Does the Association Between Healthy Lifestyle and Cardiometabolic Variables in Adolescents Depend on Obesity and Its Distribution?

Background/Objectives: The present study aimed to examine how obesity and its distribution influence the relationship between healthy lifestyle habits and cardiometabolic health indicators in adolescents. Methods: This cross-sectional study included 340 adolescents (54.8% female; mean age, 16.6 ± 1.0 years) from Brazil. The cardiometabolic variables included systolic (SBP) and diastolic blood pressure (DBP), high-sensitivity C-reactive protein (CRP), and markers of lipid and glucose metabolism. Information on regular physical activity, healthy diet, reduced alcohol consumption, and non-smoking was collected via a self-reported questionnaire. Body mass index, waist circumference, and skinfold measurements were assessed to determine general obesity, abdominal obesity, and excess body fat, respectively. Multiple linear regression, adjusted for confounding factors, was employed for the analysis. Results: The adoption of ≥3 healthy lifestyle habits was directly associated with high-density lipoprotein cholesterol (up to 1.2 mg/dL) and inversely associated with triglycerides (up to -0.11 p.p.). Engaging in multiple healthy lifestyle habits was inversely associated with SBP among adolescents with general (p = 0.018) and central obesity (p = 0.004). Furthermore, the adoption of multiple healthy lifestyle habits was inversely associated with CRP in adolescents with central obesity (p = 0.037). Conclusions: Even in adolescents with obesity, it is speculated that the adoption of healthy habits may contribute to a reduction in cardiometabolic risk, given the inverse association with SBP in those with general and central obesity and the inverse association with CRP in adolescents with central obesity.