Article Data

  • Views 249
  • Dowloads 172

Original Research

Open Access

Effects of physical activity type and sedentary time on metabolically healthy obesity and metabolically unhealthy normal weight Korean men

  • Gaofei Zhang1
  • Yonghwan Kim2
  • Yongchul Choi2,*,
  • Jiyoung Lee2,*,

1Physical Education College, Zhoukou Normal University, 466000 Zhoukou, Henan, China

2Department of Physical Education, Gangneung-Wonju National University, 25457 Gangneung, Republic of Korea

DOI: 10.22514/jomh.2023.002 Vol.19,Issue 1,January 2023 pp.51-59

Submitted: 27 September 2022 Accepted: 05 January 2023

Published: 30 January 2023

*Corresponding Author(s): Yongchul Choi E-mail:
*Corresponding Author(s): Jiyoung Lee E-mail:


Obesity has become a global health challenge linked to morbidity and mortality associated with cardiovascular diseases. This study aimed to compare metabolic health indicators according to obesity phenotypes and examine prevalence according to physical activity (PA) and sedentary time in metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW). Data were obtained from 3242 men participating in the 7th and 8th Korean National Health and Nutrition Examination Surveys. Participants were divided into four groups based on body phenotype and metabolic health status using obesity. Metabolic health was defined as metabolic syndrome. Representative statistical analyzes were one-way analysis of variance (ANOVA) and multiple logistic regression analysis. Compared with MUNW, the MHO had higher obesity, but systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), hemoglobin A1c (HbA1c), triglycerides (TG), low density lipoprotein cholesterol (LDLC), and total cholesterol (TC) were significantly lower. In comparison between MHO and metabolically healthy normal weight (MHNW), the same health group, there were no significant differences in SBP, FG, HbA1c, and LDLC. The odds ratio of MUNW in the normal weight group was 1.8 times higher than that of the high group in the low leisure PA group. The group with high sedentary time increased the MUNW odds ratio by 1.5 times compared to the low group. Meanwhile, in the obesity group, the high leisure PA group showed a 1.4-fold increase in the MHO odds ratio compared to the low group. In addition, the low sedentary group showed a 1.6-fold increase in the MHO odds ratio compared to the high sedentary group. In conclusion, MHO had higher adiposity than MUNW, but the metabolic health index was better. Low PA and high sedentary time increased the risk of MUNW even in normal weight. Conversely, high PA and low sedentary time increased the likelihood of MHO in the obesity group.


Metabolically healthy obesity; Metabolically unhealthy normal weight; Physical activity; Sedentary time; Metabolic syndrome

Cite and Share

Gaofei Zhang,Yonghwan Kim,Yongchul Choi,Jiyoung Lee. Effects of physical activity type and sedentary time on metabolically healthy obesity and metabolically unhealthy normal weight Korean men. Journal of Men's Health. 2023. 19(1);51-59.


[1] Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Morbidity and mortality associated with obesity. Annals of Translational Medicine. 2017; 5: 161.

[2] Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C. Obesity as a disease. Medical Clinics of North America. 2018; 102: 13–33.

[3] Lee HJ, Choi EK, Lee SH, Kim YJ, Han KD, Oh S. Risk of ischemic stroke in metabolically healthy obesity: a nationwide population-based study. PLoS One. 2018; 13: e0195210.

[4] Smith GI, Mittendorfer B, Klein S. Metabolically healthy obesity: facts and fantasies. The Journal of Clinical Investigation. 2019; 129: 3978–3989.

[5] Cho YK, Kang YM, Yoo JH, Lee J, Park J, Lee WJ, et al. Implications of the dynamic nature of metabolic health status and obesity on risk of incident cardiovascular events and mortality: a nationwide population-based cohort study. Metabolism. 2019; 97: 50–56.

[6] Stefan N, Schick F, Häring H. Causes, characteristics, and consequences of metabolically unhealthy normal weight in humans. Cell Metabolism. 2017; 26: 292–300.

