Obesities, Volume 1, Issue 1 (June 2021) – 6 articles

The cardiovascular disease (CVD) risk of metabolically healthy obesity (MHO) remains controversial. We sought to further characterize the CVD risk profile in MHO by evaluating postprandial triglycerides, vascular function, and systemic inflammatory markers. Control individuals that were normal-weight and metabolically healthy (Con), MHO, and metabolic syndrome (MetS) were recruited (n = 10–11/group). Each participant underwent an abbreviated fat tolerance test, fasting and postprandial flow-mediated dilation (FMD), and had a panel of inflammatory cytokines measured. MHO displayed postprandial triglycerides similar to those in Con and both MHO and Con had lower values than those for MetS (p < 0.01). Fasting FMD was lower in MHO and MetS compared to that of Con (p < 0.01), but during the postprandial period the vasodilatory response of MHO was similar to that while fasting (p = 0.39), while FMD in Con and MetS decreased after the high-fat meal (p values < 0.01). MHO displayed a number of inflammatory cytokines greater than those of Con and MetS (all p values < 0.05), while MetS and MHO had higher TNF-α than did Con (p < 0.05). In conclusion, MHO was associated with lower fasting FMD and a greater inflammatory burden but did not suffer the same negative postprandial effects as did MetS. Full article

Adverse childhood experiences (ACEs) may be an early life factor associated with adult weight stigma via biological (e.g., stress response), cognitive (e.g., self-criticism/deprecation), and/or emotional (e.g., shame) mechanisms. This pilot study investigated relationships between ACEs and internalized and experienced weight stigma in adult women with overweight/obesity and explored differential relationships between weight stigma and ACE subtypes (i.e., abuse, neglect, household dysfunction). Adult women (68% white, M_age = 33 ± 10 years, M_BMI = 33.7 ± 7.2 kg/m²) completed measures of ACEs (ACE Questionnaire), internalized weight stigma (IWS; Weight Bias Internalization Scale—Modified; WBIS—M), and lifetime experiences of weight stigma (yes/no). Data were analyzed with linear and logistic regression (n = 46), adjusting for age, race, and body mass index (BMI). Linear regressions revealed a positive association between ACE and WBIS—M scores (β = 0.40, p = 0.006), which was driven by Abuse-type ACEs (β = 0.48, p = 0.009). Relationships between WBIS—M scores and Neglect- and Household-Dysfunction-type ACEs did not reach significance (β = 0.20, p = 0.173; β = −0.16, p = 0.273). Though descriptive statistics revealed greater rates of experienced weight stigma endorsement by those with high-3+ ACEs (81%) vs. medium-1–2 ACEs (67%) or low/no-0 ACEs (60%), ACE scores were not significantly associated with experienced weight stigma in logistic regression (Wald = 1.36, p = 0.244, OR = 1.324, 95%, CI = 0.825–2.125). ACEs may be an early life factor that increase the risk for internalizing weight stigma in adulthood. Larger studies should confirm this relationship and follow-up on descriptive findings suggesting a potential association between ACEs and experienced weight stigma. Full article

Obesity is associated with increased risk for cardiovascular diseases compared to normal-weight and overweight status. We hypothesized that obese subjects would have lower ideal cardiovascular health than normal-weight and overweight subjects, but a subset among the obese would have a favorable cardiovascular health profile. Differences in ideal cardiovascular health between normal-weight (n = 523), overweight (n = 378), and obese (n = 660) subjects were examined using data from the Life’s Simple 7 survey and digital health devices. Obese participants were more likely to have prevalent cardiovascular disease, diabetes mellitus, hypertension, and hypercholesterolemia compared to normal weight and overweight (all p < 0.01). Life’s Simple 7 Health Scores, a measure of ideal cardiovascular health, were lower in obese than in normal-weight and overweight groups (5.6 ± 1.2 vs. 8.0 ± 1.1 vs. 6.8 ± 1.1, p < 0.01). A subset of obese with ideal cardiovascular health scores was identified (n = 103). Compared to obese with non-ideal health scores (n = 557), these individuals were more likely to have ideal cardiovascular risk factor status, diet, and exercise profiles. These findings indicate that there is heterogeneity among obese persons and suggest that an assessment of cardiovascular health factors and behaviors can identify areas for intervention beyond weight reduction alone to optimize cardiovascular health. Full article

Limited data is available on the sex differences and individual responses of cardiometabolic parameters adjusted with potential confounders (i.e. sex, age, baseline values) after a longer term Mediterranean diet (MedD) and high intensity interval training (HIIT) in obese subjects. The objective of this study was to compare the effects of nine-month MedD counseling and supervised HIIT on cardiometabolic risk factors and individual responses in obese women (n = 99) and obese men (n = 35). Body composition (body mass, fat mass, lean body mass, waist circumference), cardiorespiratory fitness (METs), and cardiometabolic risk factors (blood pressure, blood sample variables) were measured at baseline and after nine months of a program combining MedD and HIIT two to three times a week. When adjusted with sex, age, and baseline values, obese women similarly improved their body composition, METs, and cardiometabolic risk factors vs. obese men. The proportion of responders according to clinical cutoff levels were the same in obese women and men. A longer MedD and HIIT intervention similarly improves body composition, cardiometabolic risk factors, and individual responses in obese women and men, even after adjustment of confounders (sex, age, baseline value). Full article

Overweight/obesity and underweight among older adults remain major public health concerns in the United States. This study aims to assess cohort differences in transition among BMI (body mass index) statuses (underweight, normal weight, overweight, and obese) by various cohort and race/ethnicity–gender groups. The empirical work of this study was based on the 1992–2014 Health and Retirement Study (HRS). Multistate life tables (MSLT) were used to assess transitions among different BMI statuses. Results from multistate life tables suggested that the impact of cumulative advantage (disadvantage), persistent inequality, and aging-as-leveler on transition among BMI statuses was shaped along race/ethnicity–gender and cohort lines. Weight management and weight loss strategies should focus on ethnic minorities (i.e., Black and Hispanic populations) and White participants from recent cohorts. Programs aimed at minimizing the negative consequences associated with underweight and weight loss should focus on individuals from earlier cohorts and Black populations. Full article