Ability of physical activity measurements to assess health-related risks Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Unhealthy eating habits, physical exercise and macronutrient intakes are predictors of anthropometric indicators in the Women's Health Trial: Feasibility Study in Minority Populations. Lifestyle intervention in obese Arab women: a randomized controlled trial. Prevalence and Correlates of Obesity in a Community Sample of Individuals with Severe and Persistent Mental Illness A randomized trial of lifestyle intervention in primary healthcare for the modification of cardiovascular risk factors The Björknäs study Evaluation of weight reduction in a community intervention for cardiovascular disease risk: changes in body mass index in the Minnesota Heart Health Program. Effect of Different Obesity Phenotypes on Incidence of Chronic Kidney Disease in Tehranian Adults Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity A randomized controlled trial on a multicomponent intervention for overweight school-aged children – Copenhagen, Denmark Obesity, Abdominal Obesity and Alzheimer Disease The Master Questionnaire: preliminary report on an obesity assessment device. Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth. Impact of obesity in asthma: evidence from a large prospective disease management study. Using routinely collected growth data to assess a school-based obesity prevention strategy The long-term effectiveness of a lifestyle intervention in severely obese individuals. Obesity phenotype and incident hypertension: a prospective community-based cohort study
The aim of this study is to evaluate if two different physical activity ( PA ) question naires have similar ability to rank individuals , and to examine associations with cardiovascular-metabolic risk factors , compared to an objective measure . In a r and om sample ( n=369 , age : 65±6 years ) from the population -based ‘ Malmö Diet and Cancer ’ ( MDC ) cohort , PA was measured by a leisure-time comprehensive question naire ( MDC-score ) , a simple leisure-time question naire and by accelerometer-monitoring ( CSA ) . Moderate correlations were observed between MDC-score and CSA in men and women ( r=0.35 and 0.24 , respectively ) . In men , both question naires and CSA were inversely associated with waist circumference , insulin resistance and metabolic syndrome . In women , the MDC-score was positively associated with high-density lipoprotein-cholesterol , and the simple question naire inversely associated with anthropometric indexes , but no association was seen between PA estimates and cardiovascular components . We conclude that both PA question naires distinguish health risks associated with anthropometric-metabolic risk factors , particularly in men BACKGROUND Diet , smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation . We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study , a r and omized dietary primary prevention trial conducted in Spain . METHODS 7000 subjects at high cardiovascular risk were assessed cross-sectionally . A  healthy lifestyle pattern ( HLP ) was determined using a score including :  adherence to the Mediterranean diet , moderate alcohol consumption , expending ≥200 kcal/day in leisure-time physical activity , and non-smoking . RESULTS Inverse linear trends were observed between the HLP-score and body-mass-index ( BMI ) or waist circumference ( p<0.001 ) . The BMI and waist circumference of participants with a HLP-score=4 were , respectively , 1.3 kg/m(2 ) ( 95 % CI : 0.9 to 1.7 ) and 4.3 cm ( 3.1 to 5.4 ) lower than those of subjects with an HLP≤1 . The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score≤1 were 0.50 ( 0.42 to 0.60 ) and 0.51 ( 0.41 to 0.62 ) , respectively . CONCLUSION A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk The increasing prevalence of obesity in the USA , especially among minority population s , is a serious public health concern . This present study analysed repeated measurements at baseline and at 6 and 12 months on 351 women in the control group and 575 women in the intervention group of the Women 's Health Trial : Feasibility Study in Minority Population s. Dynamic r and om effects models were estimated using the three repeated observations to explain the effects of energy and macronutrient intakes , physical exercise , unhealthy eating habits and socio-economic characteristics on the subjects ' body weights and waist and hip circumferences . In