Effect of Different Obesity Phenotypes on Incidence of Chronic Kidney Disease in Tehranian Adults Eating behavior in humans, characterized by cumulative food intake curves—a review
Background : The aim of this community-based study is to ascertain the effect of different obesity phenotypes on the incidence of chronic kidney disease in Iranian adults . Study Design : A prospect i ve cohort study , the Tehran Lipid Glucose Study ( TLGS ) . Setting and Participants : Adults aged ≥ 20 years with a mean age of 40.38 years ( 54.8 % female ) who were free from chronic kidney disease ( CKD ) at baseline ( phase 1 ) and were followed up at 3 time stages ( phases 2 , 3 , and 4 ) for a mean duration of 9.4 years to assess the risk for CKD . Predictor : Obesity phenotypes . Outcome : Incidence of chronic kidney disease . Measurements : Glomerular filtration rate ( GFR ) was estimated from the simplified equation developed using data from the Modification of Diet in Renal Disease ( MDRD ) Study . Results : CKD events occurred in 1162 participants . The prevalence of the 2 known obesity phenotypes ( metabolically obese normal weight [ MONW ] and metabolically healthy but obese [ MHO ] ) in the overall population was 3.5 % and 8.8 % , respectively . According to Kaplan-Meier curves , rates of freedom from CKD in the MHO and MONW obesity phenotypes were 75.3 % and 60.6 % , respectively ( p < 0.0001 ) . Age- and sex-adjusted ( model 1 ) hazard ratios for participants with MHO or MONW obesity phenotype were 1.14 ( 95 % confidence interval [ CI ] , 0.91–1.43 ) and 1.43 ( 95 % CI , 1.09–1.88 ) , respectively . After further adjustment for confounder variables ( model 2 ) , multivariate-adjusted hazard ratios for CKD for participants with MHO or MONW obesity phenotypes were 1.23 ( 95 % CI , 0.93–1.62 ) and 1.43 ( 95 % CI , 1.08–1.90 ) , respectively . Conclusion : Adults with the MONW obesity phenotype compared to those with MHO obesity phenotype have a higher risk for incidence of CKD . The results indicate that having a normal weight is not the only factor to protect against incidence of CKD Cumulative food intake curves have been obtained by monitoring eating from a plate , placed on a scale built into a table , and connected to a digital computer . They describe and integrate parameters of consumption of an ad lib single course meal , i.e. meal size , meal duration , eating rate , change in eating rate , bite size and bite frequency . It is concluded that they are an adequate tool for analyzing dietary and clinical interventions on meal size , because the cumulative food intake curve parameters : are stable and consistent within subjects ; show a clear relationship with the subject characteristics dietary restraint and obesity ; show a clear relationship with the physiological parameters satiation , diet-induced thermogenesis and body-temperature near the liver , and with the cognitive parameter : estimating forthcoming ingestion ; are sensitive to instructions , clinical and dietary interventions ( preloads , palatability , energy density , macronutrient composition ) , and to a state of negative energy balance . Because of possible compensatory post-pr and ial effects , it is suggested that assessment of meal size should be part of a 24 h appetite profile and food intake observation
The baseline characteristics related to lipid profile were more favorable for metabolically healthy obese than for metabolically unhealthy obese .
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
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 .