Prevalence Of Normal Weight Obesity Research Articles

Prevalence of normal weight obesity and its cardiometabolic implications among government doctors in Gujarat, India: a cross-sectional study

BackgroundObesity is rising globally. Normal weight obesity (NWO) and normal weight central obesity (NWCO) despite normal BMI pose added metabolic risks. Limited data on these phenotypes among Indian doctors merits investigation. The present study aimed to assess the prevalence of overall obesity, NWO, NWCO, and their associations with cardiometabolic risks among doctors in Gujarat, India.MethodsIt’s a Cross-sectional study among 490 doctors aged 20–60 years at a tertiary hospital. Anthropometry, blood pressure, fasting glucose, and lipids were assessed. NWO was defined as a BMI of 18.5–24.9 kg/m2 with a high body fat percentage. NWCO as normal BMI and increased waist circumference. Body composition was assessed using an Omron body composition analyzer.ResultsThe prevalence of overall obesity was 101 (20%), NWO 239 (48.7%), and NWCO 210 (42.8%). Mean BMI, blood pressure, glucose, and LDL increased from normal weight to NWO/NWCO groups (p < 0.05). NWO and NWCO had significantly higher odds of hypertension, dyslipidemia, and high fasting blood sugar compared to non-obese after adjusting for confounders.ConclusionThe high burden of overall obesity, NWO, and NWCO among doctors highlights the need for lifestyle interventions to mitigate long-term cardiometabolic disease risk.

The Normal Weight Obesity (NWO) Problem-Prevalence and Time Changes in Children and Adolescents From Kraków (Poland).

Normal weight obesity can be associated with an increased risk of metabolic abnormalities, systemic inflammation and mortality. The main aim of the study was to analyze the changes in the prevalence of normal weight obesity in 8-18-year-olds from Kraków (Poland) between 2010 and 2020. The study was based on two sets of cross-sectional, school-based data obtained in 2010 and 2020. Body height, weight, and fat percentage were obtained. Body mass index was calculated, and only normal-weight individuals were included. Normal weight obesity was defined as normal BMI with adiposity >85 percentile for age and sex. The prevalence of normal weight obesity among Polish children and adolescents has been alarming for at least the last 10 years. Depending on the sex and age, normal weight obesity was present in more than 10% up to even more than 20% of the examined population. Alarming numbers of Polish children and adolescents suffer from NWO and this problem seems to be present for at least the last decade. A need for a maximally universal definition and cut-offs to diagnose normal weight obesity should also be stressed, as it will be helpful in providing the best prophylaxis and help to persons already suffering from normal weight obesity.

The Prevalence of Normal-Weight Obesity and Its Possible Related Dietary Factors: A Cross-Sectional Study of University Employees of Shiraz, Iran

Background: Normal-weight obesity (NWO), defined as normal body mass index (BMI) but high body fat, is related to chronic health conditions. This study aims to assess the prevalence of NWO and some possible relationships with dietary factors in an Iranian population. Methods: A cross-sectional study was conducted on the participants of the Employees Health Cohort Study, Shiraz, Iran. Based on the anthropometric assessments, participants were categorized into three groups: Normal-weight non-obese, NWO, and Overweight/Obese. NWO was defined as having a normal BMI but high body fat. Body fat was assessed by bioelectrical impedance analysis. Then, a 116-item semi-quantitative Food Frequency Questionnaire (FFQ) was used to obtain food intake. Dietary factors included energy intake, macro-nutrients intake, frequency of meals, fried and grilled foods’ consumption, and salt intake. Results: Overall, 1038 participants (513 men and 525 women) were studied with a mean age of 41.04±6.98. 35.9% had normal weight and 63.0% were overweight or obese according to BMI criteria. Based on WHO criteria, the prevalence of NWO was 21.68% and 26.63% among men and women, respectively. Women were more likely to have excess body fat compared with men (P&lt;0.001). Moreover, no significant relationship was observed between any dietary factor and NWO. Conclusions: NWO was prevalent among university employees, and no relationship was observed between dietary factors and NWO. Considering the high cardio-metabolic risk of this condition, it needs further attention.

Assessing the Risk of Normal Weight Obesity in Korean Women across Generations: A Study on Body Composition and Physical Fitness.

