title: Lifestyle and weight predictors of a healthy overweight profile over a 20-year follow-up.
abstract: OBJECTIVE
  To examine whether changes in modifiable risk factors [physical activity, cardiorespiratory fitness (CRF), body weight, and diet composition] are associated with the transition to metabolically healthy overweight/obese (MHOW) versus metabolically abnormal overweight/obese.
  
  
  METHODS
  Analysis included 1,358 adults [aged 25.0 (3.5) years] from the CARDIA study who were healthy at baseline and had overweight/obesity at follow-up. Participants with zero or one of the following six risk factors were classified as MHOW: elevated triglycerides, LDL, blood pressure, fasting glucose, and HOMA-insulin resistance and low HDL.
  
  
  RESULTS
  Over the 20-year follow-up, the sample gained weight (BMI 24.5 to 31.1 kg/m(2) ), and the prevalence of MHOW was 47% at follow-up. After adjusting for changes in CRF, diet, and weight change, physical activity and macronutrient intake were not independently associated with MHOW (P > 0.05), while changes in CRF [fit-unfit: RR (95%) = 0.58, 0.52-0.66; unfit-unfit: RR = 0.67, 0.58-0.76, versus fit-fit] and weight [gain: RR (95%) = 0.54, 0.43-0.67; cycle: RR = 0.74, 0.57-0.94, versus stable] were independently associated with MHOW.
  
  
  CONCLUSIONS
  Focusing on high CRF and strategies to limit weight gain may be important for individuals with overweight and obesity in early to mid-adulthood to maintain a metabolically healthy profile.
authors.affiliation: School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.
authors.forename: Michael D T
authors.initials: MD
authors.lastname: Fung
authors.affiliation: School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.
authors.forename: Karissa L
authors.initials: KL
authors.lastname: Canning
authors.affiliation: School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Mirdamadi
authors.affiliation: School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.
authors.forename: Chris I
authors.initials: CI
authors.lastname: Ardern
authors.affiliation: School of Kinesiology, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Kuk
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004032:Diet / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain