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We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk . Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .

INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success . About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .

Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial.

CONTEXT Low levels of cardiorespiratory fitness are associated with high risk of mortality , and improvements in fitness are associated with reduced mortality risk . However , a poor underst and ing of the physical activity-fitness dose response relation remains . OBJECTIVE To examine the effect of 50 % , 100 % , and 150 % of the NIH Consensus Development Panel recommended physical activity dose on fitness in women . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 464 sedentary , postmenopausal overweight or obese women whose body mass index ranged from 25.0 to 43.0 and whose systolic blood pressure ranged from 120.0 to 159.9 mm Hg . Enrollment took place between April 2001 and June 2005 in the Dallas , Tex , area . INTERVENTION Participants were r and omly assigned to 1 of 4 groups : 102 to the nonexercise control group and 155 to the 4-kcal/kg , 104 to the 8-kcal/kg , and 103 to the 12-kcal/kg per week energy-expenditure groups for the 6-month intervention period . Target training intensity was the heart rate associated with 50 % of each woman 's peak Vo2 . MAIN OUTCOME MEASURE The primary outcome was aerobic fitness assessed on a cycle ergometer and quantified as peak absolute oxygen consumption ( Vo2abs , L/min ) . RESULTS The mean ( SD ) baseline Vo2abs values were 1.30 ( 0.25 ) L/min . The mean ( SD ) minutes of exercising per week were 72.2 ( 12.3 ) for the 4-kcal/kg , 135.8 ( 19.5 ) for the 8-kcal/kg , and 191.7 ( 33.7 ) for the 12-kcal/kg per week exercise groups . After adjustment for age , race/ethnicity , weight , and peak heart rate , the exercise groups increased their Vo2abs compared with the control group by 4.2 % in the 4-kcal/kg , 6.0 % in the 8-kcal/kg , and 8.2 % in the 12-kcal/kg per week groups ( P<.001 for each vs control ; P for trend < .001 ) . There was no treatment x subgroup interaction for age , body mass index , weight , baseline Vo2abs , race/ethnicity , or baseline hormone therapy use . There were no significant changes in systolic or diastolic blood pressure values from baseline to 6 months in any of the exercise groups vs the control group . CONCLUSION In this study , previously sedentary , overweight or obese postmenopausal women experienced a grade d dose-response change in fitness across levels of exercise training . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00011193

We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk . Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .

INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success . About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .

We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk . Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .

INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success . About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .

Body-mass index and mortality among 1.46 million white adults.

BACKGROUND A high body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) is associated with increased mortality from cardiovascular disease and certain cancers , but the precise relationship between BMI and all-cause mortality remains uncertain . METHODS We used Cox regression to estimate hazard ratios and 95 % confidence intervals for an association between BMI and all-cause mortality , adjusting for age , study , physical activity , alcohol consumption , education , and marital status in pooled data from 19 prospect i ve studies encompassing 1.46 million white adults , 19 to 84 years of age ( median , 58 ) . RESULTS The median baseline BMI was 26.2 . During a median follow-up period of 10 years ( range , 5 to 28 ) , 160,087 deaths were identified . Among healthy participants who never smoked , there was a J-shaped relationship between BMI and all-cause mortality . With a BMI of 22.5 to 24.9 as the reference category , hazard ratios among women were 1.47 ( 95 percent confidence interval [ CI ] , 1.33 to 1.62 ) for a BMI of 15.0 to 18.4 ; 1.14 ( 95 % CI , 1.07 to 1.22 ) for a BMI of 18.5 to 19.9 ; 1.00 ( 95 % CI , 0.96 to 1.04 ) for a BMI of 20.0 to 22.4 ; 1.13 ( 95 % CI , 1.09 to 1.17 ) for a BMI of 25.0 to 29.9 ; 1.44 ( 95 % CI , 1.38 to 1.50 ) for a BMI of 30.0 to 34.9 ; 1.88 ( 95 % CI , 1.77 to 2.00 ) for a BMI of 35.0 to 39.9 ; and 2.51 ( 95 % CI , 2.30 to 2.73 ) for a BMI of 40.0 to 49.9 . In general , the hazard ratios for the men were similar . Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up . CONCLUSIONS In white adults , overweight and obesity ( and possibly underweight ) are associated with increased all-cause mortality . All-cause mortality is generally lowest with a BMI of 20.0 to 24.9

We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk . Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .

INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success . About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .