B3512 - What are the dietary lifestyle and socio-demographic predictors of metabolically healthy obesity in adolescence - 21/04/2020

B number: 
B3512
Principal applicant name: 
Genevieve Buckland | Centre for Academic Child Health (United Kingdom)
Co-applicants: 
Dr. Caroline Taylor, Sophie Edwards, Louise Jones
Title of project: 
What are the dietary, lifestyle and socio-demographic predictors of metabolically healthy obesity in adolescence?
Proposal summary: 

The on-going childhood obesity epidemic is accompanied by dramatic increases in childhood metabolic disorders, such as paediatric type 2 diabetes and a cluster of metabolic complications. However, children with obesity are not all equally prone to developing these metabolic disorders; research has shown that there is a subset of obese children who have a more ‘favourable’ health profile, including good insulin sensitivity and normal blood pressure, glucose regulation and blood lipid levels. This has been termed metabolically healthy obesity (MHO), which contrasts with metabolically unhealthy obesity (MUO), where excess body fat is accompanied by metabolic disorders. Since most of the research to date on MHO and MUO has focused on adults, the specific determinants of MHO and MUO in paediatric groups are still not clearly understood.

The concept of metabolically unhealthy and metabolically healthy profiles can also be applied to individuals of ‘normal’ weight, since normal-weight individuals can also have the metabolic and/or inflammatory abnormalities commonly observed in obese people. This group has been termed normal-weight metabolically unhealthy (NWMU). NWMU adults are also at increased risk of cardiometabolic diseases, however, little is known about the health profile and predictive characteristics of NWMU in children.

The relatively high proportion of metabolically healthy individuals in the obese (ranging from 4-60%) and metabolically unhealthy individuals in the lean population suggests that besides from total calories, diet quality could be an important influencing factor on metabolic health. However, few studies have looked at how dietary patterns in children might influence the sub-groups of obesity. Therefore, this study aims to identify which dietary patterns, lifestyle behaviours and socio-demographic factors in children are related to MHO and MUO, as well as NWMU in adolescents. Gaining a clearer understanding of the health profile, characteristics and potential determinants of MHO and MUO in paediatric groups could be valuable in developing more efficient and targeted treatment approaches for these groups of children with obesity.

Impact of research: 
Childhood obesity is associated with increased risk of cardiometabolic disease, type II diabetes, metabolic syndrome and premature mortality. Defining the sub-group of overweight/obese children who remain metabolically healthy (and lean children who are metabolically unhealthy) is important as it can aid in understanding which factors protect against the clustering of metabolic alternations in these sub-groups. Specifically, this study should improve our understanding of the health profile, socio-demographic characteristics and dietary patterns that are associated with metabolic health status in overweight/obese and lean children. This will add to the information available when updating public health guidelines and when developing more efficient personalised approaches for interventions and treatment of obese adolescents based on metabolic health status.
Date proposal received: 
Monday, 20 April, 2020
Date proposal approved: 
Tuesday, 21 April, 2020
Keywords: 
Epidemiology, Obesity, Prospective association analysis, BMI