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Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study

Ruixin Zhu, Maija Huttunen-Lenz Orcid Logo, Gareth Stratton Orcid Logo, Teodora Handjieva-Darlenska, Svetoslav Handjiev, Jouko Sundvall, Marta P. Silvestre, Elli Jalo Orcid Logo, Kirsi H. Pietiläinen Orcid Logo, Tanja C. Adam Orcid Logo, Mathijs Drummen, Elizabeth J. Simpson Orcid Logo, Moira A. Taylor Orcid Logo, Sally D. Poppitt Orcid Logo, Santiago Navas-Carretero Orcid Logo, J. Alfredo Martinez, Wolfgang Schlicht Orcid Logo, Mikael Fogelholm Orcid Logo, Jennie Brand-Miller Orcid Logo, Anne Raben Orcid Logo

International Journal of Obesity, Volume: 47, Pages: 833 - 840

Swansea University Author: Gareth Stratton Orcid Logo

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DOI (Published version): 10.1038/s41366-023-01328-y

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Background/Objectives: Some individuals with overweight/obesity may be relatively metabolically healthy (MHO) and have a lower risk of cardiovascular disease than those with metabolically unhealthy overweight/obesity (MUO). We aimed to compare changes in body weight and cardiometabolic risk factors...

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Published in: International Journal of Obesity
ISSN: 0307-0565 1476-5497
Published: Springer Science and Business Media LLC 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63573
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2024-07-25T17:06:07.3592389</datestamp><bib-version>v2</bib-version><id>63573</id><entry>2023-06-02</entry><title>Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study</title><swanseaauthors><author><sid>6d62b2ed126961bed81a94a2beba8a01</sid><ORCID>0000-0001-5618-0803</ORCID><firstname>Gareth</firstname><surname>Stratton</surname><name>Gareth Stratton</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-06-02</date><deptcode>EAAS</deptcode><abstract>Background/Objectives: Some individuals with overweight/obesity may be relatively metabolically healthy (MHO) and have a lower risk of cardiovascular disease than those with metabolically unhealthy overweight/obesity (MUO). We aimed to compare changes in body weight and cardiometabolic risk factors and type 2 diabetes incidence during a lifestyle intervention between individuals with MHO vs MUO. Methods: This post-hoc analysis included 1012 participants with MHO and 1153 participants with MUO at baseline in the randomized trial PREVIEW. Participants underwent an eight-week low-energy diet phase followed by a 148-week lifestyle-based weight-maintenance intervention. Adjusted linear mixed models and Cox proportional hazards regression models were used. Results: There were no statistically significant differences in weight loss (%) between participants with MHO vs MUO over 156 weeks. At the end of the study, weight loss was 2.7% (95% CI, 1.7%&#x2013;3.6%) in participants with MHO and 3.0% (2.1%&#x2013;4.0%) in those with MUO. After the low-energy diet phase, participants with MHO had smaller decreases in triglyceride (mean difference between MHO vs MUO 0.08&#x2009;mmol&#xB7;L&#x2212;1 [95% CI, 0.04&#x2013;0.12]; P&#x2009;&lt;&#x2009;0.001) but similar reductions in fasting glucose and HOMA-IR than those with MUO. However, at the end of weight maintenance, those with MHO had greater reductions in triglyceride (mean difference &#x2212;0.08&#x2009;mmol&#xB7;L&#x2212;1 [&#x2212;0.12&#x2013;&#x2212;0.04]; P&#x2009;&lt;&#x2009;0.001), fasting glucose, 2-hour glucose (difference &#x2212;0.28&#x2009;mmol&#xB7;L&#x2212;1 [&#x2212;0.41&#x2013;&#x2212;0.16]; P&#x2009;&lt;&#x2009;0.001), and HOMA-IR than those with MUO. Participants with MHO had smaller decreases in diastolic blood pressure and HbA1c and greater decreases in HDL cholesterol after weight loss than those with MUO, whereas the statistically significant differences disappeared at the end of weight maintenance. Participants with MHO had lower 3-year type 2 diabetes incidence than those with MUO (adjusted hazard ratio 0.37 [0.20&#x2013;0.66]; P&#x2009;&lt;&#x2009;0.001). Conclusions: Individuals with MUO had greater improvements in some cardiometabolic risk factors during the low-energy diet phase, but had smaller improvements during long-term lifestyle intervention than those with MHO.