[7] Zoghi G, Shahbazi R, Mahmoodi M, Nejatizadeh A, Kheirandish M. Prevalence of metabolically unhealthy obesity, overweight, and normal weight and the associated risk factors in a southern coastal region, Iran (the PERSIAN cohort study): a cross-sectional study. BMC Public Health. 2021; 21: 2011.

[8] Gómez-Zorita S, Queralt M, Vicente MA, González M, Portillo MP. Metabolically healthy obesity and metabolically obese normal weight: a review. Journal of Physiology and Biochemistry. 2021; 77: 175–189.

[9] Huang LO, Loos RJF, Kilpeläinen TO. Evidence of genetic predisposition for metabolically healthy obesity and metabolically obese normal weight. Physiological Genomics. 2018; 50: 169–178.

[10] Zhang Y, Fu J, Yang S, Yang M, Liu A, Wang L, et al. Prevalence of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) in Chinese Beijing urban subjects. BioScience Trends. 2017; 11: 418–426.

[11] de Winter M, Rioux BV, Boudreau JG, Bouchard DR, Sénéchal M. Physical activity and sedentary patterns among metabolically healthy individuals living with obesity. Journal of Diabetes Research. 2018; 2018: 1–8.

[12] Camhi SM, Waring ME, Sisson SB, Hayman LL, Must A. Physical activity and screen time in metabolically healthy obese phenotypes in adolescents and adults. Journal of Obesity. 2013; 2013: 1–10.

[13] Velho S, Paccaud F, Waeber G, Vollenweider P, Marques-Vidal P. Metabolically healthy obesity: different prevalences using different criteria. European Journal of Clinical Nutrition. 2010; 64: 1043–1051.

[14] Bopp M, Kaczynski AT, Campbell ME. Health-related factors associated with mode of travel to work. Journal of Environmental and Public Health. 2013; 2013: 1–9.

[15] Furie GL, Desai MM. Active transportation and cardiovascular disease risk factors in U.S. adults. American Journal of Preventive Medicine. 2012; 43: 621–628.

[16] Østergaard L, Grøntved A, Børrestad LAB, Froberg K, Gravesen M, Andersen LB. Cycling to school is associated with lower bmi and lower odds of being overweight or obese in a large population-based study of Danish adolescents. Journal of Physical Activity and Health. 2012; 9: 617–625.

[17] Craig C, Marshall A, Sjostrom M, Bauman A, Lee P, Macfarlane D, et al. International physical activity questionnaire-short form. Journal of American College Health. 2017; 65: 492–501.

[18] Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of international physical activity questionnaire (IPAQ) short form. Journal of the Korean Academy of Family Medicine. 2007; 28: 532–541.

[19] Liguori C, American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 10th edn. Lippincott Williams & Wilkins: Philadelphia, PA. 2020.

[20] Eckel RH, Cornier MA. Update on the NCEP ATP-III emerging cardiometabolic risk factors. BMC Medicine. 2014; 12: 115.

[21] Nam GE, Park HS. Perspective on diagnostic criteria for obesity and abdominal obesity in Korean adults. Journal of Obesity & Metabolic Syndrome. 2018; 27: 134–142.

[22] Karra P, Winn M, Pauleck S, Bulsiewicz‐Jacobsen A, Peterson L, Coletta A, et al. Metabolic dysfunction and obesity-related cancer: beyond obesity and metabolic syndrome. Obesity. 2022; 30: 1323–1334.

[23] Herath HMM, Weerasinghe NP, Weerarathna TP, Amarathunga A. A comparison of the prevalence of the metabolic syndrome among sri lankan patients with type 2 diabetes mellitus using who, NCEP-ATP III, and IDF definitions. International Journal of Chronic Diseases. 2018; 2018: 1–8.