Normal weight obesity (NWO) refers to a condition in which the body mass index falls within the normal range, but the percent of body fat is excessive. Although there are reports of a high prevalence of cardiovascular and metabolic diseases in NWO, analyses regarding physical fitness have been lacking. Therefore, the purpose of this study was to analyze the age-related prevalence of NWO and to examine physical fitness across generations. Our study utilized a dataset comprising 119,835 participants for analysis. The prevalence of NWO across ages was examined using cross-tabulation analysis. For body composition and physical fitness, medians and group differences were assessed by generation through Kruskal-Wallis and Bonferroni post hoc tests. Additionally, univariate logistic regression was adopted to analyze the odds ratio. The prevalence of NWO in Korean women was 18.3%. The fat-free mass of the NWO group was consistently lower than that of both the group with normal body mass indexes (Normal) and obese body mass indexes (Obesity) across all generations. Additionally, the waist circumference and blood pressure were greater in the now group than in the Normal group. When considering maximal strength, muscle endurance, power, balance, and coordination, the NWO group exhibited lower levels compared to the Normal group. The NWO group showed lower muscle mass than both the Normal and Obesity groups, resulting in significantly reduced physical fitness compared to that of the Normal group, similar to the Obesity group. This condition may increase not only the risk of posing a potentially more serious health concern than obesity but also the risk of falls in elderly people. Therefore, based on this study, it is crucial to not only define obesity using BMI criteria but also to diagnose NWO. Public health policies and preventive measures must be implemented accordingly.

Hypertension in Individuals with Normal-Weight Obesity and Normal-Weight Central Obesity: A Study on Sunni Muslims of Uttar Pradesh, North India

In practice, individuals who are found normal through various adiposity indicators are screened out from the risk of obesity and subsequently from other cardiometabolic syndromes like hypertension. Against this backdrop, this study aims to examine the prevalence of hypertension among individuals having normal-weight obesity (NWO) and normal-weight central obesity (NWCO). In the present study, Cross-sectional data of 214 participants (100 males and 114 females) were collected using purposive sampling. Adiposity indices like body mass index (BMI), percent body fat (PBF), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were calculated. Individuals were then categorized into NWO and NWCO. Systolic (SBP) and diastolic (DBP) blood pressure were also measured. All the data were analyzed using SPSS software. The prevalence of generalized obesity measured through BMI and PBF were 15% and 69.6% respectively. Central obesity measured through WC, WHR, and WHtR was 33.6%, 60.3%, and 11.2%, respectively. The prevalence of NWO in the total population was 21.9%. On the other hand, the prevalence of NWCO was 3.3%, 21.5%, and 12.1% as per WC, WHR, and WHtR respectively. The mean value of SBP and DBP was higher in individuals with NWO and NWCO. Preventive, interventional, and community-specific studies on NWO, NWCO, and their association with hypertension should be taken up by researchers who will help our policymakers in managing hypertension.

Weight a minute: Exploring the effect on weight and body composition after the initiation of elexacaftor/tezacaftor/ivacaftor in adults with CF

BackgroundLife expectancy for people with CF (PwCF) continues to increase. However, a trend of overweight and obesity is emerging along with concern of developing comorbitities. Body composition (BC) is associated with several health indices. However, body mass index (BMI) does not provide information on BC. MethodsBMI, fat mass (FM), fat free mass (FFM), using bioelectrical impedance, lung function and sweat chloride (SwCl) were assessed in adult PwCF in routine clinic before and after commencement of the CFTR modulator Elexacaftor/Tezacaftor/Ivacaftor. Results109 PwCF (76 male) underwent assessments at both time points. In all PwCF a significant upward trend in BMI was observed (p < 0.001). Males significantly gained more FFM compared to females (p0.03), whilst prevalence of normal weight obesity increased primarily in females (25–38%). ConclusionRoutine BC assessment identifies individuals with elevated FM or depleted FFM enabling individualised care with the focus of optimising BC.

Prevalence of normal weight obesity in young adults of Western Uttar Pradesh – A community-based study

