A Weight Loss Diet Intervention Has a Similar Beneficial Effect on Both Metabolically Abnormal Obese and Metabolically Healthy but Obese Premenopausal Women

Abstract

Background/Aims: We studied the effect of a 12-week energy-restricted diet intervention on cardiometabolic risk in two groups of nonmorbid obese premenopausal Caucasian women, i.e. a metabolically abnormal obese (MAO) and a metabolically healthy but obese (MHO) group. Methods: The participants were 53 MAO and 25 MHO women (age range 19-49 years; body mass index inclusion criterion: 30-39.9). We assessed changes in body weight and composition, blood lipids, insulin resistance, hepatic enzymes, inflammatory markers and adipocytokines. Results: Overall, many of the study outcomes improved with the intervention in both MAO and MHO participants, but there was no difference in the magnitude of change between the groups. Body weight, waist circumference and total fat mass decreased significantly in response to the intervention in both MAO and MHO women (all p < 0.001). Fasting insulin, insulin resistance (homeostasis model assessment), hepatic enzymes (alanine aminotransferase and γ-glutamyltransferase), fatty liver index and leptin levels also decreased in both groups after the intervention (all p < 0.001), whereas total cholesterol, triglycerides and C-reactive protein decreased significantly only in MAO women (all p < 0.001). Conclusion: These findings reinforce the idea that MHO women would also benefit from a lifestyle weight reduction intervention.

Increased Cardiometabolic Risk Factors and Inflammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy

“…Some authors have found higher adiponectin concentrations in MHO as compared with MAO, which has been related to reduced inflammation and improved metabolic function (25,26). The similarly reduced levels observed in the current study have been reported previously (7,27,28) and together with the comparable concentrations of leptin and resistin suggest that MHO and MAO show a very similarly altered adipokine profile. To our knowledge, this is the only study analyzing the circulating concentrations of SAA, VEGF, and MMP9 in MHO subjects.…”

Dietary Interventions and Changes in Cardio-Metabolic Parameters in Metabolically Healthy Obese Subjects: A Systematic Review with Meta-Analysis

“…After initial exclusion criteria, 135 papers were assigned for full-text review with 12 articles included for data extraction and analysis [17,18,19,20,21,22,23,24,25,26,27,28] (Figure 2). …”

“…The population consists of 1827 subjects and was characterized by a baseline BMI > 30 kg/m 2 , a mean age from 34.4 [18] to 61.1 [20], and representing Caucasian and Asian ethnicities. Time of interventions ranged from 12 to 104 weeks and were based on diet only [18,21,22,23,24,25,26,27] or diet with combination of light to moderate physical activity (PA) [19,20,28] that supported the daily energy deficit. …”

Obesity and Cardiovascular Disease

“…In 2014, Blüher and Schwarz 100 reviewed and updated the characterization of the MHO individuals and concluded . Based on this definition and using term/abbreviations already used in the literature, this group could be named as MAO 65,66,104,105,[153][154][155] or MUHO. 75,94,101,111,117,156 This definition would be problematic from both a clinical and analytic point of view, how would be considered/ treated those individuals who meet only 1 criteria and are therefore left out from the MHO group and also from the MAO/MUHO group?…”