Our study purpose was to determine the prevalence of metabolically healthy obesity (MHO) and examine factors associated with MHO in children with obesity. This cross-sectional study was a secondary, exploratory analysis of data that included 2–17 years old with a body mass index (BMI) ≥85th percentile from the CANadian Pediatric Weight management Registry. Children were classified as having MHO or metabolically unhealthy obesity (MUO) using consensus-based criteria. Those with MHO had normal triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose. Logistic regression was used to examine factors associated with MHO, which included calculating odds ratios (ORs) and 95% confidence intervals (CIs). In total, 945 children were included (mean age: 12.3 years; 51% female). The prevalence of MHO was 31% (n = 297), with lower levels across increasing age categories (2–5 years [n = 18; 43%], 6–11 years [n = 127; 35%], 12–17 years [n = 152; 28%]). Children with MHO were younger, weighed less, and had lower BMI z-scores than their peers with MUO (all p < 0.01). MHO status was positively associated with physical activity (OR: 1.18; 95% CI: 1.01–1.38), skim milk intake (OR: 1.10; 95% CI: 1.01–1.19), and fruit intake (OR: 1.12; 95% CI: 1.01–1.24) and negatively associated with BMI z-score (OR: 0.69; 95% CI: 0.60–0.79), total screen time in hours (OR: 0.79; 96% CI: 0.68–0.92), and intake of fruit flavoured drinks (OR: 0.91; 95% CI: 0.84–0.99). These findings may help guide clinical decision-making regarding obesity management by focusing on children with MUO who are at relatively high cardiometabolic risk.
Senior Scientist, CHEO Research Institute