ESPE Abstracts (2014) 82 S10.1

The Metabolically Healthy Obese Child

Dénes Molnár

Department of Pediatrics, University of Pécs, Pécs, Hungary

Background: Recent interest has focused on a unique subgroup of overweight and obese individuals who have normal metabolic features (MHO) despite increased BMI. According to the WHO obesity is considered a disease itself. In the light of the WHO statement it is most strange to speak about healthy and unhealthy obesity. Nevertheless, we all know that a certain portion of obese persons are free from some (most frequently investigated) obesity-related metabolic consequences.

Objective and hypotheses: The purpose of the present lecture is to find answers to the following questions: 1) Do we have enough scientific proof to use the term ‘healthy obesity’? 2) Do we have a standard set of criteria to define metabolic health? 3) Is the development of metabolic complications only question of time? 4) Can we distinguish metabolically healthy and unhealthy obese individuals by using different obesity indices or on the basis of dietary and lifestyle factors? 5) Does the metabolic phenotype modify the mortality and morbidity associated with higher BMI?

Method: Literature review and analysis of the Healthy Lifestyle in Europe by Nutrition in Adolescents (HELENA) project investigating adolescents (age range: 12.5–17.5 years).

Results: Due to the diverse criteria used in reviewed studies the prevalence of MHO has varied considerably with proportions ranging from 6 to 40% in both adults and children. The duration of exposure to the metabolic-BMI phenotypes was not investigated in the reviewed studies therefore MHO can be only a transient phenomenon. HELENA results: no significant difference between the two phenotypes could be demonstrated regarding body composition, blood pressure, heart rate, leptin concentration, etc.

Conclusion: No characteristic marker of the MHO phenotype could be identified. There are studies suggesting that there is no healthy pattern of obesity. Several definitions are currently used to describe MHO resulting in widely varying prevalence estimates.

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