Background: Obesity is described as a build-up of abnormal or excessive fat that risks life. A body mass index (BMI) is a screening tool for overweight and obesity. For a long time, BMI has been used as a marker to measure obesity. However, a significant limitation of using BMI is its failure to differentiate between a high body fat content and preserved or increased lean mass, especially in patients or subjects with a BMI &lt;30 kg/m2. Normal weight obese (NWO) is such individuals who have high fat content but a normal BMI. To identify such individuals and to save them from morbidity associated with obesity, this study was carried out. Aims and Objectives: The objective of the study was to estimate the prevalence of NWO in healthy young adults (aged between 18 and 30 years) and to suggest the methods of primary prevention for obesity. Materials and Methods: In this observational cross-sectional study, the 324 subjects were selected randomly from the residents, students, and employees of Swami Vivekananda Subharti University. Subjects were chosen according to the study’s inclusion and exclusion criteria and also, based on the self-structure questionnaire. A general and systemic examination was carried out. The body composition of these subjects was done by bioelectric impedance analyzer BODY STAT QUAD SCAN 4000. Data were analysis using R-software (1.25 version), and unpaired t-test was applied. P &lt; 0.05 was taken as significant in this study. Results: The prevalence of NWO in males was found to be 24.6% and females to be 13.4%. The body composition parameters of NWO and NWNO differed significantly. Conclusion: The increase rate of NWO is reason for concern and routine screening of body composition parameters should be done at health setups to identify that these NWO individuals and timely interventions can be made.

BODY COMPOSITION IN A SAMPLE OF THE ADULT POPULATION FROM MOSCOW

Objectives. To evaluate body composition and describe the prevalence of various types of obesity in a sample of the adult population from Moscow. Material and methods. A cross-sectional study included measurements of weight, height, waist and hip circumferences, and bioimpedance analysis for body composition assessment in the sample of 131 adults (44 males aged 21 to 73 years and 87 females aged 18 to 67 years) from Moscow. Body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) were calculated. Results. Up to 30% of the adults were classified as overweight and obese (BMI ≥ 25 kg/m2); among them more than half had signs of central obesity. Almost 20% of females with normal BMI had increased body fat and were classified as normal weight obese. A significant increase in body fat mass and a decrease in lean muscle mass were associated with ageing. Conclusions. About a third of the adults from the studied sample were classified as overweight and obese. Central obesity was observed in conjunction with general obesity. The prevalence of normal weight obesity was higher in the group of females. Because the “obesogenic” environment promotes chronic positive energy balance, people with normal BMI may also have excessive body fat and the subsequent health risks similarly to people with general obesity. Further research is needed to estimate the prevalence of different types of obesity in the Moscow population. Keywords: obesogenic environment, Moscow city, normal weight obesity, central obesity, adults.

Normal weight obesity is associated with hypercholesterolemia and low muscle mass in persons living with HIV on antiretroviral treatment

Objectives: Normal weight obesity (NWO) is defined as a condition of normal body weight, but with high body fat percentage. Clinical and immunologic implications of NWO in persons living with HIV (PLHIV) remain unknown. The aim of this study was to examine NWO prevalence and its associations with metabolic and immunologic measurements in a cohort of PLHIV on antiretroviral treatment (ART).Methods: We enrolled 73 adult PLHIV on ART. Body composition was assessed by dual-energy x-ray absorptiometry. NWO was defined as body mass index 18.5 to 24.9 kg/m2 and body fat ≥25%. We determined triacylglycerols, total cholesterol, high-density lipoprotein, low-density lipoprotein, blood glucose, blood pressure, bone mineral density, inflammatory cytokines (interleukin [IL]-1β, tumor necrosis factor-α and IL-6) and CD4+ and CD8+ T-cell activation.Results: The prevalence of NWO was 49% (36 of 73). Participants with NWO showed lower CD4+ T-cell percentage (25 versus 27%, P = 0.03), lower CD4/CD8 ratio (0.62 versus 0.82, P = 0.02), lower muscle mass (6.84 versus 7.11 kg/m2, P = 0.01) and higher prevalence of hypercholesterolemia (26% versus 6%, P = 0.03) than individuals with normal body composition. No differences in inflammation/activation markers were observed between groups (P > 0.05 in all cases).Conclusion: NWO was frequent in a cohort of Mexican PLHIV on ART and was associated with lower muscle mass, hypercholesterolemia, lower CD4+ T-cell percentage, and lower CD4/CD8 ratio. The incorporation of body fat measurements in the regular physical examination of PLHIV could contribute to early identification of the NWO condition and lead to better management of possible long-term morbidity.

Prevalence of Normal Weight Obesity and Health Risk Factors for the Female Collegiate Dancer.

