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Healthy obesity and objective physical activity

Lookup NU author(s): Dr Vincent van Hees



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Disease risk is lower in metabolically healthy obese adults than in their unhealthy obese counterparts. Studies considering physical activity as a modifiable determinant of healthy obesity have relied on self-reported measures, which are prone to inaccuracies and do not capture all movements that contribute to health.Objective: We aimed to examine differences in total and moderate-to-vigorous physical activity between healthy and unhealthy obese groups by using both self-report and wrist-worn accelerometer assessments.Design: Cross-sectional analyses were based on 3457 adults aged 60-82 y (77% male) participating in the British Whitehall II cohort study in 2012-2013. Normal-weight, overweight, and obese adults were considered "healthy" if they had <2 of the following risk factors: low HDL cholesterol, hypertension, high blood glucose, high triacylglycerol, and insulin resistance. Differences across groups in total physical activity, based on questionnaire and wrist-worn triaxial accelerometer assessments (GENEActiv), were examined by using linear regression. The likelihood of meeting 2010 World Health Organization recommendations for moderate-to-vigorous activity (>= 2.5 h/wk) was compared by using prevalence ratios.Results: Of 3457 adults, 616 were obese [body mass index (in kg/m(2)) >= 30]; 161 (26%) of those were healthy obese. Obese adults were less physically active than were normal-weight adults, regardless of metabolic health status or method of physical activity assessment. Healthy obese adults had higher total physical activity than did unhealthy obese adults only when assessed by accelerometer (P = 0.002). Healthy obese adults were less likely to meet recommendations for moderate-to-vigorous physical activity than were healthy normal-weight adults based on accelerometer assessment (prevalence ratio: 0.59; 95% CI: 0.43, 0.79) but were not more likely to meet these recommendations than were unhealthy obese adults (prevalence ratio: 1.26; 95% CI: 0.89, 1.80).Conclusions: Higher total physical activity in healthy than in unhealthy obese adults is evident only when measured objectively, which suggests that physical activity has a greater role in promoting health among obese populations than previously thought.

Publication metadata

Author(s): Bell JA, Hamer M, van Hees VT, Singh-Manoux A, Kivimaki M, Sabia S

Publication type: Article

Publication status: Published

Journal: American Journal of Clinical Nutrition

Year: 2015

Volume: 102

Issue: 2

Pages: 268-275

Print publication date: 01/08/2015

Online publication date: 08/07/2015

Acceptance date: 09/06/2015

Date deposited: 18/09/2015

ISSN (print): 0002-9165

ISSN (electronic): 1938-3207

Publisher: American Society for Nutrition


DOI: 10.3945/ajcn.115.110924


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Funder referenceFunder name
Academy of Finland
Economic and Social Research Council studentship
ES/J023299/1Economic and Social Research Council
ES/J023299/1Economic and Social Research Council professorial fellowship
MR/K013351/1Medical Research Council
R01HL36310National Heart, Lung, and Blood Institute
RE/10/005/28296British Heart Foundation
R01AG013196US NIH National Institute on Aging
R01AG034454US NIH National Institute on Aging
R01AG034454NIH National Institute on Aging