Healthy obesity and objective physical activity.

Area of Science:

• Obesity and Metabolic Health
• Physical Activity and Public Health
• Biomedical Gerontology

Background:

• Metabolically healthy obese adults exhibit lower disease risk than their unhealthy counterparts.
• Previous studies on physical activity in healthy obesity relied on self-reports, limiting accuracy and comprehensiveness.

Purpose of the Study:

• To compare total and moderate-to-vigorous physical activity in healthy versus unhealthy obese adults.
• To utilize both self-report questionnaires and wrist-worn accelerometers for objective physical activity assessment.

Main Methods:

• Cross-sectional analysis of 3457 adults (aged 60-82 years) from the British Whitehall II cohort study.
• Defined 'healthy' status based on fewer than two risk factors (low HDL, hypertension, high glucose, high triacylglycerol, insulin resistance).
• Assessed physical activity using questionnaires and GENEActiv triaxial accelerometers; analyzed differences using linear regression and prevalence ratios.

Main Results:

• Obese adults were less active than normal-weight adults, irrespective of metabolic health or assessment method.
• Higher total physical activity in healthy obese adults was observed only with accelerometer data (P = 0.002).
• Healthy obese adults were less likely to meet moderate-to-vigorous physical activity guidelines than healthy normal-weight adults (PR=0.59).

Conclusions:

• Objective measurement reveals a greater role for total physical activity in promoting health among obese individuals than previously recognized.
• The distinction between healthy and unhealthy obese individuals regarding physical activity is only apparent through objective assessment.