both the control and intervention groups , physical exercise was negatively associated with body weight and with waist and hip circumferences , while an index of unhealthy eating habits was positively associated ( P<0.05 ) . The proportion of energy derived from carbohydrate and from saturated and monounsaturated fat were often significant predictors of body weight and of waist and hip circumferences in the two groups . The results indicated that nutrition education programmes for improving eating habits and increasing physical exercise can reduce obesity prevalence in the USA BACKGROUND Few r and omized controlled trials on lifestyle interventions have been reported in non-Western population s ; none have been reported in Arab population s. METHODS From 2 Muslim Arab communities in Israel , obese , nondiabetic women aged 35 to 54 years with 1 or more components of the metabolic syndrome were r and omized to either an intensive ( n = 100 ) or a moderate ( control ) ( n = 101 ) 12-month lifestyle intervention . Women in the intensive intervention had 11 individual and 11 group counseling sessions per year with a dietitian and 22 physical activity group sessions per year . Women in the moderate intervention had 3 individual and 2 group dietary counseling sessions per year and no guided physical activity . Cultural issues were addressed in the design and conduct of both interventions . The primary outcome measure was change in the metabolic syndrome and its components . RESULTS At 12 months , the intensive intervention group had median declines of 3.0 mg/dL ( to convert to millimoles per liter , multiply by 0.0555 ) in fasting plasma glucose and 4.5 mg/dL ( to convert to millimoles per liter , multiply by 0.0113 ) in triglyceride levels compared with median increases of 1 mg/dL in fasting plasma glucose and 5.8 mg/dL in triglyceride levels in the moderate intervention group ( P = .01 and P = .02 , respectively ) . The median waist circumference decreased by 5.4 cm in the intensive intervention group and by 3.1 cm in the moderate intervention group ( P = .10 ) . The prevalence of the metabolic syndrome decreased by 4.0 % in the intensive intervention group and increased by 5.2 % in the moderate intervention group ( P = .12 ) . CONCLUSION The 12-month culturally sensitive intensive lifestyle intervention was effective in improving some of the metabolic syndrome components in obese Arab women . Trial Registration clinical trials.gov Identifier : NCT00273572 Individuals with severe and persistent mental illness ( SPMI ) have a preponderance of weight problems , possibly even greater than the obesity epidemic in the general population . Although atypical antipsychotics cause weight gain , their contribution to obesity has not been characterized in a community setting where individuals may take multiple psychotropics associated with weight gain . Using survey information including measured height and weight from a r and om sample of Maryl and Medicaid recipients with SPMI , we compared obesity prevalence to the National Health and Nutrition Examination Survey ( NHANES III ) sample and a Maryl and sample ( Behavioral Risk Factor Surveillance System ) of the general population adjusted to SPMI demographic characteristics . We investigated correlates of obesity in the SPMI sample . The results indicate that both men and especially women with SPMI had a higher prevalence of obesity than the general population ; this portends substantial health implication s. A fourfold association between atypical antipsychotics and prevalent obesity was found in men but not in women ; further work should clarify mechanisms of obesity in the SPMI Aims : To evaluate the effects of a lifestyle intervention programme in primary healthcare , targeted to patients with moderate to high risk of cardiovascular disease in terms of cardiovascular risk factors , physical activity , and quality of life . Method : R and omized controlled trial with one-year follow-up , carried out in a primary healthcare centre in Northern Sweden . A total of 151 middle-aged men and women , with hypertension , dyslipidemia , type 2 diabetes , or obesity were enrolled . The subjects were r and omized to either the intervention ( n=75 ) or the control group ( n=76 ) . A total of 123 subjects completed the one-year follow-up . Interventions : Exercise : supervised endurance and circuit training in groups three times a week for three months . Diet : five group sessions