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1000
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Abstract/Summary
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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.
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