</abstract><type>Journal Article</type><journal>International Journal of Obesity</journal><volume>47</volume><journalNumber/><paginationStart>833</paginationStart><paginationEnd>840</paginationEnd><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0307-0565</issnPrint><issnElectronic>1476-5497</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-09-01</publishedDate><doi>10.1038/s41366-023-01328-y</doi><url>http://dx.doi.org/10.1038/s41366-023-01328-y</url><notes/><college>COLLEGE NANME</college><department>Engineering and Applied Sciences School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>EAAS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was supported by EU framework programme 7 (FP7/2007&#x2013;2013) grant agreement # 312057; National Health and Medical Research Council - EU Collaborative Grant, AUS 8, ID 1067711); the Glycemic Index Foundation Australia through royalties to the University of Sydney; the New Zealand Health Research Council (grant #14/191) and University of Auckland Faculty Research Development Fund; the Cambridge Weight Plan&#xA9; donated all products for the low-energy diet phase; the Danish Agriculture &amp; Food Council; the Danish Meat and Research Institute; National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK); Biotechnology and Biological Sciences Research Council (BBSRC) (UK); Engineering and Physical Sciences Research Council (EPSRC) (UK); Nutritics (Dublin) donated all dietary analyses software used by UNOTT; Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN); China Scholarship Council. The funding source had no role in the study design and conduct, data analysis, or manuscript preparation. Open access funding provided by Royal Library, Copenhagen University Library.</funders><projectreference/><lastEdited>2024-07-25T17:06:07.3592389</lastEdited><Created>2023-06-02T14:37:48.3308249</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>Ruixin</firstname><surname>Zhu</surname><order>1</order></author><author><firstname>Maija</firstname><surname>Huttunen-Lenz</surname><orcid>0000-0002-1034-1613</orcid><order>2</order></author><author><firstname>Gareth</firstname><surname>Stratton</surname><orcid>0000-0001-5618-0803</orcid><order>3</order></author><author><firstname>Teodora</firstname><surname>Handjieva-Darlenska</surname><order>4</order></author><author><firstname>Svetoslav</firstname><surname>Handjiev</surname><order>5</order></author><author><firstname>Jouko</firstname><surname>Sundvall</surname><order>6</order></author><author><firstname>Marta P.</firstname><surname>Silvestre</surname><order>7</order></author><author><firstname>Elli</firstname><surname>Jalo</surname><orcid>0000-0002-9987-1716</orcid><order>8</order></author><author><firstname>Kirsi H.</firstname><surname>Pietil&#xE4;inen</surname><orcid>0000-0002-8522-1288</orcid><order>9</order></author><author><firstname>Tanja C.</firstname><surname>Adam</surname><orcid>0000-0002-7840-5003</orcid><order>10</order></author><author><firstname>Mathijs</firstname><surname>Drummen</surname><order>11</order></author><author><firstname>Elizabeth J.</firstname><surname>Simpson</surname><orcid>0000-0001-9353-6258</orcid><order>12</order></author><author><firstname>Moira A.</firstname><surname>Taylor</surname><orcid>0000-0003-4100-8343</orcid><order>13</order></author><author><firstname>Sally D.</firstname><surname>Poppitt</surname><orcid>0000-0002-2214-8378</orcid><order>14</order></author><author><firstname>Santiago</firstname><surname>Navas-Carretero</surname><orcid>0000-0002-5163-2230</orcid><order>15</order></author><author><firstname>J. Alfredo</firstname><surname>Martinez</surname><order>16</order></author><author><firstname>Wolfgang</firstname><surname>Schlicht</surname><orcid>0000-0002-2134-2259</orcid><order>17</order></author><author><firstname>Mikael</firstname><surname>Fogelholm</surname><orcid>0000-0001-8110-102x</orcid><order>18</order></author><author><firstname>Jennie</firstname><surname>Brand-Miller</surname><orcid>0000-0002-6797-8754</orcid><order>19</order></author><author><firstname>Anne</firstname><surname>Raben</surname><orcid>0000-0001-5229-4491</orcid><order>20</order></author></authors><documents><document><filename>63573__27730__ff5d7a6a0d4245a7a3e3e3cc3f8b1cb9.pdf</filename><originalFilename>63573.pdf</originalFilename><uploaded>2023-06-07T09:06:01.4092766</uploaded><type>Output</type><contentLength>331159</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2024-01-07T00:00:00.0000000</embargoDate><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2024-07-25T17:06:07.3592389 