Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults

Individuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown. The objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as...

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Bibliographic Details
Published in:Journal of the Academy of Nutrition and Dietetics 2020-12, Vol.120 (12), p.1963-1973.e2
Main Authors: Bellissimo, Moriah P., Bettermann, Erika L., Tran, Phong H., Crain, Benjamin H., Ferranti, Erin P., Binongo, Jose N., Hartman, Terryl J., Jones, Dean P., Ziegler, Thomas R., Alvarez, Jessica A.
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Adipose Tissue - physiopathology
Adult
Biomarkers - analysis
Body Composition
Body Mass Index
Body Weight - physiology
Cardiometabolic Risk Factors
Cross-Sectional Studies
Diet Surveys
Diet, Healthy - statistics & numerical data
Diet, Mediterranean - statistics & numerical data
Dietary Approaches To Stop Hypertension - statistics & numerical data
Eating - physiology
Exercise
Exercise Test
Fat distribution
Female
Humans
Ideal Body Weight
Linear Models
Male
Middle Aged
Nutrition
Obesity - physiopathology
Overweight
Overweight - physiopathology
Oxygen Consumption - physiology
Physical Fitness - physiology
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Summary:Individuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown. The objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as lean, NWO, and overweight-obese. Secondary objectives of the study were to compare clinical biomarkers and food groups and macronutrient intakes between the three groups, and to test for associations between body composition components with diet quality scores and physical fitness levels. This is a secondary data analysis from a cross-sectional study that included metropolitan university and health care system employees. Body composition was measured by dual energy x-ray absorptiometry. Individuals with a body mass index 23% for men and >30% for women were classified as having NWO. Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score were calculated from Block food frequency questionnaires. Physical fitness was assessed by measuring maximal oxygen uptake (VO2 maximum) during treadmill testing. This study included 693 adults (65% women, mean age 48.9 ± 11.5 years) enrolled between 2007 and 2013 in Atlanta, GA. The main outcome measures were Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Mediterranean Diet Score diet quality scores and maximal oxygen uptake. Multiple linear regression analyses with post hoc comparisons were used to investigate group differences in fitness, diet quality, and biomarkers. Regression analyses were also used to examine relationships between diet quality scores and fitness with body composition. VO2 maximum was significantly lower in the NWO compared with the lean group (36.2 ± 0.8 mL/min/kg vs 40.2 ± 1.0 mL/min/kg; P < 0.05). Individuals with NWO reported similar diet quality to lean individuals and more favorable Alternate Healthy Eating Index and Dietary Approaches to Stop Hypertension scores than individuals with overweight-obesity (P < 0.05). Diet quality scores and physical fitness levels were inversely associated with percent body fat and visceral adipose tissue (P < 0.05), regardless of weight status. Individuals with NWO exhibited higher fasting blood insulin concentrations, insulin resistance, low-density lipoprotein cholesterol, and triglyceride levels, and significantly lower high-density lipoprotein cholesterol level
ISSN:2212-2672
2212-2680
DOI:10.1016/j.jand.2020.07.020