paradoxes of obesity. It is essential to adopt all possible strategies to be able to combat obesity, ameliorate the suffering of patients, and reduce the social and treatment costs of obesity.
Collapse
Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Santo Gratteri
- Department of Surgery and Medical Science, Magna Græcia University, Germaneto, Catanzaro Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Cammarano
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Pierfrancesco Bertucci
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
43
|
Ortega-Loubon C, Fernández-Molina M, Singh G, Correa R. Obesity and its cardiovascular effects. Diabetes Metab Res Rev 2019; 35:e3135. [PMID: 30715772 DOI: 10.1002/dmrr.3135] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/21/2022]
Abstract
Obesity is described in terms of body fat percentage or body mass index (BMI), despite the fact that these measures do not give full insight about the body fat distribution. It is presently a consistently growing universal challenge since it has tripled in the last 10 years, killing approximately 28 million people each year. In this review, we aim to clarify the different results of obesity on the working and physiology of the cardiovascular system and to reveal changes in the obesity "paradox"-a variety of cardiovascular outcomes in typical/overweight people. Central fat build-up in ordinary/overweight populaces has been related to expanded occurrences of myocardial infarction, heart failure, or all-cause mortality when contrasted with the obese populace. These discoveries are additionally clarified as the abundance and prolonged vulnerability to free fatty acids (FFAs) in obesity. This has been believed to cause the myocardial substrate to move from glucose to FFAs digestion, which causes lipid gathering in cardiomyocytes, spilling over to other lean tissues, and prompting a general atherogenic impact. This cardiomyocyte lipid aggregation has been demonstrated to cause insulin resistance and cardiovascular hypertrophy, and to lessen the heart functions in general. There is a proof backing the fact that fat tissue is not only an energy reservoir, it also coordinates hormones and proinflammatory cytokines and deals with the energy transition of the body by putting away abundant lipids in diverse tissues.
Collapse
Affiliation(s)
- Christian Ortega-Loubon
- Department of Pediatric Cardiac Surgery, Universidad Autonoma de Barcelona, Barcelona, Spain
| | | | - Gauri Singh
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida
| | - Ricardo Correa
- Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| |
Collapse
|
44
|
Amani R, Parohan M, Jomehzadeh N, Haghighizadeh MH. Dietary and Biochemical Characteristics Associated with Normal-Weight Obesity. INT J VITAM NUTR RES 2019; 89:331-336. [PMID: 30856081 DOI: 10.1024/0300-9831/a000477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Inflammation and oxidative stress have been reported to be higher in subjects with normal weight obesity (NWO) syndrome [normal body mass index (BMI) (<25 kg/m2) but excessive body fat (for women ≥ 30% and for men ≥ 20%) according to World Health Organization (WHO) definitions]; however, it is unclear whether this is due to inadequate dietary antioxidant intake or the pathophysiology of NWO. The aim of present study was to assess the association between dietary factors and body antioxidant status with NWO syndrome in male university students. Methods: This study was a case-control study carried out on ninety age-matched male university students [30 normal weights (NW), 30 NWO and 30 overweight-obese (OB)]. A validated food frequency questionnaire (98 items) and 3-day 24-h recalls were used for dietary assessment. Total antioxidant capacity (TAC) of diet and serum and high-sensitive C-reactive protein (hs-CRP) concentrations were also measured. Results: Dietary intake of fruits (frequency factor (FF) = 2.3 vs 2.9, p < 0.05), legumes (FF = 0.7 vs 1.3, p < 0.01), nuts and seeds (FF = 0.4 vs 0.8, p < 0.05), beta-cryptoxanthin (p < 0.05), lycopene (p < 0.05) and serum TAC levels (p < 0.01) were significantly lower in NWO compared to the NW group. No significant differences in these parameters were observed between NWO and OB group. A significant negative correlation was observed between serum TAC levels and BMI (r = -0.57, p < 0.001) and body fat percent (r = -0.52, p < 0.001). Conclusions: This study shows that NWO male subjects consume lower amounts of dietary antioxidants and share the same low body antioxidant status as obese individuals, although they appear lean.