v2 63573 2023-06-02 Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study 6d62b2ed126961bed81a94a2beba8a01 0000-0001-5618-0803 Gareth Stratton Gareth Stratton true false 2023-06-02 EAAS Background/Objectives: Some individuals with overweight/obesity may be relatively metabolically healthy (MHO) and have a lower risk of cardiovascular disease than those with metabolically unhealthy overweight/obesity (MUO). We aimed to compare changes in body weight and cardiometabolic risk factors and type 2 diabetes incidence during a lifestyle intervention between individuals with MHO vs MUO. Methods: This post-hoc analysis included 1012 participants with MHO and 1153 participants with MUO at baseline in the randomized trial PREVIEW. Participants underwent an eight-week low-energy diet phase followed by a 148-week lifestyle-based weight-maintenance intervention. Adjusted linear mixed models and Cox proportional hazards regression models were used. Results: There were no statistically significant differences in weight loss (%) between participants with MHO vs MUO over 156 weeks. At the end of the study, weight loss was 2.7% (95% CI, 1.7%–3.6%) in participants with MHO and 3.0% (2.1%–4.0%) in those with MUO. After the low-energy diet phase, participants with MHO had smaller decreases in triglyceride (mean difference between MHO vs MUO 0.08 mmol·L−1 [95% CI, 0.04–0.12]; P < 0.001) but similar reductions in fasting glucose and HOMA-IR than those with MUO. However, at the end of weight maintenance, those with MHO had greater reductions in triglyceride (mean difference −0.08 mmol·L−1 [−0.12–−0.04]; P < 0.001), fasting glucose, 2-hour glucose (difference −0.28 mmol·L−1 [−0.41–−0.16]; P < 0.001), and HOMA-IR than those with MUO. Participants with MHO had smaller decreases in diastolic blood pressure and HbA1c and greater decreases in HDL cholesterol after weight loss than those with MUO, whereas the statistically significant differences disappeared at the end of weight maintenance. Participants with MHO had lower 3-year type 2 diabetes incidence than those with MUO (adjusted hazard ratio 0.37 [0.20–0.66]; P < 0.001). Conclusions: Individuals with MUO had greater improvements in some cardiometabolic risk factors during the low-energy diet phase, but had smaller improvements during long-term lifestyle intervention than those with MHO. Journal Article International Journal of Obesity 47 833 840 Springer Science and Business Media LLC 0307-0565 1476-5497 1 9 2023 2023-09-01 10.1038/s41366-023-01328-y http://dx.doi.org/10.1038/s41366-023-01328-y COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee This work was supported by EU framework programme 7 (FP7/2007–2013) grant agreement # 312057; National Health and Medical Research Council - EU Collaborative Grant, AUS 8, ID 1067711); the Glycemic Index Foundation Australia through royalties to the University of Sydney; the New Zealand Health Research Council (grant #14/191) and University of Auckland Faculty Research Development Fund; the Cambridge Weight Plan© donated all products for the low-energy diet phase; the Danish Agriculture & Food Council; the Danish Meat and Research Institute; National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK); Biotechnology and Biological Sciences Research Council (BBSRC) (UK); Engineering and Physical Sciences Research Council (EPSRC) (UK); Nutritics (Dublin) donated all dietary analyses software used by UNOTT; Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN); China Scholarship Council. The funding source had no role in the study design and conduct, data analysis, or manuscript preparation. Open access funding provided by Royal Library, Copenhagen University Library. 2024-07-25T17:06:07.3592389 2023-06-02T14:37:48.3308249 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Ruixin Zhu 1 Maija Huttunen-Lenz 0000-0002-1034-1613 2 Gareth Stratton 0000-0001-5618-0803 3 Teodora Handjieva-Darlenska 4 Svetoslav Handjiev 5 Jouko Sundvall 6 Marta P. Silvestre 7 Elli Jalo 0000-0002-9987-1716 8 Kirsi H. Pietiläinen 0000-0002-8522-1288 9 Tanja C. Adam 0000-0002-7840-5003 10 Mathijs Drummen 11 Elizabeth J. Simpson 0000-0001-9353-6258 12 Moira A. Taylor 0000-0003-4100-8343 13 Sally D. Poppitt 0000-0002-2214-8378 14 Santiago Navas-Carretero 0000-0002-5163-2230 15 J. Alfredo Martinez 16 Wolfgang Schlicht 0000-0002-2134-2259 17 Mikael Fogelholm 0000-0001-8110-102x 18 Jennie Brand-Miller 0000-0002-6797-8754 19 Anne Raben 0000-0001-5229-4491 20 63573__27730__ff5d7a6a0d4245a7a3e3e3cc3f8b1cb9.pdf 63573.pdf 2023-06-07T09:06:01.4092766 Output 331159 application/pdf Accepted Manuscript true 2024-01-07T00:00:00.0000000 true eng
title Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
spellingShingle Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
Gareth Stratton
title_short Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
title_full Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
title_fullStr Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
title_full_unstemmed Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
title_sort Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
author_id_str_mv 6d62b2ed126961bed81a94a2beba8a01
author_id_fullname_str_mv 6d62b2ed126961bed81a94a2beba8a01_***_Gareth Stratton
author Gareth Stratton
author2 Ruixin Zhu
Maija Huttunen-Lenz
Gareth Stratton
Teodora Handjieva-Darlenska
Svetoslav Handjiev
Jouko Sundvall
Marta P. Silvestre
Elli Jalo
Kirsi H. Pietiläinen
Tanja C. Adam
Mathijs Drummen
Elizabeth J. Simpson
Moira A. Taylor
Sally D. Poppitt
Santiago Navas-Carretero
J. Alfredo Martinez
Wolfgang Schlicht
Mikael Fogelholm
Jennie Brand-Miller
Anne Raben
format Journal article
container_title International Journal of Obesity
container_volume 47
container_start_page 833
publishDate 2023
institution Swansea University
issn 0307-0565
1476-5497
doi_str_mv 10.1038/s41366-023-01328-y
publisher Springer Science and Business Media LLC
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
url http://dx.doi.org/10.1038/s41366-023-01328-y
document_store_str 1
active_str 0
description Background/Objectives: Some individuals with overweight/obesity may be relatively metabolically healthy (MHO) and have a lower risk of cardiovascular disease than those with metabolically unhealthy overweight/obesity (MUO). We aimed to compare changes in body weight and cardiometabolic risk factors and type 2 diabetes incidence during a lifestyle intervention between individuals with MHO vs MUO. Methods: This post-hoc analysis included 1012 participants with MHO and 1153 participants with MUO at baseline in the randomized trial PREVIEW. Participants underwent an eight-week low-energy diet phase followed by a 148-week lifestyle-based weight-maintenance intervention. Adjusted linear mixed models and Cox proportional hazards regression models were used. Results: There were no statistically significant differences in weight loss (%) between participants with MHO vs MUO over 156 weeks. At the end of the study, weight loss was 2.7% (95% CI, 1.7%–3.6%) in participants with MHO and 3.0% (2.1%–4.0%) in those with MUO. After the low-energy diet phase, participants with MHO had smaller decreases in triglyceride (mean difference between MHO vs MUO 0.08 mmol·L−1 [95% CI, 0.04–0.12]; P < 0.001) but similar reductions in fasting glucose and HOMA-IR than those with MUO. However, at the end of weight maintenance, those with MHO had greater reductions in triglyceride (mean difference −0.08 mmol·L−1 [−0.12–−0.04]; P < 0.001), fasting glucose, 2-hour glucose (difference −0.28 mmol·L−1 [−0.41–−0.16]; P < 0.001), and HOMA-IR than those with MUO. Participants with MHO had smaller decreases in diastolic blood pressure and HbA1c and greater decreases in HDL cholesterol after weight loss than those with MUO, whereas the statistically significant differences disappeared at the end of weight maintenance. Participants with MHO had lower 3-year type 2 diabetes incidence than those with MUO (adjusted hazard ratio 0.37 [0.20–0.66]; P < 0.001). Conclusions: Individuals with MUO had greater improvements in some cardiometabolic risk factors during the low-energy diet phase, but had smaller improvements during long-term lifestyle intervention than those with MHO.
published_date 2023-09-01T14:26:10Z
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