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A healthy lifestyle pattern is associated with a metabolically healthy phenotype in overweight and obese adults: a cross-sectional study

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Abstract

Purpose

This study tried at identifying lifestyle patterns in a sample of Lebanese adults and investigating their association with metabolically healthy overweight and obesity (MHOv/O).

Methods

This study used data from a community-based survey of Lebanese adults living in Greater Beirut (n = 305). Dietary intake was assessed using an 80-item food frequency questionnaire. MHOv/O was defined as having one or none of the following metabolic abnormalities: triglycerides ≥ 150 mg/dL; systolic blood pressure ≥ 130 mmHg; diastolic blood pressure ≥ 85 mmHg; fasting blood glucose ≥ 100 mg/dL; HDL-cholesterol < 40 mg/dL for men and < 50 mg/dL for women. 201 subjects were overweight/obese and 98 had MHOv/O. Factor analysis was implemented to derive lifestyle patterns.

Results

Two lifestyle patterns were identified: the unhealthy lifestyle pattern, which included foods such as fast food and soft drinks and was characterized by alcohol consumption and cigarette smoking. Eating at home loaded negatively on this pattern. The healthy lifestyle pattern was characterized by positive loadings of food groups such as milk and dairy products, fruits, vegetables and legumes. Sleep difficulties loaded negatively on this pattern, while vigorous and moderate physical activity loaded positively. Multiple logistic regression analyses showed that subjects belonging to the 3rd tertile of the healthy pattern scores had higher odds of MHOv/O as compared to those in the 1st tertile (OR 2.33, CI 1.04–4.81).

Conclusions

Findings of this study provided evidence on the combined effect of lifestyle patterns in relation to cardiometabolic abnormalities and highlighted the importance of focusing on ‘holistic’ lifestyle pattern modifications in designing and implementing prevention interventions in overweight and obese subjects.

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Acknowledgements

We would like to acknowledge the contribution of Mrs. Hibeh Shatila for coordinating data analysis and editing the manuscript.

Funding

The original survey was supported by a Grant from the National Council for Scientific Research (LNCSR) (L. N., award number 02-06-14); the American University of Beirut Research Board (L. N. award number 103006/22691); the Medical Practice Plan at the American University of Beirut (H. T., award number 100410, project number 20061); and the Novo Nordisk development programme. The funders had no role in the design, analysis or writing of this article.

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Authors and Affiliations

  1. Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon

    Farah Naja & Lara Nasreddine

  2. Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, PO Box 11-5020, 1107 2809, Beirut, Lebanon

    Leila Itani

  3. Vascular Medicine Program, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon

    Mona P. Nasrallah

  4. Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon

    Mona P. Nasrallah

  5. Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon

    Hassan Chami & Hani Tamim

  6. Faculty of Medicine, Clinical Research Institute, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon

    Hani Tamim

Authors
  1. Farah Naja
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  2. Leila Itani
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  3. Mona P. Nasrallah
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  4. Hassan Chami
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  5. Hani Tamim
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  6. Lara Nasreddine
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Contributions

LN and FN formulated the research question. LN drafted the manuscript and contributed to the interpretation of the data. HT led the parent study. MN and LN provided support in conceiving and designing the parent study. LI contributed to data analysis and interpretation. LN, HT and MN acquired the data. FN conducted data analysis and contributed to data interpretation and write up of the manuscript. All authors critically reviewed the manuscript and guarantee the accuracy of their input and the integrity of this work.

Corresponding authors

Correspondence to Hani Tamim or Lara Nasreddine.

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Conflict of interest

The authors declare that they have no conflict of interest.

Appendix 1

Appendix 1

See Table 5.

Table 5 Food items included in each food group included in the factor analysis
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Naja, F., Itani, L., Nasrallah, M.P. et al. A healthy lifestyle pattern is associated with a metabolically healthy phenotype in overweight and obese adults: a cross-sectional study. Eur J Nutr 59, 2145–2158 (2020). https://doi.org/10.1007/s00394-019-02063-9

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  • DOI: https://doi.org/10.1007/s00394-019-02063-9

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