Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults |
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| Institution: | 1. Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Diagonal 643, 08028 Barcelona, Spain;2. Arnau de Vilanova University Hospital (UdL), Surgery Unit, Spain;3. Endocrinology and Nutrition Department at Arnau de Vilanova University Hospital (UdL) and Diabetes and Metabolism Research Unit (VHIR, UAB) and CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM) at the Instituto de Salud Carlos III, Spain;4. Biochemistry Department, Hospital Universitari Vall D''Hebron, Universitat Autònoma De Barcelona, Spain;5. Endocrinology Surgery Unit, Hospital Universitari Vall D''Hebron, Universitat Autònoma De Barcelona, Spain;1. Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;2. Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;1. Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University, Baltimore, Maryland;2. Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, Maryland;3. Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University, Baltimore, Maryland;4. Cypress Fairbanks Medical Center, Houston, Texas;5. Department of Surgery, The Johns Hopkins University, Baltimore, Maryland;1. Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China;2. Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China;3. Department of Ultrasonography, Ningbo First Hospital, Ningbo, Zhejiang, China;4. Arrhythmia Center, Ningbo First Hospital, Ningbo, Zhejiang, China |
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| Abstract: | BackgroundIndividuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown.ObjectiveThe objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as lean, NWO, and overweight-obese. Secondary objectives of the study were to compare clinical biomarkers and food groups and macronutrient intakes between the three groups, and to test for associations between body composition components with diet quality scores and physical fitness levels.DesignThis is a secondary data analysis from a cross-sectional study that included metropolitan university and health care system employees. Body composition was measured by dual energy x-ray absorptiometry. Individuals with a body mass index <25 kg/m2 and body fat >23% for men and >30% for women were classified as having NWO. Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score were calculated from Block food frequency questionnaires. Physical fitness was assessed by measuring maximal oxygen uptake (VO2 maximum) during treadmill testing.Participants/settingThis study included 693 adults (65% women, mean age 48.9 ± 11.5 years) enrolled between 2007 and 2013 in Atlanta, GA.Main outcome measuresThe main outcome measures were Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Mediterranean Diet Score diet quality scores and maximal oxygen uptake.Statistical analysesMultiple linear regression analyses with post hoc comparisons were used to investigate group differences in fitness, diet quality, and biomarkers. Regression analyses were also used to examine relationships between diet quality scores and fitness with body composition.ResultsVO2 maximum was significantly lower in the NWO compared with the lean group (36.2 ± 0.8 mL/min/kg vs 40.2 ± 1.0 mL/min/kg; P < 0.05). Individuals with NWO reported similar diet quality to lean individuals and more favorable Alternate Healthy Eating Index and Dietary Approaches to Stop Hypertension scores than individuals with overweight-obesity (P < 0.05). Diet quality scores and physical fitness levels were inversely associated with percent body fat and visceral adipose tissue (P < 0.05), regardless of weight status. Individuals with NWO exhibited higher fasting blood insulin concentrations, insulin resistance, low-density lipoprotein cholesterol, and triglyceride levels, and significantly lower high-density lipoprotein cholesterol levels than lean individuals (P < 0.05).ConclusionsPhysical fitness was significantly decreased in individuals with NWO compared with lean individuals. Higher diet quality was associated with decreased total and visceral fat but did not distinguish individuals with NWO from lean individuals. |
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| Keywords: | Exercise Fat distribution Nutrition Overweight |
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