Determinants of the transition from a cardiometabolic normal to abnormal overweight/obese phenotype in a Spanish population.

Abstract

PURPOSE:

There is limited prospective evidence at population scale of the impacts of lifestyle and surrogate measures of general and abdominal adiposity on the transition of a metabolically healthy (absence of a metabolic disorder) overweight/obese (MHOO) phenotype to a metabolically abnormal overweight/obese (MAOO) phenotype. Therefore, we determined the relationship between 10-year body mass index (BMI), waist circumferences (WC), waist to height ratio (WHtR), and lifestyle changes and the transition of the MHOO phenotype.

METHODS:

We conducted a prospective population-based study of 3,052 male and female Spaniards aged 25-74 years who were followed from 2000 through 2009. Diet and leisure-time physical activity were recorded on validated questionnaires. Weight, height, WC, blood lipids, glycemia, and blood pressure were measured. All variables were obtained at baseline (BL) and follow-up (FL). Participants with a BMI ≥ 25 kg/m(2) and free from hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, and low HDL and high LDL cholesterol levels were characterized as the MHOO phenotype. A composite healthy lifestyle index (HLI) was constructed by including temporary changes in 3 lifestyle variables (diet, leisure-time physical activity, and smoking).

RESULTS:

Initially, 20.8% of subjects had the MHOO phenotype; 49.2% of these shifted to MAOO phenotype. In multivariate analysis, changes in BMI, WC, WHtR were positively associated (p = 0.004, p = 0.018, and p = 0.016, respectively) with this transition. One unit increase in the HLI was associated with a 33% lower risk (p = 0.025) to the MAOO phenotype transition after adjusting for age, sex, educational level, and baseline energy intake, BMI, WC, and WHtR.

CONCLUSIONS:

The presence of metabolic disorders in the MHOO phenotype is predicted by an increase in anthropometric surrogate measures of general and abdominal adiposity. In contrast, a healthy lifestyle protects against a transition to the MAOO phenotype.

• Authors: Helmut Schröder, Rafel Ramos, José M Baena-Díez, Michelle A Mendez, Dolors Juvinyà Canal, Montserrat Fíto, Joan Sala, Roberto Elosua
• Journal: European journal of nutrition (Eur J Nutr) Vol. 53 Issue 6 Pg. 1345-53 (Sep 2014) ISSN: 1436-6215 [Electronic] Germany
• PMID: 24322835 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Triglycerides
• Cholesterol

Topics

• Adult
• Aged
• Blood Glucose (metabolism)
• Body Mass Index
• Cardiovascular Diseases (epidemiology, prevention & control)
• Cholesterol (blood)
• Cross-Sectional Studies
• Diet
• Feeding Behavior
• Female
• Follow-Up Studies
• Humans
• Life Style
• Male
• Metabolic Syndrome (epidemiology, prevention & control)
• Middle Aged
• Motor Activity
• Obesity (epidemiology)
• Overweight (epidemiology)
• Prospective Studies
• Risk Factors
• Spain (epidemiology)
• Surveys and Questionnaires
• Triglycerides (blood)
• Waist Circumference
• Waist-Hip Ratio
• White People