[24] Janghorbani M, Salamat MR, Amini M, Aminorroaya A. Risk of diabetes according to the metabolic health status and degree of obesity. Diabetes & Metabolic Syndrome. 2017; 11: S439-S444.

[25] Garralda-Del-Villar M, Carlos-Chillerón S, Diaz-Gutierrez J, Ruiz-Canela M, Gea A, Martínez-González MA, et al. Healthy lifestyle and incidence of metabolic syndrome in the SUN cohort. Nutrients. 2018; 11: 65.

[26] Ko DH, Lee KH, Kim YH. Longitudinal study on the relative risk of type 2 diabetes mellitus according to obesity and physical activity. Journal of Men’s Health. 2020; 16: 1–10.

[27] Ko DH, Kim YH, Han JK. Relationship between cardiovascular disease risk factors, health behavior and physical fitness according to visceral fat in older men. Journal of Men’s Health. 2022; 18: 128.

[28] Lemes IR, Sui X, Fernandes RA, Blair SN, Turi-Lynch BC, Codogno JS, et al. Association of sedentary behavior and metabolic syndrome. Public Health. 2019; 167: 96–102.

[29] Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012; 55: 2895–2905.

[30] Iacobini C, Pugliese G, Blasetti Fantauzzi C, Federici M, Menini S. Metabolically healthy versus metabolically unhealthy obesity. Metabolism. 2019; 92: 51–60.

[31] Messier V, Karelis AD, Robillard M, Bellefeuille P, Brochu M, Lavoie J, et al. Metabolically healthy but obese individuals: relationship with hepatic enzymes. Metabolism. 2010; 59: 20–24.

[32] Hinnouho G, Czernichow S, Dugravot A, Batty GD, Kivimaki M, Singh-Manoux A. Metabolically healthy obesity and risk of mortality. Diabetes Care. 2013; 36: 2294–2300.

[33] Hankinson AL, Daviglus ML, Horn LV, Chan Q, Brown I, Holmes E, et al. Diet composition and activity level of at risk and metabolically healthy obese American adults. Obesity. 2013; 21: 637–643.

[34] Jennings CL, Lambert EV, Collins M, Joffe Y, Levitt NS, Goedecke JH. Determinants of insulin-resistant phenotypes in normal-weight and obese black African women. Obesity. 2008; 16: 1602–1609.

[35] Phillips CM, Dillon C, Harrington JM, McCarthy VJ, Kearney PM, Fitzgerald AP, et al. Defining metabolically healthy obesity: role of dietary and lifestyle factors. PLoS One. 2013; 8: e76188.

[36] Buscemi S, Chiarello P, Buscemi C, Corleo D, Massenti MF, Barile AM, et al. Characterization of metabolically healthy obese people and metabolically unhealthy normal-weight people in a general population cohort of the ABCD study. Journal of Diabetes Research. 2017; 2017: 1–9.

[37] Julian V, Bergsten P, Forslund A, Ahlstrom H, Ciba I, Dahlbom M, et al. Sedentary time has a stronger impact on metabolic health than moderate to vigorous physical activity in adolescents with obesity: a cross-sectional analysis of the Beta-JUDO study. Pediatric Obesity. 2022; 17: e12897.

[38] Gilardini L, Zambon A, Soranna D, Croci M, Invitti C. Predictors of the transition from metabolically healthy obesity to unhealthy obesity. Eating and Weight Disorders. 2018; 23: 739-744.

[39] Gay C, Eschalier B, Levyckyj C, Bonnin A, Coudeyre E. Motivators for and barriers to physical activity in people with knee osteoarthritis: a qualitative study. Joint Bone Spine. 2018; 85: 481–486.

[40] Baillot A, Chenail S, Barros Polita N, Simoneau M, Libourel M, Nazon E, et al. Physical activity motives, barriers, and preferences in people with obesity: a systematic review. PLoS One. 2021; 16: e0253114.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus CiteScore 0.7 (2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time