One-third of obese children may be considered metabolically healthy

Prince RL. Diabetes Care. 2014;doi:10.2337/dc13-1697.

  • March 12, 2014

In a study to determine prevalence of metabolically healthy obesity in children with obesity, researchers determined that one in three could be classified as metabolically healthy obese and that adiposity and lifestyle behavior may have important roles.

One limitation of the study was the lack of a universally accepted definition of metabolically healthy obesity (MHO). Due to this, the researchers selected cardiometabolic risk (CR) factors based on what was routinely assessed in the clinic. Also, lifestyle predictors included were based on assessments by dietitians and fitness professionals in the clinic.

Demographic, anthropometric, lifestyle and cardiometabolic data were examined for 181 children aged 8 to 17 years. All of the children had a BMI ≥85th percentile and were enrolled in a multidisciplinary pediatric weight management clinic in Edmonton, Canada, from 2005 to 2010. The patients were then classified into two groups: MHO and metabolically unhealthy obese. Two separate classification systems were used, taking into consideration insulin resistance (IR) and CR factors such as blood pressure, serum lipids, and glucose.

The researchers concluded that up to one in three children may be MHO. Of the 181 children, 57 were found to be MHO-IR (31.5%), with waist circumference (OR=0.33; P=.0002) and dietary fat intake (OR=0.56; P=.04) as independent predictors of MHO insulin resistance. Also, 39 of 181 were MHO-CR (21.5%), with moderate-to-vigorous physical activity (OR=1.8; 95% CI, 1.24-2.62) shown to be the strongest predictor of MHO-CR.

“The high prevalence of pediatric obesity highlights the importance of delivering health services for obesity management in a manner that is both efficient and effective. Our study offers important insights into MHO in children that can inform how such services are delivered,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

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