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UBC Theses and Dissertations

Metabolically healthy obesity in children attending pediatric weight-management programs in Canada Bains, Amandeep


Background: Childhood obesity continues to be a global health concern.¹ Health risks associated with childhood obesity include hypertension and orthopedic disorders, among others.² However, not all children with obesity present with obesity-associated health risks.³,⁴ These health risks are thought to be part of one’s obesity phenotype.⁵ Distinguishing among them may lead to better treatment and management strategies.⁶⁻⁸ For this reason, obesity without metabolic syndrome health risk factors (i.e., lowered HDL, elevated triglycerides, blood pressure, fasting glucose) is known as metabolically healthy obesity (MHO), and those with abnormal metabolic markers are classified as metabolically unhealthy obesity (MUO).⁵,⁹ Objectives: Using data from the CANadian Pediatric Weight-Management Registry (CANPWR), this thesis aims to (i) establish the prevalence of MHO in participants 6-17 years old at baseline and one-year follow-up; and (ii) explore which health behaviour factors (diet, physical activity, sedentary, and sleep behaviours) are associated with MHO status. Methods: This secondary analysis included participants (n = 387, 52.7% female; mean age: 12.8 ± 2.9 years). Questionnaires were used to capture all non-metabolic variables. T-tests and chi-square tests were used to analyze continuous and categorical variables. Anthropometrics and biochemical assessments occurred at CANPWR sites at baseline and 1-year. Results: At baseline, n = 135 (34.9%) of participants were classified as MHO; n = 254 (65.1%) were identified as MUO. At follow-up, a similar percentage were classified as MHO (34.4%) and MUO (65.6%). However, n = 108 (27.9%) participants who were MHO at baseline presented as MUO at follow-up. Reported lifestyle behaviours that significantly differed for MHO/MUO were inconsistent at baseline and follow-up (baseline: fruit juice intake, weekly screen time hours, computer/video game hours; follow-up: fruit, ice cream/frozen yogurt intake). A lower BMI z-score was associated with MHO at both baseline and follow-up. Conclusion: The overall prevalence of MHO and MUO was similar at baseline and follow-up. Further analyses revealed variables that predicated this switching of status. This study highlights the need for more research in assessing metabolic health of children who are referred to weight-management programs, as children can present with worsening of metabolic health status at follow-up.

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