of diet counselling with a dietitian . Follow- up meetings with a physiotherapist were conducted monthly thereafter . Primary outcomes were changes in anthropometry , maximal oxygen uptake , health-related quality of life , and self-reported physical activity . The secondary outcomes were changes in blood pressure and metabolic variables . Results : After one year the intervention group significantly increased maximal oxygen uptake , physical activity , and quality of life and significantly decreased body weight , waist and hip circumference , body mass index , waist — hip ratio , systolic and diastolic blood pressure , triglycerides , and glycosylated haemoglobin . There were significant differences between groups , mean changes ( and their 95 % confidence intervals , CI ) in waist circumference -1.9 cm ( -2.80 to -0.90 ; p<0.001 ) , in waist — hip ratio -0.01 ( -.02 to -0.004 ; p<0.01 ) and in diastolic blood pressure -2.3 mmHg ( -4.04 to -0.51 ; p<0.05 ) . Conclusion : A prevention programme in primary healthcare with a focus on physical activity and diet counselling followed by structured follow-up meetings can favourably influence several risk factors for cardiovascular diseases and quality of life in high-risk subjects for at least one year This paper describes the effectiveness of the Minnesota Heart Health Program ( MHHP ) in modifying mean body mass index ( BMI ) in whole communities . The MHHP is a 13-year research and demonstration project design ed to reduce cardiovascular risk . One member of each of three pairs of matched communities received 7 years of community intervention activities that included risk factor screening , mass media education , adult education classes , worksite interventions , home correspondence programs , school-based programs , restaurant programs , and point-of-purchase education in supermarkets .  Weight gain prevention was emphasized for all adults and weight loss was encouraged among those who were obese or who had elevated risk factors known to be responsive to weight loss ( e.g. , high blood pressure ) . A strong upward secular trend in weight was noted in all MHHP communities over time . Intervention effects were evaluated conservatively with community as the unit of analysis . This analysis showed no overall effect of the MHHP intervention program on mean BMI . However , a positive intervention effect was noted early in the intervention among those with elevated cholesterol or a history of obesity-related disease . Possible reasons for this relatively weak community effect are discussed , including secular forces overwhelming intervention effects , an intervention effort not sufficiently focused on obesity , ceiling effects for weight concern in a population that was highly aware of the issue at baseline , and inherent limitations in educational approaches for this recalcitrant public health problem Background : The aim of this community-based study is to ascertain the effect of different obesity phenotypes on the incidence of chronic kidney disease in Iranian adults . Study Design : A prospect i ve cohort study , the Tehran Lipid Glucose Study ( TLGS ) . Setting and Participants : Adults aged ≥ 20 years with a mean age of 40.38 years ( 54.8 % female ) who were free from chronic kidney disease ( CKD ) at baseline ( phase 1 ) and were followed up at 3 time stages ( phases 2 , 3 , and 4 ) for a mean duration of 9.4 years to assess the risk for CKD . Predictor : Obesity phenotypes . Outcome : Incidence of chronic kidney disease . Measurements : Glomerular filtration rate ( GFR ) was estimated from the simplified equation developed using data from the Modification of Diet in Renal Disease ( MDRD ) Study . Results : CKD events occurred in 1162 participants . The prevalence of the 2 known obesity phenotypes ( metabolically obese normal weight [ MONW ] and metabolically healthy but obese [ MHO ] ) in the overall population was 3.5 % and 8.8 % , respectively . According to Kaplan-Meier curves , rates of freedom from CKD in the MHO and MONW obesity phenotypes were 75.3 % and 60.6 % , respectively ( p < 0.0001 ) . Age- and sex-adjusted ( model 1 ) hazard ratios for participants with MHO or MONW obesity phenotype were 1.14 ( 95 % confidence interval [ CI ] , 0.91–1.43 ) and 1.43 ( 95 % CI , 1.09–1.88 ) , respectively . After further adjustment for confounder variables ( model 2 ) , multivariate-adjusted hazard ratios for CKD for participants with MHO or MONW obesity phenotypes