Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, 9700, RB, Groningen, The Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700, RB, Groningen, The Netherlands.
Nutr J. 2018 Feb 12;17(1):18. doi: 10.1186/s12937-018-0319-0.
Diversity in the reported prevalence of metabolically healthy obesity (MHO), suggests that modifiable factors may be at play. We evaluated differences in dietary patterns and physical activity between MHO and metabolically unhealthy obesity (MUO).
Cross-sectional data of 9270 obese individuals (30-69 years) of the Lifelines Cohort Study was used. MHO was defined as obesity and no metabolic syndrome risk factors and no cardiovascular disease history. MUO was defined as obesity and ≥2 metabolic syndrome risk factors. Sex-specific associations of dietary patterns (identified by principal component analysis) and physical activity with MHO were assessed by multivariable logistic regression (reference group: MUO). Analyses were adjusted for multiple covariates.
Among 3442 men and 5828 women, 10.2% and 24.4% had MHO and 56.9% and 35.3% MUO, respectively. We generated four obesity-specific dietary patterns. Two were related to MHO, and in women only. In the highest quartile (Q) of 'bread, potatoes and sweet snacks' pattern, odds ratio (OR) (95% CI) for MHO was 0.52 (0.39-0.70). For the healthier pattern 'fruit, vegetables and fish', an OR of 1.36 (1.09-1.71) in Q3 and 1.55 (1.21-1.97) in Q4 was found for MHO. For physical activity, there was a positive association between moderate physical activity and vigorous physical activity in the highest tertile and MHO in women and men, respectively (OR 1.19 (1.01-1.41) and OR 2.02 (1.50-2.71)).
The healthier diet -characterized by 'fruit, vegetables and fish'- and moderate physical activity in women, and vigorous physical activity in men may be related to MHO. The (refined) carbohydrate-rich 'bread, potatoes and sweet snacks' dietary pattern was found to counteract MHO in women.
代谢健康型肥胖（MHO）的报道患病率存在差异，这表明可能存在可改变的因素。我们评估了 MHO 和代谢不健康型肥胖（MUO）之间的饮食模式和身体活动差异。
使用 Lifelines 队列研究的 9270 名肥胖个体（30-69 岁）的横断面数据。MHO 定义为肥胖且无代谢综合征危险因素和无心血管疾病史。MUO 定义为肥胖且≥2 个代谢综合征危险因素。通过多变量逻辑回归（参考组：MUO）评估饮食模式（通过主成分分析确定）和身体活动与 MHO 的性别特异性关联。分析调整了多种协变量。
在 3442 名男性和 5828 名女性中，分别有 10.2%和 24.4%为 MHO，分别有 56.9%和 35.3%为 MUO。我们生成了四个肥胖特异性饮食模式。其中两个与 MHO 相关，且仅在女性中相关。在“面包、土豆和甜食”模式的最高四分位数 (Q) 中，MHO 的比值比 (OR) (95%CI) 为 0.52 (0.39-0.70)。对于更健康的模式“水果、蔬菜和鱼类”，在 Q3 和 Q4 中，MHO 的 OR 分别为 1.36 (1.09-1.71) 和 1.55 (1.21-1.97)。对于身体活动，在女性和男性中，中等到剧烈身体活动的最高三分位与 MHO 呈正相关（OR 分别为 1.19 (1.01-1.41) 和 OR 2.02 (1.50-2.71)）。
在女性中，更健康的饮食模式——以“水果、蔬菜和鱼类”为特征，以及中等强度的身体活动，而在男性中，剧烈的身体活动可能与 MHO 有关。在女性中，发现富含（精制）碳水化合物的“面包、土豆和甜食”饮食模式与 MHO 相反。
