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

• Published in: European journal of nutrition Vol. 53; no. 6; pp. 1345 - 1353
• Main Authors: Schröder, Helmut, Ramos, Rafel, Baena-Díez, José M, Mendez, Michelle A, Canal, Dolors Juviny, Fíto, Montserrat, Sala, Joan, Elosua, Roberto
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2014; Springer Berlin Heidelberg; Springer; Springer Nature B.V
• Subjects: abdominal fat; Adult; Aged; Biological and medical sciences; blood glucose; Blood Glucose - metabolism; blood lipids; blood pressure; Body Mass Index; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Chemistry; Chemistry and Materials Science; Cholesterol - blood; Cross-Sectional Studies; diabetes; Diet; educational status; energy intake; European Continental Ancestry Group; Feeding Behavior; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; high density lipoprotein; Humans; hypercholesterolemia; hypertension; hypertriglyceridemia; Life Style; lifestyle; low density lipoprotein cholesterol; Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - epidemiology; Metabolic Syndrome - prevention & control; Middle Aged; Motor Activity; multivariate analysis; Nutrition; Obesity; Obesity - epidemiology; Original Contribution; overweight; Overweight - epidemiology; phenotype; physical activity; Prospective Studies; questionnaires; risk; Risk Factors; Spain - epidemiology; Surveys and Questionnaires; Triglycerides - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; waist; Waist Circumference; Waist-Hip Ratio; Lifestyle; Diet; Prospective study; Metabolically healthy obese phenotype; Obesity; Phenotype; Nutrition; Nutrition disorder; Population; Nutritional status; Feeding; Overweight
• ISSN: 1436-6207; 1436-6215
• DOI: 10.1007/s00394-013-0635-2

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/m² 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.