Collapse
Affiliation(s)
- Reza Amani
- Food Security Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Parohan
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nabi Jomehzadeh
- Department of Medical Microbiology, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | |
Collapse
|
45
|
There is an association between body fat percentage and metabolic abnormality in normal weight subjects: Iranian large population. TRANSLATIONAL METABOLIC SYNDROME RESEARCH 2019. [DOI: 10.1016/j.tmsr.2019.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
|
46
|
Gender Stratified Analyses of the Association of Skinfold Thickness with Hypertension: A Cross-Sectional Study in General Northeastern Chinese Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122748. [PMID: 30563102 PMCID: PMC6313501 DOI: 10.3390/ijerph15122748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 11/11/2018] [Accepted: 12/01/2018] [Indexed: 02/07/2023]
Abstract
The association of hypertension with skinfold thickness (ST) in adults is not clear. Our study was aimed at finding out the association of hypertension with ST in different gender and obesity categories. This is a cross-sectional study based on 2336 Chinese residents (767 men). Both subscapular skinfold thickness (SST) and tricep skinfold thickness (TST) were examined. We estimated the association of hypertension with per SD increase of SST and TST using multivariable logistic regression analyses in men and women. Six subgroups were stratified using cutoff points of body mass index (BMI) and ST: larger and smaller ST in normal weight (BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 28 kg/m2) and obesity (BMI ≥ 28 kg/m2), respectively. The association of hypertension with ST was only shown in women after adjustment for other risk factors. Among women of the normal weight subgroup, higher prevalence of hypertension was shown in those with larger ST. No difference of the prevalence of hypertension was found between women with larger ST in the normal weight subgroup and those with smaller ST in overweight or obesity subgroups. Our study suggested that even for people with normal weight, it was necessary to monitor the subcutaneous fat using ST for preventing hypertension at least in general Chinese women.
Collapse
|
47
|
Zhang M, Schumann M, Huang T, Törmäkangas T, Cheng S. Normal weight obesity and physical fitness in Chinese university students: an overlooked association. BMC Public Health 2018; 18:1334. [PMID: 30509225 PMCID: PMC6278052 DOI: 10.1186/s12889-018-6238-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 11/20/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The primary aim of this study was to examine the associations of normal weight obesity (NWO) with physical fitness in Chinese university students. As a secondary aim, we assessed whether possible differences in physical fitness between students classified as NWO and normal weight non-obese (NWNO) were mediated by skeletal muscles mass. METHODS A total of 383 students (205 males and 178 females, aged 18-24 years) from two universities volunteered to participate in this study. Body height and weight were measured by standard procedures and body composition was assessed by bio-impedance analysis (InBody 720). NWO was defined by a BMI of 18.5-23.9 kg/m2 and a body fat percentage of > 20% or > 30% in male and female students, respectively. Physical fitness was measured using a 10-min intermittent endurance running test (Andersen test), countermovement jumps (CMJ) and a 5 × 5 m shuttle run test (5mSR). The level of leisure time physical activity (PA) was assessed by a questionnaire. RESULTS 13.7% of male and 27.5% of female students were classified as NWO. Compared to NWNO, students classified as NWO showed a significantly poorer performance in the Andersen test (males: 1146 ± 70 m vs. 1046 ± 95 m, females: 968 ± 61 m vs. 907 ± 67 m, p < 0.001), CMJ (males: 55.0 ± 7.6 cm vs. 44.9 ± 7.5 cm, females: 39.8 ± 8.0 cm vs. 33.7 ± 5.9 cm, p < 0.001) and 5mSR (males: 18.7 ± 1.0 s vs. 20.0 ± 0.9 s, females: 21.1 ± 1.1 s vs. 22.4 ± 1.3 s, p < 0.001), respectively. The lower levels of physical fitness in NWO were partially explained by lower skeletal muscle mass (p < 0.001) both in male and female students. CONCLUSIONS NWO was associated with poorer physical fitness and the relationship was partially mediated by lower skeletal muscle mass. The study indicated that attention should be paid for the potential hidden health risk in university students with normal body mass index but excessive fat mass.
