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

doi:10.1007/s00394-019-02063-9

. 2020 Aug;59(5):2145-2158.

doi: 10.1007/s00394-019-02063-9. Epub 2019 Jul 30.

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

Farah Naja¹, Leila Itani², Mona P Nasrallah^{3

4}, Hassan Chami⁵, Hani Tamim^{6

7}, Lara Nasreddine⁸

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.
² Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, PO Box 11-5020, 1107 2809, Beirut, Lebanon.
³ Vascular Medicine Program, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon.
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.
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.
⁶ Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon. htamim@aub.edu.lb.
⁷ Faculty of Medicine, Clinical Research Institute, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon. htamim@aub.edu.lb.
⁸ 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. ln10@aub.edu.lb.

PMID: 31363827
DOI: 10.1007/s00394-019-02063-9

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

Farah Naja et al. Eur J Nutr. 2020 Aug.

. 2020 Aug;59(5):2145-2158.

doi: 10.1007/s00394-019-02063-9. Epub 2019 Jul 30.

Authors

Farah Naja¹, Leila Itani², Mona P Nasrallah^{3

4}, Hassan Chami⁵, Hani Tamim^{6

7}, Lara Nasreddine⁸

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.
² Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, PO Box 11-5020, 1107 2809, Beirut, Lebanon.
³ Vascular Medicine Program, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon.
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.
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.
⁶ Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon. htamim@aub.edu.lb.
⁷ Faculty of Medicine, Clinical Research Institute, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon. htamim@aub.edu.lb.
⁸ 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. ln10@aub.edu.lb.

PMID: 31363827
DOI: 10.1007/s00394-019-02063-9

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.

Keywords: Factor analysis; Lebanon; Lifestyle pattern; Metabolically healthy obesity.

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References

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[1] Eckel RH, Kahn R, Robertson RM, Rizza RA (2006) Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Diabetes Care 29(7):1697–1699. https://doi.org/10.1161/CIRCULATIONAHA.106.176583 - DOI - PubMed

[2] Eckel RH, Kahn R, Robertson RM, Rizza RA (2006) Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Diabetes Care 29(7):1697–1699. https://doi.org/10.1161/CIRCULATIONAHA.106.176583 - DOI - PubMed

[3] Correia ML, Haynes WG, Mark AL (2005) Obesity-associated hypertension. Hypertension. https://doi.org/10.1161/01.hyp.0000151325.83008.b4 - DOI - PubMed

[4] Correia ML, Haynes WG, Mark AL (2005) Obesity-associated hypertension. Hypertension. https://doi.org/10.1161/01.hyp.0000151325.83008.b4 - DOI - PubMed

[5] Blood Pressure Lowering Treatment Trialists’ Collaboration (2015) Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials. Lancet 385(9971):867–874. https://doi.org/10.1016/S0140-6736(14)61171-5 - DOI

[6] Blood Pressure Lowering Treatment Trialists’ Collaboration (2015) Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials. Lancet 385(9971):867–874. https://doi.org/10.1016/S0140-6736(14)61171-5 - DOI

[7] Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364(9438):937–952. https://doi.org/10.1016/S0140-6736(04)17018-9 - DOI - PubMed

[8] Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364(9438):937–952. https://doi.org/10.1016/S0140-6736(04)17018-9 - DOI - PubMed

[9] Eckel N, Li Y, Kuxhaus O, Stefan N, Hu FB, Schulze MB (2018) Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90257 women (the Nurses’ Health Study): 30 year follow-up from a prospective cohort study. Lancet Diabetes Endocrinol. https://doi.org/10.1016/s2213-8587(18)30137-2 - DOI - PubMed

[10] Eckel N, Li Y, Kuxhaus O, Stefan N, Hu FB, Schulze MB (2018) Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90257 women (the Nurses’ Health Study): 30 year follow-up from a prospective cohort study. Lancet Diabetes Endocrinol. https://doi.org/10.1016/s2213-8587(18)30137-2 - DOI - PubMed

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

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