149
Views
8
CrossRef citations to date
0
Altmetric
Theme: Obesity - Review

Healthy obesity as an intermediate state of risk: a critical review

&
Pages 403-413 | Received 10 May 2016, Accepted 01 Aug 2016, Published online: 12 Aug 2016

References

  • Collaboration NRF. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19· 2 million participants. Lancet. 2016;387(10026):1377–1396.
  • Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–814.
  • Scantlebury R, Moody A. Health survey for England 2014. In: Chapter 9: Adult Obesity and Overweight. London: The Health and Social Care Information Centre, Joint Health Surveys Unit, NatCen Social Research & Research Department of Epidemiology and Public Health, UCL; 2015.
  • Kopelman P. Health risks associated with overweight and obesity. Obes Rev. 2007;8(s1):13–17.
  • Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body-mass index and mortality among 1.46 million white adults. New England J Med. 2010;363(23):2211–2219.
  • Collaboration PS. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–1096.
  • Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–825.
  • Blew RM, Sardinha LB, Milliken LA, et al. Assessing the validity of body mass index standards in early postmenopausal women. Obes Res. 2002;10(8):799–808.
  • Evans E, Rowe D, Racette S, et al. Is the current BMI obesity classification appropriate for black and white postmenopausal women? Int Obes. 2006;30(5):837–843.
  • Brunner EJ, Hemingway H, Walker BR, et al. Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study. Circulation. 2002;106(21):2659–2665. Epub 2002 Nov 20.
  • Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9(1):1.
  • Vazquez G, Duval S, Jacobs DR, et al. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev. 2007;29(1):115–128.
  • Butland B, Jebb S, Kopelman P, et al. Foresight. Tackling obesities: future choices. Project report. Foresight tackling obesities: future choices project report. London: Government Office for Science; 2007.
  • Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–814.
  • Curioni C, Lourenco P. Long-term weight loss after diet and exercise: a systematic review. Int Obes. 2005;29(10):1168–1174.
  • Anderson JW, Konz EC, Frederich RC, et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001;74(5):579–584.
  • Fildes A, Charlton J, Rudisill C, et al. Probability of an obese person attaining normal body weight: cohort study using electronic health records. Am J Public Health. 2015;105(9):e54–e59.
  • Frayn K. Metabolic regulation: a human perspective. Chichester: Wiley-Blackwell; 2010.
  • Expert Panel on Detection E. Executive summary of the Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486.
  • Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering - Prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008;168(15):1617–1624.
  • Flegal KM, Shepherd JA, Looker AC, et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. Am J Clin Nutr. 2009;89(2):500–508.
  • Iacobellis G, Ribaudo MC, Zappaterreno A, et al. Prevalence of uncomplicated obesity in an Italian obese population. Obes Res. 2005;13(6):1116–1122.
  • Després J-P, Lemieux I, Bergeron J, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol. 2008;28(6):1039–1049.
  • Mathieu P, Poirier P, Pibarot P, et al. Visceral obesity the link among inflammation, hypertension, and cardiovascular disease. Hypertension. 2009;53(4):577–584.
  • Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013;93(1):359–404.
  • Philipsen A, Jørgensen ME, Vistisen D, et al. Associations between ultrasound measures of abdominal fat distribution and indices of glucose metabolism in a population at high risk of type 2 diabetes: the ADDITION-PRO study. Plos One. 2015;10(4):e0123062.
  • Sattar N, Gill JM. Type 2 diabetes as a disease of ectopic fat? BMC Med. 2014;12(1):1.
  • Alligier M, Meugnier E, Debard C, et al. Subcutaneous adipose tissue remodeling during the initial phase of weight gain induced by overfeeding in humans. J Clin Endocrinol Metabolism. 2011;97(2):E183–E192.
  • Alligier M, Gabert L, Meugnier E, et al. Visceral fat accumulation during lipid overfeeding is related to subcutaneous adipose tissue characteristics in healthy men. J Clin Endocrinol Metabolism. 2013;98(2):802–810.
  • Appleton SL, Seaborn CJ, Visvanathan R, et al. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype A cohort study. Diabetes Care. 2013;36:2388–2394.
  • Koster A, Stenholm S, Alley DE, et al. Body fat distribution and inflammation among obese older adults with and without metabolic syndrome. Obesity. 2010;18(12):2354–2361.
  • Brochu M, Tchernof A, Dionne IJ, et al. What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocr Metab. 2001;86(3):1020–1025.
  • Hayes L, Pearce MS, Firbank MJ, et al. Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study. BMC Public Health. 2010;10:723.
  • Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. 2008;168(15):1609–1616.
  • Stefan N, Häring H-U, Hu FB, et al. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol. 2013;1(2):152–162.
  • Sung K-C, Cha S-C, Sung J-W, et al. Metabolically healthy obese subjects are at risk of fatty liver but not of pre-clinical atherosclerosis. Nutrition, Metabolism Cardiovasc Dis. 2014;24(3):256–262.
  • Fabbrini E, Yoshino J, Yoshino M, et al. Metabolically normal obese people are protected from adverse effects following weight gain. J Clin Invest. 2015;125(2):787.
  • Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8(8):457–465.
  • Zierath JR. Invited review: exercise training-induced changes in insulin signaling in skeletal muscle. J Appl Physiol. 2002;93(2):773–781.
  • Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56(11):2655–2667.
  • Gill JM. Exercise and postprandial lipid metabolism–an analysis of the current evidence. Eur J Lipid Sci Technol. 2004;106(2):110–121.
  • Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473.
  • Cornelissen VA, Buys R, Smart NA. Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis. J Hypertens. 2013;31(4):639–648.
  • Laaksonen DE, Lakka H-M, Salonen JT, et al. Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care. 2002;25(9):1612–1618.
  • Lakka TA, Laaksonen DE. Physical activity in prevention and treatment of the metabolic syndrome. Applied Physiology, Nutrition, Metabolism. 2007;32(1):76–88.
  • Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126.
  • Church TS, Earnest CP, Skinner JS, et al. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297(19):2081–2091.
  • Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Can Med Assoc J. 2006;174(6):801–809.
  • Sattelmair J, Pertman J, Ding EL, et al. Dose response between physical activity and risk of coronary heart disease a meta-analysis. Circulation. 2011;124(7):789–795.
  • Phillips CM, Dillon C, Harrington JM, et al. Defining metabolically healthy obesity: role of dietary and lifestyle factors. Plos One. 2013;8(10):e76188.
  • Hankinson AL, Daviglus ML, Van Horn L, et al. Diet composition and activity level of at risk and metabolically healthy obese American adults. Obesity. 2012;21(3):637–643.
  • Sabia S, van Hees VT, Shipley MJ, et al. Association between questionnaire-and accelerometer-assessed physical activity: the role of sociodemographic factors. Am J Epidemiol. 2014;179(6):781–790.
  • Warner ET, Wolin KY, Duncan DT, et al. Differential accuracy of physical activity self-report by weight status. Am J Health Behav. 2012;36(2):168.
  • Bell JA, Hamer M, van Hees VT, et al. Healthy obesity and objective physical activity. Am J Clin Nutr. 2015;102(2):268–275.
  • Ortega FB, Lee DC, Katzmarzyk PT, et al. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013;34:389–397.
  • Chang Y, Kim B-K, Yun KE, et al. Metabolically-healthy obesity and coronary artery calcification. J Am Coll Cardiol. 2014;63(24):2679–2686.
  • Bell JA, Hamer M, Batty GD, et al. Incidence of metabolic risk factors among healthy obese adults: 20-year follow-up. J Am Coll Cardiol. 2015;66(7):871–873.
  • Hamer M, Bell JA, Sabia S, et al. Stability of metabolically healthy obesity over 8 years: the English longitudinal study of ageing. Eur J Endocrinol. 2015;173(5):703–708.
  • Bell JA, Hamer M, Sabia S, et al. The natural course of healthy obesity over 20 years. J Am Coll Cardiol. 2015;65(1):101–102.
  • Soriguer F, Gutiérrez-Repiso C, Rubio-Martín E, et al. Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study. J Clin Endocr Metab. 2013;98:2318–2325.
  • Khan UI, Wang D, Karvonen-Gutierrez CA, et al. Progression from metabolically benign to at-risk obesity in perimenopausal women: a longitudinal analysis of study of women across the nation (SWAN). J Clin Endocrinol Metabolism. 2014;99(7):2516–2525.
  • Achilike I, Hazuda H, Fowler S, et al. Predicting the development of the metabolically healthy obese phenotype. Int Obes. 2015;39(2):228–234.
  • Eshtiaghi R, Keihani S, Hosseinpanah F, et al. Natural course of metabolically healthy abdominal obese adults after 10 years of follow-up: the Tehran Lipid and Glucose Study. Int Obes. 2015;39(3):514–519.
  • Bell J, Kivimaki M, Hamer M. Metabolically healthy obesity and risk of incident type 2 diabetes: a meta‐analysis of prospective cohort studies. Obes Rev. 2014;15(6):504–515.
  • Hinnouho G-M, Czernichow S, Dugravot A, et al. Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. Eur Heart J. 2015;36(9):551–559.
  • Aung K, Lorenzo C, Hinojosa MA, et al. Risk of developing diabetes and cardiovascular disease in metabolically unhealthy normal-weight and metabolically healthy obese individuals. J Clin Endocrinol Metabolism. 2013;99(2):462–468.
  • Heianza Y, Kato K, Kodama S, et al. Risk of the development of Type 2 diabetes in relation to overall obesity, abdominal obesity and the clustering of metabolic abnormalities in Japanese individuals: does metabolically healthy overweight really exist? The Niigata wellness study. Diabetic Med. 2015;32(5):665–672.
  • Twig G, Afek A, Derazne E, et al. Diabetes risk among overweight and obese metabolically healthy young adults. Diabetes Care. 2014;37(11):2989–2995.
  • Heianza Y, Arase Y, Tsuji H, et al. Metabolically healthy obesity, presence or absence of fatty liver, and risk of type 2 diabetes in Japanese individuals: Toranomon hospital health management center study 20 (TOPICS 20). J Clin Endocrinol Metabolism. 2014;99(8):2952–2960.
  • Jung CH, Lee MJ, Kang YM, et al. The risk of incident type 2 diabetes in a Korean metabolically healthy obese population: the role of systemic inflammation. J Clin Endocrinol Metabolism. 2015;100(3):934–941.
  • Fan J, Song Y, Chen Y, et al. Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies. Int J Cardiol. 2013;168(5):4761–4768.
  • Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions?: a systematic review and meta-analysis. Ann Intern Med. 2013;159(11):758–769.
  • Meigs JB, Wilson PWF, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocr Metab. 2006;91(8):2906–2912.
  • Arnlov J, Ingelsson E, Sundstrom J, et al. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation. 2010;121(2):230–236. Epub 2009 Dec30.
  • Ogorodnikova AD, Kim M, McGinn AP, et al. Incident cardiovascular disease events in metabolically benign obese individuals. Obesity (Silver Spring). 2012;20(3):651–659. Epub 2011 Jul 30.
  • Song Y, Manson JE, Meigs JB, et al. Comparison of usefulness of body mass index versus metabolic risk factors in predicting 10-year risk of cardiovascular events in women. Am J Cardiol. 2007;100(11):1654–1658.
  • Chang Y, Ryu S, Choi Y, et al. Metabolically healthy obesity and development of chronic kidney disease. Ann Intern Med. 2016;164(5):305–312.
  • Jung CH, Lee MJ, Kang YM, et al. The risk of chronic kidney disease in a metabolically healthy obese population. Kidney Int. 2015;88(4):843–850.
  • Panwar B, Hanks LJ, Tanner RM, et al. Obesity, metabolic health, and the risk of end-stage renal disease. Kidney Int. 2015;87(6):1216–1222.
  • Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–578.
  • Bhaskaran K, Douglas I, Forbes H, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5· 24 million UK adults. Lancet. 2014;384(9945):755–765.
  • Jokela M, Hamer M, Singh-Manoux A, et al. Association of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies. Mol Psychiatr. 2014;19(8):910–914.
  • Bauman AE, Sallis JF, Dzewaltowski DA, et al. Toward a better understanding of the influences on physical activity: the role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med. 2002;23(2):5–14.
  • Cuthbertson DJ, Bell JA, Ng S, et al. Dynapenic obesity and the risk of incident type 2 diabetes: the English longitudinal study of ageing. Diabetic Med. 2016;33:1052–1059.
  • Cleasby ME, Jamieson P, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol. 2016;229:R67–R81. JOE-15-0533.
  • Fukui M. Maintaining metabolically healthy over-weight and risk of incident type 2 diabetes or cardiovascular disease. Int J Diabetol Vasc Dis Res S. 2015;3:1–6.
  • Arnlov J, Sundstrom J, Ingelsson E, et al. Impact of BMI and the metabolic syndrome on the risk of diabetes in middle-aged men. Diabetes Care. 2011;34(1):61–65.
  • Kim C-H, Kim H-K, Bae S-J, et al. Independent impact of body mass index and metabolic syndrome on the risk of type 2 diabetes in Koreans. Metab Syndr Relat Disord. 2012;10(5):321–325.
  • Hwang L-C, Bai C-H, Sun C-A, et al. Prevalence of metabolicallv healthy obesity and its impacts on incidences of hypertension, diabetes and the metabolic syndrome in Taiwan. Asia Pac J Clin Nutr. 2012;21(2):227.
  • Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women a report from the women’s ischemia syndrome evaluation (WISE) study. Circulation. 2004;109(6):706–713.
  • Ekelund U, Brage S, Besson H, et al. Time spent being sedentary and weight gain in healthy adults: reverse or bidirectional causality? Am J Clin Nutr. 2008;88(3):612–617.
  • Hjorth MF, Chaput J-P, Ritz C, et al. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: support from a longitudinal study in 8-to 11-year-old children. Int Obes. 2014;38(7):959–965.
  • Richmond RC, Smith GD, Ness AR, et al. Assessing causality in the association between child adiposity and physical activity levels: a Mendelian randomization analysis. PLoS Med. 2014;11(3):e1001618.
  • Smith GD, Ebrahim S. ‘Mendelian randomization’: can genetic epidemiology contribute to understanding environmental determinants of disease? Int J Epidemiol. 2003;32(1):1–22.
  • Evans DM, Davey Smith G. Mendelian randomization: new applications in the coming age of hypothesis-free causality. Annu Rev Genomics Hum Genet. 2015;16:327–350.
  • Rana JS, Li TY, Manson JE, et al. Adiposity compared with physical inactivity and risk of type 2 diabetes in women. Diabetes Care. 2007;30(1):53–58.
  • Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA. 2004;292(10):1188–1194.
  • Lee D-C, Sui X, Church TS, et al. Associations of cardiorespiratory fitness and obesity with risks of impaired fasting glucose and type 2 diabetes in men. Diabetes Care. 2009;32(2):257–262.
  • Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev. 2010;11(3):202–221.
  • Hu G, Tuomilehto J, Silventoinen K, et al. Joint effects of physical activity, body mass index, waist circumference and waist-to-hip ratio with the risk of cardiovascular disease among middle-aged Finnish men and women. Eur Heart J. 2004;25(24):2212–2219.
  • Weinstein AR, Sesso HD, Lee I-M, et al. The joint effects of physical activity and body mass index on coronary heart disease risk in women. Arch Intern Med. 2008;168(8):884–890.
  • Li TY, Rana JS, Manson JE, et al. Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation. 2006;113(4):499–506.
  • Jensen MK, Chiuve SE, Rimm EB, et al. Obesity, behavioral lifestyle factors, and risk of acute coronary events. Circulation. 2008;117(24):3062–3069.
  • Janiszewski PM, Ross R. Physical activity in the treatment of obesity: beyond body weight reduction. Applied Physiology, Nutrition, Metabolism. 2007;32(3):512–522.
  • Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men: a randomized, controlled trial. Ann Intern Med. 2000;133(2):92–103.
  • Ross R, Hudson R, Stotz PJ, et al. Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: a randomized trial. Ann Intern Med. 2015;162(5):325–334.
  • Ekkekakis P, Vazou S, Bixby W, et al. The mysterious case of the public health guideline that is (almost) entirely ignored: call for a research agenda on the causes of the extreme avoidance of physical activity in obesity. Obes Rev. 2016;17:313–329.
  • Holmes MV, Lange LA, Palmer T, et al. Causal effects of body mass index on cardiometabolic traits and events: a Mendelian randomization analysis. Am J Hum Genet. 2014;94(2):198–208.
  • Würtz P, Wang Q, Kangas AJ, et al. Metabolic signatures of adiposity in young adults: Mendelian randomization analysis and effects of weight change. PLoS Med. 2014;11(12):e1001765.
  • Magkos F, Fraterrigo G, Yoshino J, et al. Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity. Cell Metab. 2016;23:591–601.
  • Shin MJ, Hyun YJ, Kim OY, et al. Weight loss effect on inflammation and LDL oxidation in metabolically healthy but obese (MHO) individuals: low inflammation and LDL oxidation in MHO women. Int Obes. 2006;30(10):1529–1534.
  • Karelis AD, Messier V, Brochu M, et al. Metabolically healthy but obese women: effect of an energy-restricted diet. Diabetologia. 2008;51(9):1752–1754.
  • Arsenault BJ, Côté M, Cartier A, et al. Effect of exercise training on cardiometabolic risk markers among sedentary, but metabolically healthy overweight or obese postmenopausal women with elevated blood pressure. Atherosclerosis. 2009;207(2):530.
  • Janiszewski PM, Ross R. Effects of weight loss among metabolically healthy obese men and women. Diabetes Care. 2010;33(9):1957–1959.
  • Kantartzis K, Machann J, Schick F, et al. Effects of a lifestyle intervention in metabolically benign and malign obesity. Diabetologia. 2011;54(4):864–868.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.