The “metabolically-obese,” normal-weight individual

Ruderman, Neil B.; Schneider, Stephen H.; Berchtold, Peter

doi:10.1093/ajcn/34.8.1617

Cited by 489 publications

(322 citation statements)

References 28 publications

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“…33 This review concluded that 'even modest amounts of physical activity can have tremendous health benefits in high-risk youngsters (for example, obese, high blood pressure)'. 33 The 'fat-but-fit' phenotype Classical and recent studies in adults, [69][70][71] as well as in children and adolescents, 18,50,51 have shown the strong relationship between PA and adiposity, expressed both as BMI or percent body fat. In light of this, we can state that PA influences the MS risk within fatness categories.…”

Section: Physical Activity As a Therapeutic Tool In Pediatrics P Brammentioning

confidence: 99%

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Brambilla¹,

Pozzobon

Pietrobelli

2010

Int J Obes

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Physical activity (PA) and diet directly influence obesity and metabolic syndrome (MS) as important determinants of body composition. Understanding how PA relates to MS in youth is of great importance, and could offer a common strategy for clinical and public health approaches to control this condition. The underlying disorder of MS is a condition of insulin resistance, and a strong relationship between PA level and insulin sensitivity is clearly ascertained. The type, duration, frequency and intensity of PA affect fuel metabolism, in particular carbohydrate and lipid oxidation. The possible modulation of metabolism because of increased fat oxidation by PA is the basis for both prevention and restoration of insulin resistance and MS in obese children. In daily clinical practice, diet followed by pharmacologic treatment are usually the approaches taken, whereas PA is often considered just a suggestion. Although diet and PA have different effects on body composition, with both contributing to fat loss, only PA increases muscle mass and thus has a direct effect on metabolic function, expressed by changes in cardiovascular risk factors. Therefore, it is important to remember their complementary but different targets in daily clinical practice, such as body weight control for diet and metabolic health for PA. In this review, we have summarized the literature on the relationship between PA and MS in pediatrics. Then, we have analyzed the possibility of using PA for MS treatment, as an alternative to drugs, by discussing the results of intervention studies, reasons for low compliance to PA, related benefits, adherence difficulties and costs. Finally, we have tried to suggest recommendations for a multiple-step PA strategy in children and adolescents at risk for MS, by considering PA as the 'key' player in treatment.

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Section: Physical Activity As a Therapeutic Tool In Pediatrics P Brammentioning

confidence: 99%

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Brambilla¹,

Pozzobon

Pietrobelli

2010

Int J Obes

View full text Add to dashboard Cite

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“…It may be hypothesized that, although the discrepant group did not show central obesity, they have metabolic abnormalities associated with these unfavorable lifestyles and that these may lead to the consequences of metabolic syndrome. Ruderman et al 28,29 insisted that metabolically obese, normal-weight individuals are also predisposed to type 2 diabetes, hypertriglyceridemia, and coronary heart disease like people with overt obesity; therefore, it is important to identify and treat these individuals before these diseases become overt. Insulin resistance can occur independently of obesity and apparently contributes to a high prevalence of type 2 diabetes and CVD.…”

Section: Ncep-r(+) and Idf(+) Ncep-r(+) And Idf(à) Ncep-r(à) And Idf(à) Ncementioning

confidence: 99%

The new definition of metabolic syndrome by the international diabetes federation is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program: The Korea NHANES Study

et al. 2006

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Objective: The new definitions for metabolic syndrome (MS) proposed by the IDF and revised NCEP have caused some confusion because patients have emerged that have satisfied the revised NCEP but not the IDF criteria. We performed this study to compare the prevalence of these criteria and to investigate the characteristics of discrepant cases. Research design and methods: A total of 7962 individuals aged X 20 years (3597 men; 4365 women) who participated in the 1998 Korean NHANES were included. We assessed the agreement between the revised NCEP and IDF criteria and investigated the characteristics of cases satisfying the revised NCEP criteria but not the IDF criteria. Results: The prevalence of MS by the revised NCEP (25.7% of men and 31.9% of women) was higher than that according to the IDF (14.2% of men and 26.6% of women). The IDF criteria failed to identify 44.9% of men and 16.6% of women identified as having MS according to the revised NCEP criteria. The discrepant group showed more adverse metabolic profiles and unfavorable lifestyles despite lower waist circumference as compared with those having MS by both the IDF and revised NCEP criteria. The prevalence of discrepant cases was higher among the elderly. Conclusions: The IDF criteria were inferior to the revised NCEP criteria in identifying the metabolically abnormal but nonobese groups known to be predisposed to type 2 diabetes and cardiovascular disease. Further research regarding the appropriateness of central obesity as an obligatory criterion proposed by the IDF seems to be warranted.

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“…This relationship was also observed in non-obese men. Our non-obese male subjects included metabolically obese subjects who had accumulated visceral fat despite having normal BMI; 15,16 this may explain the signi®-cant relationship observed in non-obese men. Further studies must be carried out to clarify the mechanism by which circulating concentrations of a-MSH are increased in obese male subjects.…”

Section: Plasma Levels Of a A-msh In Obese Menmentioning

confidence: 99%

Elevated plasma levels of α-melanocyte stimulating hormone (α-MSH) are correlated with insulin resistance in obese men

et al. 2000

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OBJECTIVE: The role of a-melanocyte stimulating hormone (MSH) in obesity has been well-documented. However, circulating a-MSH concentrations in obese men and their relationship with clinical indicators of obesity and glucose metabolism have not as yet been evaluated. METHODS: We measured the plasma concentrations of a-MSH in 15 obese and 15 non-obese male subjects. The relationship of the plasma concentrations of a-MSH with body mass index (BMI), body fat mass (measured by bioelectric impedance), body fat distribution (measured by computed tomography), insulin levels, insulin resistance (assessed by the glucose infusion rate (GIR) during an euglycemic hyperinsulinemic clamp study) and with the serum concentrations of leptin and TNF-a were also evaluated. RESULTS: In obese men, the plasma a-MSH concentrations were signi®cantly increased compared with those in nonobese men (P`0.02). The plasma levels of a-MSH were positively correlated with BMI (r 0.560, P`0.05), fasting insulin levels (r 0.528, P`0.05) and with visceral fat area (r 0.716, P`0.01), but negatively correlated with GIR (r 70.625, P`0.02) in obese male subjects. There were signi®cant correlations between plasma concentrations of a-MSH and visceral fat area (r 0.631, P`0.02), and GIR (r 70.549, P`0.05) in non-obese male subjects. Circulating concentrations of a-MSH were not signi®cantly correlated with the serum concentrations of leptin and TNF-a in both obese and non-obese men. CONCLUSION: Circulating concentrations of a-MSH are signi®cantly increased and correlated with insulin resistance in obese men.

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The “metabolically-obese,” normal-weight individual

Cited by 489 publications

References 28 publications

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

The new definition of metabolic syndrome by the international diabetes federation is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program: The Korea NHANES Study

Elevated plasma levels of α-melanocyte stimulating hormone (α-MSH) are correlated with insulin resistance in obese men

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