were 1.23 ( 95 % CI , 0.93–1.62 ) and 1.43 ( 95 % CI , 1.08–1.90 ) , respectively . Conclusion : Adults with the MONW obesity phenotype compared to those with MHO obesity phenotype have a higher risk for incidence of CKD . The results indicate that having a normal weight is not the only factor to protect against incidence of CKD Background : Anthropometric-based classification schemes for excess adiposity do not include direct assessment of obesity-related comorbidity and functional status and thus have limited clinical utility . We examined the ability of the Edmonton obesity staging system , a 5-point ordinal classification system that considers comorbidity and functional status , in predicting mortality in a nationally representative US sample . Methods : We analyzed data from the National Health and Human Nutrition Examination Surveys ( NHANES ) III ( 1988–1994 ) and the NHANES 1999–2004 , with mortality follow-up through to the end of 2006 . Adults ( age ≥ 20 yr ) with overweight or obesity who had been r and omized to the morning session at the mobile examination centre were scored according to the Edmonton obesity staging system . We examined the relationship between staging system scores and mortality , and Cox proportional hazards models were adjusted for the presence of the metabolic syndrome or hypertriglyceridemic waist . Results : Over 75 % of the cohort with overweight or obesity were given scores of 1 or 2 . Scores of 4 could not be reliably assigned because specific data elements were lacking . Survival curves clearly diverged when stratified by scores of 0–3 , but not when stratified by obesity class alone . Within the data from the NHANES 1988–1994 , scores of 2 ( hazard ratio [ HR ] 1.57 ; 95 % confidence interval [ CI ] 1.16 to 2.13 ) and 3 ( HR 2.69 ; 95 % CI 1.98 to 3.67 ) were associated with increased mortality compared with scores of 0 or 1 , even after adjustment for body mass index and the metabolic syndrome . We found similar results after adjusting for hypertriglyceridemic waist ( i.e. , waist circumference ≥ 90 cm and a triglyceride level ≥ 2 mmol/L for men ; the corresponding values for women were ≥ 85 cm and ≥ 1.5 mmol/L ) , as well as in a cohort eligible for bariatric surgery . Interpretation : The Edmonton obesity staging system independently predicted increased mortality even after adjustment for contemporary methods of classifying adiposity . The Edmonton obesity staging system may offer improved clinical utility in assessing obesity-related risk and prioritizing treatment Background Obesity amongst children is a growing problem worldwide . In contrast to adults , little is known on the effects of controlled weight loss on components of the metabolic syndrome in children . The primary aim of the study was to evaluate the effects of a 20-week exercise and diet guidance intervention on body mass index ( BMI ) in a group of overweight children . Our hypothesis was an observed reduction in BMI and secondarily in body fat content , insulin insensitivity , and other components of the metabolic syndrome in the intervention group . Methods School children from Copenhagen were r and omly allocated to an  intervention group  ( n = 19 ) or a control group  ( n = 19 ) . Anthropometric assessment , whole body dual-energy X-ray absorptiometry scan , two hours oral glucose tolerance test , steps measured by pedometer , and fitness tests  were measured at baseline and at 20 weeks . Results Thirty-seven children ( 30 girls ) participated at baseline , aged 8.7 ± 0.9 years with a BMI of 21.8 ± 3.7 kg/m2 ( mean ± SD ) , and 36 children completed the study . The intervention group decreased their BMI ( the intervention effect is the difference in change between the groups adjusted for the respective baseline values ( DELTA ) = -2.0 kg/m2 , 95 % CI : -2.5 ; -1.5 , P < 0.001 ) , total body mass ( DELTA = -4.0 kg , 95 % CI : -4.9 ; -3.0 , P < 0.001 ) , and fat mass ( DELTA = -3.3 kg , 95 % CI : -4.2 ; -2.7 , P < 0.001 ) compared to the control group after the intervention . The intervention group displayed decreased waist , hip and waist-to-height ratio ( WHtR ) ( all three variables ; P < 0.001 ) , area under curve for plasma insulin ( P < 0.05 ) , and increased mean and minimum steps/day ( P < 0.05 and P < 0.01 , respectively ) . Conclusions The multicomponent intervention had significant favorable effects on BMI , weight , WHtR , mean and minimum steps/day , and fat mass . In addition , similar beneficial metabolic effects were found in the children as shown in adults , e.g. increase in peripheral insulin sensitivity . Trial registration Clinical trials.gov Identifier number NCT01660789 Background / Aims : Obesity has a strong association with vascular and metabolic diseases , which have been linked with Alzheimer disease ( AD ) . While recent studies have reported an association between mid-life obesity and dementia , the role of later-life obesity is less clear . This study investigated the relation between AD , obesity and abdominal obesity at later-life in a case-control study . Methods : Participants were 50 consecutive patients with probable AD from memory disorders clinics in Launceston , Australia , and Bristol , Engl and , and 75 cognitively normal controls .  Height and weight [ from which body mass index ( BMI ) was calculated ] and hip and waist circumferences ( from which waist-hip ratio was calculated ) were measured . Participants were classified according to their BMI as : underweight ( BMI < 20.0 kg/m2 ) ; normal weight ( BMI 20.0–24.9 kg/m2 ) ; overweight ( BMI 25–29.9 kg/m2 ) , or obese ( BMI ≧30 kg/m2 ) . They were classified as abdominally obese if their waist-hip ratio was > 0.9 ( men ) or > 0.8 ( women ) . Results : AD was associated with obesity [ OR 9.5 , 95 % CI 2.4–37.3 , p = 0.001 ] , underweight ( OR 5.4 , CI 0.9–33.7 , p = 0.07 ) and abdominal obesity ( OR 2.5 , CI 1.1–5.7 , p = 0.027 ) using logistic regression analyses adjusted for age , sex and location . The inclusion of metabolic risk factors in the model increased the ORs for obesity ( OR 12.6 , CI 2.8–56.5 , p = 0.001 ) and underweight ( OR 7.9 , CI 1.0–66.3 , p = 0.056 ) . Conclusion : AD may be associated with obesity , underweight and abdominal obesity at later life . Larger prospect i ve studies are required to investigate this further Behavioral obesity research ers are increasingly concerned with thorough assessment of obesity . The present report describes the preliminary testing and refinement of the Master Question naire ( MQ ) , a true-false scale developed expressly for use in obesity research . It was initially divided into four subscales : Spouse Support , Energy Balance Habits , Cognitive Factors , and Energy Balance Knowledge , and was intended for use as an outcome measure and as a predictor of change in obesity status . Its stability , internal consistency , sensitivity to treatment-related change , and predictive validity were examined . Test-retest reliability and sensitivity to treatment-related change were each found to be acceptable for three out of four subscales . Two subscales , Energy Balance Knowledge and Cognitive Factors , predicted outcome . The major weakness of the subscales was a lack of unidimensionality which would limit their utility . Cluster and factor analyses were used to develop five new subscales with acceptable levels of internal consistency . While some additional development and validation is still needed , the available evidence suggests that we have the nucleus of a strong assessment tool for obesity research Intervention studies in youth with obesity that can be translated into primary care are limited . We compared a lifestyle intervention to a brief intervention applied by primary care physicians ( control group ) for treating pediatric obesity in the primary care setting . Seventy-six youth with obesity ( body mass index [ BMI ] > 95th percentile or > 90th percentile plus waist circumference > 90th percentile , aged 9 to 17 years ) participated in a 12-month , r and omized , controlled trial , conducted at a primary care unit in Northern México from June 2006 through October 2007 . Participants r and omized to lifestyle intervention attended a family-centered program consisting of 12 sessions of behavioral curriculum , dietary advice from a registered dietitian ( weekly for the first 3 months and monthly thereafter ) , and monthly consultations with a primary care physician . Control group participants attended monthly consultations with a primary care physician who received a brief training on obesity . Forty-three ( 57 % ) participants completed the 12 months of study . After 12 months , mean changes ( 95 % confidence interval ) in body weight for the lifestyle group and the control group were -0.8 kg ( -3.2 , 1.5 ) vs + 5.6 kg ( 3 , 8.2 ; P<0.001 ) and mean changes in BMI were -1.8 ( -2.6 , -0.9 ) vs + 0.4 ( -0.5 , 1.3 ; P<0.001 ) , respectively . Intention-to-treat analysis at 12 months confirmed significant differences in primary outcomes ( weight -3.5 kg , P=0.02 ; BMI -1.2 , P=0.03 ) in favor of the lifestyle group . This study provides preliminary evidence that primary care physicians supported by a registered dietitian and a behavioral curriculum can be a successful strategy for treating pediatric obesity in the primary care setting BACKGROUND asthma and obesity continue to have a significant effect on public health . It is widely accepted that obesity may be an independent risk factor for asthma and affect asthma severity and quality of life ( QOL ) . OBJECTIVE to examine the relationship between body mass index ( BMI [ calculated as weight in kilograms divided by height in meters squared ] ) and asthma severity , spirometry findings , health care utilization ( HCU ) , and QOL . METHODS this 12-month prospect i ve r and omized controlled trial comparing disease management with traditional care enrolled 902 patients ( 473 pediatric and 429 adults ) representing an underserved population . Data collected at baseline and at 6-month intervals included demographics , asthma severity , medication use , spirometry findings , and HCU . The QOL was assessed using the pediatric and adult versions of the Asthma Quality of Life Question naire and the 36-Item Short Form Health Survey .  All HCU was determined by means of patient interview and extensive medical record review . Data were analyzed using negative binomial regression and analysis of variance . RESULTS in children , 45 % were overweight/obese ( 17 % with BMI s > 85th percentile ; 28 % with BMI s ≥ 95th percentile ) . In adults , 58 % were obese ( BMI s ≥ 30 ) . There was no relationship in children between BMI and severity of asthma , spirometry findings , QOL , or HCU . In adults , there was no relationship between BMI and asthma severity or HCU . Higher BMI was associated with a significant reduction in QOL ( P < .001 ) . The BMI had an inverse relationship with forced vital capacity but with no other spirometric values . CONCLUSIONS obesity was not associated with worse asthma severity , spirometry findings , QOL , or HCU in children . In adults with asthma , obesity was associated with lower forced vital capacity and QOL but not with severity or HCU Background : Studies of school-based anti-obesity interventions have yielded inconsistent results . Using growth screening data from a school administrative data base , we re-evaluated an obesity prevention strategy that was previously reported to have a beneficial effect on weight status of a sample of students in grade s 5–7 . Methods : Ten K-8 schools ( five control and five intervention ) participated in a 2-year cluster-r and omized trial of a multi-component nutrition education intervention . We obtained student height and weight data for 6 consecutive school years and imputed missing baseline and follow-up measurements ( 53 % and 55 % , respectively ) and defined the target population based on the intent-to-treat principle . We analyzed changes in body mass index ( BMI ) Z-scores via mixed-effects linear regression and in the prevalence of overweight/obesity via conditional logistic regression . We also assessed incidence and remission of overweight/obesity and long-term effects . Results : We analyzed data for 8186 ( 96 % ) K-8 students in the 10 schools ( 4511 in intervention ; 3675 in control ) . From baseline to the end of the intervention period , mean increases in BMI Z-score were 0.10 and 0.09 in the control and intervention groups , respectively ( P=0.671 ) . The prevalence of overweight/obesity increased by 3 % in both groups ( P=0.926 ) . There was no significant intervention effect on the incidence or remission of overweight/obesity .  Among 5469 students who attended study schools during both years of the intervention , there was no significant intervention effect . Furthermore , there was no long-term effect among students with up to 2 years of data beyond the end of the intervention . Conclusion : Using routinely collected data for the entire target population , we failed to confirm earlier findings of an intervention effect observed in a subset of students in grade s 5–7 . Volunteer bias in the prior evaluation and /or measurement error in the routinely collected data are potential reasons for the discrepant findings OBJECTIVE Severe obesity ( body mass index [ BMI ] ≥40 kg/m(2 ) ) is a serious public health concern . Although bariatric surgery is an efficacious treatment approach , it is limited in reach ; thus , nonsurgical treatment alternatives are needed . We examined the 4-year effects of an intensive lifestyle intervention  on body weight and cardiovascular disease risk factors among severely obese , compared with overweight ( 25 ≤ BMI < 30 ) , class I ( 30 ≤ BMI < 35 ) , and class II obese ( 35 ≤ BMI < 40 ) participants . METHODS There were 5145 individuals with type 2 diabetes ( 45 - 76 years , BMI ≥25 kg/m(2 ) ) r and omized to an intensive lifestyle intervention or diabetes support and education .  