Brown, AF, Alfiero, CJ, Brooks, SJ, Kviatkovsky, SA, Smith-Ryan, AE, and Ormsbee, MJ. Prevalence of normal weight obesity and health risk factors for the female collegiate dancer. J Strength Cond Res 35(8): 2321-2326, 2021-The purpose of this study was to investigate the prevalence of normal weight obesity (NWO) and evaluate the relationship between NWO and health risk factors in a collegiate dancer population. Reanalysis of data of female dancers (N = 42) from 2 larger studies was used to assess prevalence and health risk factors of NWO. Dancers completed a dual-energy x-ray absorptiometry scan to assess fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT) and a 3-day food record. Normal weight obesity was defined as a body mass index (BMI) of 18.5-24.9 kg·m-2 and body fat (BF) ≥30%. Twenty-five (60%) dancers were classified as normal weight lean (NWL), and 17 dancers (40%) were classified as NWO. Significant differences were observed for BMI (NWL: 21.1 ± 1.7, NWO: 23.1 ± 1.6, p < 0.001), LM (NWL: 71.0 ± 2.9%, NWO: 62.5 ± 2.7%, p < 0.001), %BF (NWL: 24.8 ± 3.1%, NWO: 33.9 ± 2.6%, p < 0.001), and VAT (NWL: 130.6 ± 43.0 g, NWO: 232.3 ± 70.8 g, p < 0.001) between NWL and NWO. A significant difference was observed for carbohydrate intake (NWL: 4.7 ± 1.8 g·kg-1, NWO: 3.7 ± 1.0 g·kg-1, p = 0.020) between groups. Significant positive correlations with FM were observed between carbohydrate (kcal, p = 0.048), fat (kcal, p = 0.018; g·kg-1, p = 0.040), and total calories (p = 0.019) in NWO. Normal weight obesity in collegiate dancers may be more prevalent than previously perceived and may be significantly related to important health risk factors. The current study demonstrates the need for body composition assessments and emphasizing on promoting overall health in collegiate dancers.

Prevalence of normal weight obesity and its associated cardio-metabolic risk factors - Results from the baseline data of the Kerala Diabetes Prevention Program (KDPP).

BackgroundCardiometabolic disorders are frequently observed among those who have obesity as measured by body mass index (BMI). However, there is limited data available on the cardiometabolic profile of those who are non-obese by BMI but with a high body fat percentage (BFP), a phenotype frequently observed in the Indian population. We examined the prevalence of individuals with normal weight obesity (NWO) and the cardiometabolic profile of NWO individuals at high risk for type 2 diabetes(T2D) in a south Asian population.Material and methodsIn the Kerala Diabetes Prevention Program, individuals aged between 30 to 60 years were screened using the Indian Diabetes Risk Score(IDRS) in 60 rural communities in the Indian state of Kerala. We used data from the baseline survey of this trial for this analysis which included 1147 eligible high diabetes risk individuals(IDRS >60). NWO was defined as BMI within the normal range and a high BFP (as per Asia-pacific ethnicity based cut-off); Non-obese (NO) as normal BMI and BFP and overtly obese (OB) as BMI ≥25 kg/m2 irrespective of the BFP. Data on demographic, clinical and biochemical characteristics were collected using standardized questionnaires and protocols. Body fat percentage was assessed using TANITA body composition analyser (model SC330), based on bioelectrical impedance.ResultsThe mean age of participants was 47.3 ± 7.5 years and 46% were women. The proportion with NWO was 32% (n = 364; 95% CI: 29.1 to 34.5%), NO was 17% (n = 200) and OB was 51% (n = 583). Among those with NWO, 19.7% had T2D, compared to 18.7% of those who were OB (p value = 0.45) and 8% with NO (p value = 0.003). Among those with NWO, mean systolic and diastolic blood pressure were 129 ± 20; 78 ± 12 mmHg, compared to 127 ± 17; 78±11 mmHg among those with OB (p value = 0.12;0.94) and 120 ± 16; 71±10 mmHg among with NO (p value<0.001; 0.001), respectively. A similar pattern of association was observed for LDL cholesterol and triglycerides. After adjusting for other risk factors, the odds of having diabetes (OR:2.72[95% CI:1.46–5.08]) and dyslipidemia (2.37[1.55–3.64]) was significantly more in individuals with NWO as compared to non-obese individuals.ConclusionsAlmost one-third of this South Asian population, at high risk for T2D, had normal weight obesity. The significantly higher cardiometabolic risk associated with increased adiposity even in lower BMI individuals has important implications for recognition in clinical practice.

Prevalence of Normal-Weight Obesity in Community-Dwelling Chinese Older Adults: Results from the Beijing Longitudinal Study of Aging.

