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Determinants of the transition from a cardiometabolic normal to abnormal overweight/obese phenotype in a Spanish population

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Abstract

Purpose

There is limited prospective evidence at population scale of the impacts of lifestyle and surrogate measures of general and abdominal adiposity on the transition of a metabolically healthy (absence of a metabolic disorder) overweight/obese (MHOO) phenotype to a metabolically abnormal overweight/obese (MAOO) phenotype. Therefore, we determined the relationship between 10-year body mass index (BMI), waist circumferences (WC), waist to height ratio (WHtR), and lifestyle changes and the transition of the MHOO phenotype.

Methods

We conducted a prospective population-based study of 3,052 male and female Spaniards aged 25–74 years who were followed from 2000 through 2009. Diet and leisure-time physical activity were recorded on validated questionnaires. Weight, height, WC, blood lipids, glycemia, and blood pressure were measured. All variables were obtained at baseline (BL) and follow-up (FL). Participants with a BMI ≥ 25 kg/m2 and free from hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, and low HDL and high LDL cholesterol levels were characterized as the MHOO phenotype. A composite healthy lifestyle index (HLI) was constructed by including temporary changes in 3 lifestyle variables (diet, leisure-time physical activity, and smoking).

Results

Initially, 20.8 % of subjects had the MHOO phenotype; 49.2 % of these shifted to MAOO phenotype. In multivariate analysis, changes in BMI, WC, WHtR were positively associated (p = 0.004, p = 0.018, and p = 0.016, respectively) with this transition. One unit increase in the HLI was associated with a 33 % lower risk (p = 0.025) to the MAOO phenotype transition after adjusting for age, sex, educational level, and baseline energy intake, BMI, WC, and WHtR.

Conclusions

The presence of metabolic disorders in the MHOO phenotype is predicted by an increase in anthropometric surrogate measures of general and abdominal adiposity. In contrast, a healthy lifestyle protects against a transition to the MAOO phenotype.

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Acknowledgments

The authors appreciate the English revision made by Elaine Lilly, PhD (Writers First Aid). This research was supported by grants from European Regional Development Found-EDRF (2FD097-0297-CO2-01), Instituto de Salud Carlos III-EDRF (PI11/01900; Red HERACLES RD06/0009), Agència de Gestió d’Ajuts Universitaris de Recerca (2009 SGR 1195) and by a joint contract of the Instituto de Salud Carlos III and the Health Department of the Catalan Government (Generalitat de Catalunya), CP 03/00115. The CIBEROBN and CIBERESP are initiatives of the Instituto de Salud Carlos III, Madrid, Spain.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Institut de Recerca Hospital del Mar), Barcelona, Spain

    Helmut Schröder & Montserrat Fíto

  2. Network of Centers for Biomedical Research (Centros de Investigación Biomédica en Red—CIBER), CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain

    Helmut Schröder & José M. Baena-Díez

  3. Research Unit, Àmbit d’Atenció Primària de Girona, IDIAP JGol, Institut Català de la Salut, Girona, Spain

    Rafel Ramos

  4. School of Medicine, Universitat de Girona, Girona, Spain

    Rafel Ramos

  5. Centro de Salud La Marina, IDIAP Jordi Gol, Barcelona, Spain

    José M. Baena-Díez

  6. Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Michelle A. Mendez

  7. Universitat de Girona, Girona, Spain

    Dolors Juvinyà Canal

  8. Network of Centers for Biomedical Research (Centros de Investigación Biomédica en Red—CIBER), Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain

    Montserrat Fíto

  9. Department of Cardiology, Hospital Josep Trueta, Girona, Spain

    Joan Sala

  10. Cardiovascular Epidemiology and Genetics Research Group (EGEC-ULEC), Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Institut de Recerca Hospital del Mar), Barcelona, Spain

    Roberto Elosua

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  1. Helmut Schröder
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  2. Rafel Ramos
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  3. José M. Baena-Díez
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  4. Michelle A. Mendez
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  7. Joan Sala
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  8. Roberto Elosua
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Correspondence to Helmut Schröder.

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Schröder, H., Ramos, R., Baena-Díez, J.M. et al. Determinants of the transition from a cardiometabolic normal to abnormal overweight/obese phenotype in a Spanish population. Eur J Nutr 53, 1345–1353 (2014). https://doi.org/10.1007/s00394-013-0635-2

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  • DOI: https://doi.org/10.1007/s00394-013-0635-2

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