Abstract
Normal-weight obesity (NWO) syndrome has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in Latin American children and adolescents. The aim of this study was two-fold: (i) to investigate whether Colombian youth with NWO syndrome have a poorer cardiometabolic profile and physical fitness performance than normal-weight lean (NWL) peers; and (ii) to determine if physical fitness levels are related to prevalence of normal-weight obesity in youth. This was an analytical cross-sectional study of 1919 youths (9–179 years old, 53.0% girls) in the capital area of Colombia. NWO was defined as a body mass index < 25 kg/m2 and a validated body fat percentage above the sex-age-specific 90th percentile for Colombian children and adolescents. Body fat was estimated using bioelectrical impedance analysis, cardiorespiratory fitness (CRF) was estimated using the 20-meter shuttle run test, and muscular fitness with the handgrip test. Biochemical profile blood samples were collected for cardiometabolic risk factors. After adjusting for chronological age, pubertal stage, and Mediterranean diet adherence, the NWO group (boys and girls) had significantly higher values for cardiometabolic risk factors, and waist circumference (WC) than the NWL group. The prevalence of NWO was lower in youth classified with healthy CRF (boys, odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.37 to 0.78; girls, OR = 0.35, 95% CI 0.24 to 0.50), p < 0.001. Our findings indicate that using only body mass index for the assessment of cardiometabolic risk likely misrepresents true adiposity and suggest the need to include the assessment of body fat in the routine clinical evaluation of individuals during childhood and adolescence.
Highlights
The World Health Organization (WHO) defines overweight and obesity as abnormal or excessive fat accumulation that may impair health [1]
The number of normal-weight youths included in the study was 1919 (53.0% girls), of which 46.0% were classified as normal-weight obesity (NWO) (47.0% girls)
Our findings reveal that NWO youth have a significantly poorer cardiometabolic profile and level of physical fitness than their normal-weight lean (NWL) counterparts
Summary
The World Health Organization (WHO) defines overweight and obesity as abnormal or excessive fat accumulation that may impair health [1]. Thresholds to identify overweight and obesity because of their correlations with body fat [2] and Nutrients 2020, 12, 1171; doi:10.3390/nu12041171 www.mdpi.com/journal/nutrients. Extensive research has shown that excess of adiposity is related to the development of non-communicable diseases such as cardiovascular diseases [1]. Youth with normal BMI may have a higher-than-normal percentage of body fat and be at a greater risk of developing non-communicable chronic diseases [4]. Excess body fat despite normal BMI has been termed “normal-weight obesity (NWO) syndrome” [5], and research in adults shows that normal-weight obese individuals are insulin-resistant, hyperinsulinemic, and predisposed to type 2 diabetes mellitus and premature coronary heart disease [6]
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