The lifestyle intervention group received a behavioral weight loss program that included group and individual meetings , a ≥10 % weight loss goal , calorie restriction , and increased physical activity . Diabetes support and education received a less intense educational intervention . Four-year changes in body weight and cardiovascular disease risk factors were assessed . RESULTS Across BMI categories , 4-year changes in body weight were significantly greater in lifestyle participants compared with diabetes support and education ( Ps < .05 ) . At year 4 , severely obese lifestyle participants lost 4.9%±8.5 % , which was similar to class I ( 4.8%±7.2 % ) and class II obese participants ( 4.4%±7.6 % ) , and significantly greater than overweight participants ( 3.4%±7.0 % ; P < .05 ) . Four-year changes in low-density-lipoprotein cholesterol , triglycerides , diastolic blood pressure , HbA(1c ) , and blood glucose were similar across BMI categories in lifestyle participants ; however , the severely obese had less favorable improvements in high-density-lipoprotein cholesterol ( 3.1±0.4 mg/dL ) and systolic blood pressure ( -1.4±0.7 mm Hg ) compared with the less obese ( Ps < .05 ) . CONCLUSION Lifestyle interventions can result in important long-term weight losses and improvements in cardiovascular disease risk factors among a significant proportion of severely obese individuals Objective : The relationship betweens the healthy obese phenotype and the risk of cardiovascular events remains unclear . We prospect ively investigated the association between the obesity phenotype and the incidence of hypertension . Methods : We studied 2352 participants , aged 40–69 years at baseline , with normal blood pressure ( BP ) from the Ansan cohort and the Ansung cohort of the Korean Genome Epidemiology Study . Participants were divided into six groups based on BMI and the metabolic syndrome ( MetS ) components : healthy ( none of the five MetS components ) normal weight ( BMI < 23 kg/m2 ) , unhealthy ( one or more MetS component ) normal weight , healthy overweight ( BMI 23–24.9 kg/m2 ) , unhealthy overweight , healthy obesity ( BMI ≥25 kg/m2 ) , and unhealthy obesity .  The incidence of hypertension was identified by biennial health examinations during the 8-year follow-up . Results : After adjusting for age , sex , cohort , physical activity , smoking , alcohol consumption , and family history of hypertension and cardiovascular diseases , an increased risk for hypertension in combined cohort was observed in the healthy obesity [ hazard ratio ( HR ) : 2.20 , 95 % confidence interval (CI):1.34–3.60 ] , unhealthy overweight ( HR : 1.47 , 95 % CI : 1.00–2.14 ) , and unhealthy obesity ( HR : 2.45 , 95 % CI : 1.79–3.37 ) , compared with the healthy normal weight group . In each cohort , the healthy obesity was still associated with a higher incidence of hypertension ( HR 2.20 , 95 % CI 1.11–4.36 for the Ansan cohort and HR 2.21 , 95 % CI 1.01–4.83 for the Ansung cohort ) . Conclusion : These findings provide evidence that the metabolically healthy obese phenotype may not be a benign condition
Following intervention , there was certain and significant improvement of metabolic state for metabolically abnormal obesity ( MAO ) subjects .
Only diastolic blood pressure had reduced for MHO individuals after intervention .
Conclusions : Almost one-third of the obese individuals are in metabolic health .
However , they are still at higher risk of advancing to unhealthy state .
Background : We conducted a systematic review and meta- analysis to firstly obtain a reliable estimation of the prevalence of metabolically healthy obese ( MHO ) individuals in obesity , then assessed the risk of developing metabolic abnormalities ( MA ) among MHO individuals .
At last , we evaluated the effects of traditional lifestyle interventions on metabolic level for MHO subjects .