Metabolically Healthy Obesity Is Not Associated with Food Intake in White or Black Men

Kimokoti, Ruth W; Judd, Suzanne E.; Shikany, James M.; Newby, P. K.

doi:10.3945/jn.115.221283

Cited by 24 publications

(14 citation statements)

References 63 publications

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“…Nevertheless, differences in MHO prevalence according to ethnicity have been reported, although this recent meta-analysis did not include any studies based on African cohorts [ 33 ]. There are reports indicating that overall dietary intake was not associated with healthy obesity in both Europeans and African Americans [ 27 , 34 ]. In addition to lifestyle and ethnicity, data was not available on the pharmacological compounds included in the ART regimens of the participants as well as the duration of treatment with those compounds, precluding detailed analyses by potency of pharmacological compounds and duration of treatments.…”

Section: Discussionmentioning

confidence: 99%

The Distribution of Obesity Phenotypes in HIV-Infected African Population

et al. 2016

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The distribution of body size phenotypes in people with human immunodeficiency virus (HIV) infection has yet to be characterized. We assessed the distribution of body size phenotypes overall, and according to antiretroviral therapy (ART), diagnosed duration of the infection and CD4 count in a sample of HIV infected people recruited across primary care facilities in the Western Cape Province, South Africa. Adults aged ≥ 18 years were consecutively recruited using random sampling procedures, and their cardio-metabolic profile were assessed during March 2014 and February 2015. They were classified across body mass index (BMI) categories as normal-weight (BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2), and further classified according to their metabolic status as “metabolically healthy” vs. “metabolically abnormal” if they had less than two vs. two or more of the following abnormalities: high blood glucose, raised blood pressure, raised triglycerides, and low HDL-cholesterol. Their cross-classification gave the following six phenotypes: normal-weight metabolically healthy (NWMH), normal-weight metabolically abnormal (NWMA), overweight metabolically healthy (OvMH), overweight metabolically abnormal (OvMA), obese metabolically healthy (OMH), and obese metabolically abnormal (OMA). Among the 748 participants included (median age 38 years (25th–75th percentiles: 32–44)), 79% were women. The median diagnosed duration of HIV was five years; the median CD4 count was 392 cells/mm3 and most participants were on ART. The overall distribution of body size phenotypes was the following: 31.7% (NWMH), 11.7% (NWMA), 13.4% (OvMH), 9.5% (OvMA), 18.6% (OMH), and 15.1% (OMA). The distribution of metabolic phenotypes across BMI levels did not differ significantly in men vs. women (p = 0.062), in participants below vs. those at or above median diagnosed duration of HIV infection (p = 0.897), in participants below vs. those at or above median CD4 count (p = 0.447), and by ART regimens (p = 0.205). In this relatively young sample of HIV-infected individuals, metabolically abnormal phenotypes are frequent across BMI categories. This highlights the importance of general measures targeting an overall improvement in cardiometabolic risk profile across the spectrum of BMI distribution in all adults with HIV.

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Section: Discussionmentioning

confidence: 99%

The Distribution of Obesity Phenotypes in HIV-Infected African Population

et al. 2016

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“…In most studies, MHO was defined as having ≤2 of the following five metabolic syndrome components: high systolic and diastolic blood pressures, high plasma TG concentration, low HDL-C concentration, high fasting blood glucose, and a large waist circumference; or ≤1 abnormal component excluding waist circumference (4). Additional criteria, including high plasma total cholesterol, LDL-cholesterol, and C-reactive protein concentrations, 2-hour blood glucose concentrations during an oral glucose tolerance test, and indices of insulin sensitivity/resistance (based on the homeostasis model assessment of insulin resistance [HOMA-IR] , have also been used to determine MHO (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In some studies, even people with impaired glucose tolerance, T2D, and history of CVD were considered metabolically healthy because they did not have a sufficient number of the specified metabolic abnormalities to be identified as MUO (15,(25)(26)(27)(28).…”

Section: Definition Of Metabolically Healthy Obesitymentioning

confidence: 99%

“…The prevalence of MHO, defined as "normal" insulin sensitivity (based on the HOMA-IR score) and absence of any metabolic syndrome components (excluding waist circumference), is approximately 7%, whereas half of all people with obesity can be classified as MHO when defined as ≤2 metabolic syndrome components (including waist circumference). However, it is likely that these results overestimate the prevalence of MHO in the general population, because many studies excluded people with existing cardiometabolic diseases, such as T2D and CVD (9,11,13,28,(42)(43)(44).…”

Section: Definition Of Metabolically Healthy Obesitymentioning

confidence: 99%

Metabolically healthy obesity: facts and fantasies

Smith¹,

Mittendorfer²,

Klein³

2019

Journal of Clinical Investigation

434

371

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“…One variable that has been scrutinized as a possible determinant of MUO is diet. Although some large population studies have identified subtle differences in diet as a determinant of the MUO phenotype,6, 7 others have not been able to detect a difference in either calorie or nutrient consumption between MHO and MUO subgroups 8, 9, 10. This may be due to the imperfect quality of dietary data in population studies, which in general rely on self-report and recall.…”

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confidence: 99%

Specific Macronutrients Exert Unique Influences on the Adipose-Liver Axis to Promote Hepatic Steatosis in Mice

Duwaerts

Amin

Siao

et al. 2017

Cellular and Molecular Gastroenterology and Hepatology

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Background & AimsThe factors that distinguish metabolically healthy obesity from metabolically unhealthy obesity are not well understood. Diet has been implicated as a determinant of the unhealthy obesity phenotype, but which aspects of the diet induce dysmetabolism are unknown. The goal of this study was to investigate whether specific macronutrients or macronutrient combinations provoke dysmetabolism in the context of isocaloric, high-energy diets.MethodsMice were fed 4 high-energy diets identical in calorie and nutrient content but different in nutrient composition for 3 weeks to 6 months. The test diets contained 42% carbohydrate (sucrose or starch) and 42% fat (oleate or palmitate). Weight and glucose tolerance were monitored; blood and tissues were collected for histology, gene expression, and immunophenotyping.ResultsMice gained weight on all 4 test diets but differed significantly in other metabolic outcomes. Animals fed the starch-oleate diet developed more severe hepatic steatosis than those on other formulas. Stable isotope incorporation showed that the excess hepatic steatosis in starch-oleate–fed mice derived from exaggerated adipose tissue lipolysis. In these mice, adipose tissue lipolysis coincided with adipocyte necrosis and inflammation. Notably, the liver and adipose tissue abnormalities provoked by starch-oleate feeding were reproduced when mice were fed a mixed-nutrient Western diet with 42% carbohydrate and 42% fat.ConclusionsThe macronutrient composition of the diet exerts a significant influence on metabolic outcome, independent of calories and nutrient proportions. Starch-oleate appears to cause hepatic steatosis by inducing progressive adipose tissue injury. Starch-oleate phenocopies the effect of a Western diet; consequently, it may provide clues to the mechanism whereby specific nutrients cause metabolically unhealthy obesity.

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Metabolically Healthy Obesity Is Not Associated with Food Intake in White or Black Men

Abstract: Healthy obesity in men is not associated with a healthier diet. Future studies need to consider dietary patterns, which may better inform the holistic effect of diet on healthy obesity, in prospective analyses.

Cited by 24 publications

References 63 publications

The Distribution of Obesity Phenotypes in HIV-Infected African Population

The Distribution of Obesity Phenotypes in HIV-Infected African Population

Metabolically healthy obesity: facts and fantasies

Specific Macronutrients Exert Unique Influences on the Adipose-Liver Axis to Promote Hepatic Steatosis in Mice

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