title: Dietary Interventions and Changes in Cardio-Metabolic Parameters in Metabolically Healthy Obese Subjects: A Systematic Review with Meta-Analysis.
abstract: The aim of this systematic review was to assess the effect of diet on changes in parameters describing the body size phenotype of metabolically healthy obese subjects. The databases Medline, Scopus, Web of Knowledge and Embase were searched for clinical studies carried out between 1958 and June 2016 that reported the effect of dietary intervention on BMI, blood pressure, concentration of fasting triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting glucose level, the homoeostatic model assessment of insulin resistance (HOMA-IR) and high sensitivity C-Reactive Protein (hsCRP) in metabolically healthy, obese subjects. Twelve clinical studies met inclusion criteria. The combined analyzed population consists of 1827 subjects aged 34.4 to 61.1 with a BMI > 30 kg/m². Time of intervention ranged from eight to 104 weeks. The baseline characteristics related to lipid profile were more favorable for metabolically healthy obese than for metabolically unhealthy obese. The meta-analyses revealed a significant associations between restricted energy diet and BMI (95% confidence interval (CI): -0.88, -0.19), blood pressure (systolic blood pressure (SBP): -4.73 mmHg; 95% CI: -7.12, -2.33; and diastolic blood pressure (DBP): -2.75 mmHg; 95% CI: -4.30, -1.21) and TG (-0.11 mmol/l; 95% CI: -0.16, -0.06). Changes in fasting glucose, HOMA-IR and hsCRP did not show significant changes. Sufficient evidence was not found to support the use of specific diets in metabolically healthy obese subjects. This analysis suggests that the effect of caloric restriction exerts its effects through a reduction in BMI, blood pressure and triglycerides in metabolically healthy obese (MHO) patients.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany. stelmach@dife.de.|Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str 27/33, Poznan 60-572, Poland. stelmach@dife.de.
authors.forename: Marta
authors.initials: M
authors.lastname: Stelmach-Mardas
authors.affiliation: Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str 27/33, Poznan 60-572, Poland. jarwalk@ump.edu.pl.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Walkowiak
mesh_terms: D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D004038:Diet, Reducing; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control; D015228:Hypertriglyceridemia / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D000067329:Obesity, Metabolically Benign / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D015431:Weight Loss
chemical_list: D015415:Biomarkers
keywords: biomarkers; diet; metabolically healthy obese