Martin-Piedra, LauraAlcala-Diaz, Juan FGutierrez-Mariscal, Francisco MArenas de Larriva, Antonio PRomero-Cabrera, Juan LTorres-Peña, Jose DCaballero-Villarraso, JavierLuque, Raul MPerez-Martinez, PabloLopez-Miranda, JoseDelgado-Lista, Javier2025-01-072025-01-072021-11-12https://hdl.handle.net/10668/25862Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Mediterranean dietcoronary patientsdiet interventionfatty liver indexlow-fat dietmetabolically healthy obesemetabolically unhealthy obeseobesity metabolic phenotypesAdultAgedBody Mass IndexDietDiet, Fat-RestrictedDiet, MediterraneanFatty LiverFemaleHealth StatusHumansMaleMetabolic SyndromeMiddle AgedObesityPhenotypeYoung Adultresearch article34836298open access10.3390/nu131140462072-6643PMC8624211https://www.mdpi.com/2072-6643/13/11/4046/pdf?version=1636714455https://pmc.ncbi.nlm.nih.gov/articles/PMC8624211/pdf