A favorable metabolic profile in metabolically healthy obesity is associated with physical activity level rather than abdominal fat volume in Japanese males.

The men were from a single community and were middle-aged Japanese males, so the results may not apply to women, older adults, or other populations. Only 26 men were classified as metabolically healthy obesity and 104 as metabolically unhealthy obesity, and several analyses used fewer men because of missing measurements. The study did not test an exercise intervention, so it cannot show that physical activity caused a healthier metabolic profile. Men taking medications for blood pressure, cholesterol or blood sugar were excluded, so the findings do not address people commonly treated for these conditions. Metabolically healthy obesity and metabolically unhealthy obesity were defined by cardiovascular risk factors, not by insulin sensitivity alone, so the groups may not match other definitions.

The study was supported by Japanese government research grants. The authors declared no competing interests.

Do not conclude that increasing physical activity will make obesity metabolically healthy, or that abdominal fat volume has no role. This was an observational comparison of existing groups, not a trial of an exercise intervention.