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Role of Physical Activity and Fitness in the Characterization and Prognosis of the Metabolically Healthy Obesity Phenotype: A Systematic Review and Meta-analysis

dc.contributor.authorOrtega F.B.
dc.contributor.authorCadenas-Sanchez C.
dc.contributor.authorMigueles J.H.
dc.contributor.authorLabayen I.
dc.contributor.authorRuiz J.R.
dc.contributor.authorSui X.
dc.contributor.authorBlair S.N.
dc.contributor.authorMartínez-Vizcaino V.
dc.contributor.authorLavie C.J.
dc.date.accessioned2020-09-02T22:25:11Z
dc.date.available2020-09-02T22:25:11Z
dc.date.issued2018
dc.identifier10.1016/j.pcad.2018.07.008
dc.identifier.citation61, 2, 190-205
dc.identifier.issn00330620
dc.identifier.urihttps://hdl.handle.net/20.500.12728/5682
dc.descriptionThe aims of the present article are to systematically review and meta-analyze the existing evidence on: 1) differences in physical activity (PA), sedentary behavior (SB), cardiorespiratory fitness (CRF) and muscular strength (MST) between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO); and 2) the prognosis of all-cause mortality and cardiovascular disease (CVD) mortality/morbidity in MHO individuals, compared with the best scenario possible, i.e., metabolically healthy normal-weight (MHNW), after adjusting for PA, SB, CRF or MST. Our systematic review identified 67 cross-sectional studies to address aim 1, and 11 longitudinal studies to address aim 2. The major findings and conclusions from the current meta-analysis are: 1) MHO individuals are more active, spend less time in SB, and have a higher level of CRF (yet no differences in MST) than MUO individuals, suggesting that their healthier metabolic profile could be at least partially due to these healthier lifestyle factors and attributes. 2) The meta-analysis of cohort studies which accounted for PA (N = 10 unique cohorts, 100% scored as high-quality) support the notion that MHO individuals have a 24–33% higher risk of all-cause mortality and CVD mortality/morbidity compared to MHNW individuals. This risk was borderline significant/non-significant, independent of the length of the follow-up and lower than that reported in previous meta-analyses in this topic including all type of studies, which could be indicating a modest reduction in the risk estimates as a consequence of accounting for PA. 3) Only one study has examined the role of CRF in the prognosis of MHO individuals. This study suggests that the differences in the risk of all-cause mortality and CVD mortality/morbidity between MHO and MHNW are largely explained by differences in CRF between these two phenotypes. © 2018 Elsevier Inc.
dc.language.isoen
dc.publisherW.B. Saunders
dc.subjectCardiorespiratory fitness
dc.subjectCardiovascular disease
dc.subjectExercise
dc.subjectMetabolically health normal-weight
dc.subjectMetabolically healthy obesity
dc.subjectMetabolically unhealthy obesity
dc.subjectMortality
dc.subjectMuscular strength
dc.subjectObesity
dc.subjectPhysical activity
dc.subjectSedentary behaviors
dc.subjectaerobic exercise
dc.subjectall cause mortality
dc.subjectcardiorespiratory fitness
dc.subjectcardiovascular disease
dc.subjectcardiovascular mortality
dc.subjectcardiovascular risk
dc.subjectcoronary artery disease
dc.subjecthuman
dc.subjecthyperlipidemia
dc.subjectischemic heart disease
dc.subjectmeta analysis
dc.subjectmuscle strength
dc.subjectobesity
dc.subjectphenotype
dc.subjectphysical activity
dc.subjectprognosis
dc.subjectReview
dc.subjectrisk reduction
dc.subjectsedentary lifestyle
dc.subjectsystematic review
dc.subjectenergy metabolism
dc.subjectfitness
dc.subjecthealth status
dc.subjecthealthy lifestyle
dc.subjectmetabolically benign obesity
dc.subjectmetabolism
dc.subjectpathophysiology
dc.subjectphenotype
dc.subjectrisk factor
dc.subjectCardiorespiratory Fitness
dc.subjectEnergy Metabolism
dc.subjectHealth Status
dc.subjectHealthy Lifestyle
dc.subjectHumans
dc.subjectMuscle Strength
dc.subjectObesity, Metabolically Benign
dc.subjectPhenotype
dc.subjectPhysical Fitness
dc.subjectPrognosis
dc.subjectRisk Factors
dc.titleRole of Physical Activity and Fitness in the Characterization and Prognosis of the Metabolically Healthy Obesity Phenotype: A Systematic Review and Meta-analysis
dc.typeReview


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