Metabolically Healthy Obesity Redefined

April-Sanders, Ayana; Rodríguez, Carlos J.

doi:10.1001/jamanetworkopen.2021.8860

Cited by 39 publications

(35 citation statements)

References 7 publications

(15 reference statements)

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“…Obesity, a state of pathological increase in the amount of adipose tissue and accumulation of excessive body fat mass, is recognized as a risk factor for developing non-communicable diseases (NCDs), such as type 2 diabetes, hypertension, hyperlipidemia and cardiovascular diseases (CVDs) [2]. Interestingly, not all people meeting the criteria for obesity demonstrate poor metabolic complications; they are considered to present with a metabolically healthy obesity that is in transition into developing into metabolically unhealthy obesity [3].…”

Section: Introductionmentioning

confidence: 99%

Clitoria ternatea Flower Extract Attenuates Postprandial Lipemia and Increases Plasma Antioxidant Status Responses to a High-Fat Meal Challenge in Overweight and Obese Participants

Thilavech

Channuwong

Radarit

et al. 2021

Biology

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High-fat (HF) meal-induced postprandial lipemia, oxidative stress and low-grade inflammation is exacerbated in overweight and obese individuals. This postprandial dysmetabolism contributes to an increased risk of cardiovascular disease and metabolic disorders. Clitoria ternatea flower extract (CTE) possesses antioxidant potential and carbohydrate and fat digestive enzyme inhibitory activity in vitro. However, no evidence supporting a favorable role of CTE in the modulation of postprandial lipemia, antioxidant status and inflammation in humans presently exists. In the present study, we determine the effect of CTE on changes in postprandial glycemic and lipemic response, antioxidant status and pro-inflammatory markers in overweight and obese men after consumption of an HF meal. Following a randomized design, sixteen participants (age, 23.5 ± 0.6 years, and BMI, 25.7 ± 0.7 kg/m2) were assigned to three groups that consumed the HF meal, or HF meal supplemented by 1 g and 2 g of CTE. Blood samples were collected at fasting state and then at 30, 60, 90, 120, 180, 240, 300 and 360 min after the meal consumption. No significant differences were observed in the incremental area under the curve (iAUC) for postprandial glucose among the three groups. Furthermore, 2 g of CTE decreased the iAUC for serum triglyceride and attenuated postprandial serum free fatty acids at 360 min after consuming the HF meal. In addition, 2 g of CTE significantly improved the iAUC for plasma antioxidant status, as characterized by increased postprandial plasma FRAP and thiol levels. Postprandial plasma glutathione peroxidase activity was significantly higher at 180 min after the consumption of HF meal with 2 g of CTE. No significant differences in the level of pro-inflammatory cytokines (interleukin-6, interleukin-1β and tumor necrosis factor-α) were observed at 360 min among the three groups. These findings suggest that CTE can be used as a natural ingredient for reducing postprandial lipemia and improving the antioxidant status in overweight and obese men after consuming HF meals.

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Section: Introductionmentioning

confidence: 99%

Clitoria ternatea Flower Extract Attenuates Postprandial Lipemia and Increases Plasma Antioxidant Status Responses to a High-Fat Meal Challenge in Overweight and Obese Participants

Thilavech

Channuwong

Radarit

et al. 2021

Biology

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“…Currently, there is no internationally adopted standard for identifying MHO, and more than 30 distinct criteria have been employed to operationalize the symptoms in research [ 3 , 83 ]. Some criteria used to define metabolically healthy obesity are shown in Table 2 .…”

Section: Definition and Concept Of Mhomentioning

confidence: 99%

“…Some criteria used to define metabolically healthy obesity are shown in Table 2 . This may explain why the prevalence, stability, and clinical effects of MHO differ from study to study, contributing to an ongoing unresolved dispute [ 83 ]. Despite differences in definitions, some common elements of MHO are repeatedly empathized: healthy obesity denotes an absence of metabolic abnormalities in obese individuals, such as type 2 diabetes, dyslipidemia, and hypertension.…”

Section: Definition and Concept Of Mhomentioning

confidence: 99%

Pathogenesis, Murine Models, and Clinical Implications of Metabolically Healthy Obesity

Cho

Lee

Jung

2022

IJMS

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Although obesity is commonly associated with numerous cardiometabolic pathologies, some people with obesity are resistant to detrimental effects of excess body fat, which constitutes a condition called “metabolically healthy obesity” (MHO). Metabolic features of MHO that distinguish it from metabolically unhealthy obesity (MUO) include differences in the fat distribution, adipokine types, and levels of chronic inflammation. Murine models are available that mimic the phenotype of human MHO, with increased adiposity but preserved insulin sensitivity. Clinically, there is no established definition of MHO yet. Despite the lack of a uniform definition, most studies describe MHO as a particular case of obesity with no or only one metabolic syndrome components and lower levels of insulin resistance or inflammatory markers. Another clinical viewpoint is the dynamic and changing nature of MHO, which substantially impacts the clinical outcome. In this review, we explore the pathophysiology and some murine models of MHO. The definition, variability, and clinical implications of the MHO phenotype are also discussed. Understanding the characteristics that differentiate people with MHO from those with MUO can lead to new insights into the mechanisms behind obesity-related metabolic derangements and diseases.

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“…Thus, delaying the transition of MHO to MUO is suggested as a pragmatic strategy to reduce complications from obesity [11]. MHO is a temporary state and could transition to MUO as a result of ageing, weight gain, and an unhealthy lifestyle [12]. Nutritional factors, such as energy restriction and healthy eating patterns, have been identified as potential factors associated with MHO duration [13,14].…”

Section: Introductionmentioning

confidence: 99%

Do Temporal Eating Patterns Differ in Healthy versus Unhealthy Overweight/Obese Individuals?

et al. 2021

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This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41–13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11–5.13) (OR = 2.33, 95% CI 1.03–5.32) (OR = 4.45, 95% CI 1.71–11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.

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Metabolically Healthy Obesity Redefined

Cited by 39 publications

References 7 publications

Clitoria ternatea Flower Extract Attenuates Postprandial Lipemia and Increases Plasma Antioxidant Status Responses to a High-Fat Meal Challenge in Overweight and Obese Participants

Clitoria ternatea Flower Extract Attenuates Postprandial Lipemia and Increases Plasma Antioxidant Status Responses to a High-Fat Meal Challenge in Overweight and Obese Participants

Pathogenesis, Murine Models, and Clinical Implications of Metabolically Healthy Obesity

Do Temporal Eating Patterns Differ in Healthy versus Unhealthy Overweight/Obese Individuals?

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