Collapse
Affiliation(s)
- Meizhen Zhang
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, 200240 China
- College of Physical Education, Taiyuan University of Technology, Taiyuan, Shanxi China
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240 China
| | - Moritz Schumann
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, 200240 China
- Department of Molecular and Cellular Sports Medicine, German Sport University, Cologne, Germany
| | - Tao Huang
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, 200240 China
| | - Timo Törmäkangas
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sulin Cheng
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, 200240 China
- The Key Laboratory of Systems Biomedicine, Ministry of Education, and Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
48
|
Kim MH, Kim HN, Choi WS. The association between subclinical inflammation and abnormal glucose and lipid metabolisms in normal-weight Korean individuals. Nutr Metab Cardiovasc Dis 2018; 28:1106-1113. [PMID: 30287123 DOI: 10.1016/j.numecd.2018.06.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUNDS AND AIMS We aimed to reveal the association between subclinical inflammation and metabolic risk factors and to determine the difference in the association between normal-weight and obese Korean individuals. METHODS AND RESULTS Data collected from the Korean National Health and Nutrition Examination Survey (KNHANES) 2015, conducted from January to December 2015, were analyzed. Overall, 4620 subjects were examined and divided into two subgroups: 2987 and 1633 subjects in the normal-weight and obese groups, respectively. The prevalence of obesity in the study population was 34.5% (n = 1633). After multivariate adjustment, impaired fasting glucose (IFG) (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.05-1.42, P = 0.010), high triglyceride (TG) levels (OR 1.29, 95% CI 1.13-1.47, P < 0.001), and low high-density lipoprotein-cholesterol (HDL-C) levels (OR 1.47, 95% CI 1.31-1.64, P < 0.001) were significantly associated with increased high-sensitivity C-reactive protein (hs-CRP) levels in the normal-weight group but not in the obesity group. CONCLUSION Subclinical inflammation was associated with IFG, high TG levels, and low HDL-C levels in normal-weight Korean individuals. Prospective and biochemical research is necessary to clarify the role of subclinical systemic inflammation in individuals with normal body weight and its impact on insulin resistance and abnormal lipid metabolism, which promote the incidence of metabolic syndrome and cardiovascular disease.
Collapse
Affiliation(s)
- M-H Kim
- Department of Family Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-N Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - W-S Choi
- Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
49
|
Jia A, Xu S, Xing Y, Zhang W, Yu X, Zhao Y, Ming J, Ji Q. Prevalence and cardiometabolic risks of normal weight obesity in Chinese population: A nationwide study. Nutr Metab Cardiovasc Dis 2018; 28:1045-1053. [PMID: 30143410 DOI: 10.1016/j.numecd.2018.06.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Several studies have reported increased cardiovascular risks in normal weight obesity (NWO) populations. We aimed to investigate the prevalence of NWO and its relationships with cardiometabolic risks in Chinese patients. METHODS AND RESULTS The data were from the 2007-2008 China National Diabetes and Metabolic Disorders Study. The body fat (BF) was measured using the biological impedance method. NWO was defined as a normal BMI (18.5-23.9 kg/m2) but with excess BF% (BF% ≥ 24% for men and ≥33% for women). 23,748 people (9633 males and 14,115 females) were enrolled and the prevalence of NWO was 9.5% for men, 6.06% for women. The prevalence risks of diabetes (odds ratio [OR]1.519, 95% confidence interval [CI] 1.262-1.828), Framingham risk score (FRS) ≥10% (OR 1.973, 95% CI 1.596-2.439), hypertension (OR 1.525, 95% CI 1.333-1.745), and metabolic syndrome Mets (OR 2.175, 95% CI 1.920-2.463) significantly increased in the NWO group compared with the normal group. Subgroup analyses showed that, after ruling out participants with abnormal waist circumference, the male group had similar findings to the overall population; but in the female group, the prevalence risks of FRS ≥10%, hypertension, and Mets increased, although the risk of diabetes did not. CONCLUSION NWO is in a relatively high prevalence in Chinese population, and the prevalence of NWO is higher in Chinese men compared to Chinese women. Cardiometabolic risks significantly increase in an NWO population, and such risks persist after excluding the effect of abdominal obesity.
Collapse
Affiliation(s)
- A Jia
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China; Department of Endocrinology, The First Hospital of Yulin, Yulin, 719000, China
| | - S Xu
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, China; Department of Health Statistics, Faculty of Preventive Medicine, Air Force Medical University, Xi'an, 710032, China
| | - Y Xing
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - W Zhang
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - X Yu
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Y Zhao
- Department of Endocrinology, The First Hospital of Yulin, Yulin, 719000, China
| | - J Ming
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China.
| | - Q Ji
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China.
| |
Collapse
|
50
|
Malandrino N, Capristo E, Taveira TH, Mingrone G, Wu WC. Cognitive Function in Individuals with Normal Weight Obesity: Results from the Third National Health and Nutrition Examination Survey (NHANES III). J Alzheimers Dis 2018; 65:125-135. [DOI: 10.3233/jad-180264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Noemi Malandrino
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Esmeralda Capristo
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Tracey H. Taveira
- Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI, USA
- Department of Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA
- University of Rhode Island, College of Pharmacy, Kingston, RI, USA
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Wen-Chih Wu
- Department of Medicine, Section of Cardiology, Veterans Affairs Medical Center, Providence, RI, USA
- Center for Cardiac Fitness, The Miriam Hospital, Providence, RI, USA
- Department of Medicine, Division of Cardiology, Brown University Warren Alpert Medical School, Providence, RI, USA
| |
Collapse
|