Association of dietary behaviors, biochemical, and lifestyle factors with metabolic phenotypes of obesity in children and adolescents

Abstract

Background and aims To examine the association of dietary behaviors, lifestyle, and biochemical factors with metabolic phenotypes of obesity among obese Iranian children and adolescents. Methods This cross-sectional study was conducted within the framework of the fifth phase of CASPIAN study. Of 3840 students aged 7-18 years of 30 Iranian provinces, 408 subjects were diagnosed as obese; they were divided into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) groups. Biochemical factors, anthropometric measures, dietary, and lifestyle habits were compared between groups. Results Of the 408 obese subjects, 68 (16.7) were the MUO; the remaining 340 (84.3) fall in the MHO group. The MUO group had significantly higher systolic and diastolic BPs, FBS, TG, ALT, anthropometric measures, and lower HDL levels than MHO groups (all p-value < 0.05). The frequency of high birth weight (> 4000 gr) was significantly higher in the MUO group than the MHO group (p-value: 0.04). A higher percentage of individuals with breastfeeding duration >= 6 month was found in the MUO group (95.5 (95 CI 86.1-98.6)) compared to MHO group (85.7 (95 CI 80.4-89.7)) (p-value = 0.04). Among dietary and lifestyle-related behaviors, only the frequency of salty snack consumption and eating food according to the parents' request was significantly higher in the MUO group than the MHO group (p-value < 0.05). Conclusion Dietary habits and lifestyle factors may determine the obesity phenotypes in children and adolescents.