Prevalence of Metabolically Obese, Normal-Weight Individuals and Its Dietary Patterns Characteristics: A Cross-Sectional Study in Thai Adults

Abstract

Abstract Objectives Metabolically obese normal weight (MONW) individuals are subjects who have a normal body mass index (BMI), but manifest obesity-related metabolic syndrome (MetS). Nevertheless, the prevalence and correlation between MONW and dietary patterns have not been fully explored in Thais. This study aimed to investigate the national prevalence of MONW, determine which dietary patterns are consumed in Thai normal-weight adults and to identify whether those patterns were associated with the risk of MetS and its features. Methods Total 6899 Thais ≥18 years with normal BMI (18.5–22.9 kg/m2) were obtained from the Thai National Health Examination Survey IV. Sociodemographic, eating-habits, anthropometric, blood pressure and biochemical parameters were measured. MONW was diagnosed by the National Cholesterol Education Program/Adult Treatment Panel III within normal BMI. Dietary patterns were determined by means of factor analysis, and were evaluated by multiple logistic regressions for its association with MONW. Results Overall, the weighted prevalence of MONW was 9.9% (95% CI: 9.1–10.6%), particularly, the MONW prevalence was 7.2% (95% CI: 6.5–8.0%) and 13.1% (95% CI: 11.6–14.7%) in male and female respectively. Three major dietary patterns were distinguished: “westernized”, “healthy” and “carbohydrate” patterns. After controlling for potential confounders, compared with the lowest quartile, individuals in the highest quartile of the westernized and carbohydrate pattern were connected with the greater risk of MONW (adjusted odds ratio [OR]: 1.64, 95% CI: 1.25–2.17, P < 0.001) and (OR: 1.57, 95% CI: 1.19–2.08, P < 0.05) respectively, whereas subjects in the fourth quartile of healthy pattern reduce the risk of MONW and its components, except for elevated blood pressure and hyperglycemia (OR: 0.68, 95% CI: 0.50–0.92 for MONW, P < 0.05; OR: 0.43, 95% CI: 0.28–0.68 for abdominal obesity, P < 0.001; OR: 0.63, 95% CI: 0.49–0.81 for hypertriglyceridemia, P < 0.001; OR: 0.67, 95% CI: 0.54–0.82 for low high-density lipoprotein cholesterol [HDL-C], P < 0.01). Conclusions In Thai normal-weight adults, high consumption of whole grains, fruits, beans, juices, and dairy products is connected with a lower risk of metabolic syndrome and its features, i.e., lower risk of abdominal obesity, hypertriglyceridemia, and low HDL-C. Funding Sources This research received no funding.