ObjectiveNormal-weight obesity (NWO) is characterized by high body fat percentage (BFP) in individuals with normal body mass index (BMI). This condition may increase the risk of serious health problems, such as cardiovascular diseases, diabetes, insulin resistance, hypertension, and metabolic syndrome. However, the prevalence of NWO in older adults in Beijing remains unclear. This study aimed to investigate the prevalence of overweight and obesity among older adults in Beijing, using three obesity assessment indicators: BMI, waist circumference, and BFP.DesignCross-sectional study.Setting and ParticipantsData were obtained from the 2012 Beijing Longitudinal Study of Aging, which used a stratified, sectional, random, and cluster sampling method.MethodsQuestionnaires, physical examinations, and laboratory tests were completed. Obesity was divided into four categories based on combinations of BMI and BFP: non-obese, muscle-type obesity, NWO and fatty obesity.ResultsA total of 2393 community-dwelling older adults with an average age of 72.98±8.09 years old were recruited. Of them, 1051 were male (43.92%) and 1245 were living in rural areas (52.03%). The prevalence of overweight and obesity among older people in Beijing was 35.5% and 16.1%, respectively. When the sample was divided according to obesity classification, the proportion of muscular obesity, NWO and adipose obesity was 14.7%, 10.7%, and 41.8%, respectively. The prevalence of central obesity was 62.3%. The prevalence of obesity decreased with age, but it was higher in females than in males as well as among individuals living in urban areas than in individuals living in rural areas.ConclusionThe prevalence of NWO was 10.7% among older adults in Beijing and increased with age. Older adults who are female or living in urban areas should be instructed to take measures aimed at reducing body fat and increasing muscle strength.

Normal-Weight Obesity Is Associated with Poorer Cardiometabolic Profile and Lower Physical Fitness Levels in Children and Adolescents.

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.

Prevalence and cardiometabolic risks of normal weight obesity in Chinese population: A nationwide study

Background and aimsSeveral studies have reported increased cardiovascular risks in normal weight obesity (NWO) populations. We aimed to investigate the prevalence of NWO and its relationships with cardiometabolic risks in Chinese patients. Methods and resultsThe data were from the 2007–2008 China National Diabetes and Metabolic Disorders Study. The body fat (BF) was measured using the biological impedance method. NWO was defined as a normal BMI (18.5–23.9 kg/m2) but with excess BF% (BF% ≥ 24% for men and ≥33% for women). 23,748 people (9633 males and 14,115 females) were enrolled and the prevalence of NWO was 9.5% for men, 6.06% for women. The prevalence risks of diabetes (odds ratio [OR]1.519, 95% confidence interval [CI] 1.262–1.828), Framingham risk score (FRS) ≥10% (OR 1.973, 95% CI 1.596–2.439), hypertension (OR 1.525, 95% CI 1.333–1.745), and metabolic syndrome Mets (OR 2.175, 95% CI 1.920–2.463) significantly increased in the NWO group compared with the normal group. Subgroup analyses showed that, after ruling out participants with abnormal waist circumference, the male group had similar findings to the overall population; but in the female group, the prevalence risks of FRS ≥10%, hypertension, and Mets increased, although the risk of diabetes did not. ConclusionNWO is in a relatively high prevalence in Chinese population, and the prevalence of NWO is higher in Chinese men compared to Chinese women. Cardiometabolic risks significantly increase in an NWO population, and such risks persist after excluding the effect of abdominal obesity.

Normal-weight obesity and clinical outcomes in nondiabetic chronic kidney disease patients: a cohort study

Normal-weight obesity (NWO), defined by a normal body mass index (BMI) and high body fat percentage, has been shown to be associated with cardiometabolic dysfunction and an increased risk of cardiovascular disease and mortality in the general population. However, little is known about the clinical implications of NWO among patients with chronic kidney disease (CKD). The aim of this study was to assess the characteristics and outcomes of nondiabetic CKD patients with NWO. A total of 178 nondiabetic patients with stages 3-5 CKD were prospectively followed for a median of 4.9 y. The patients were classified into 3 different adiposity phenotypes: nonobese [BMI (in kg/m2) <25 and fat mass percentage (FM%) ≤25% for men or ≤35% for women], NWO (BMI <25 and FM% >25% for men or >35% for women), and preobese-obese (BMI ≥25). FM% was determined using the Body Composition Monitor, a multifrequency bioimpedance spectroscopy device. The outcome was a composite of cardiovascular events or all-cause mortality. The prevalence of NWO was 28.1% among nondiabetic CKD patients with a normal BMI. NWO patients were older, had lower lean body mass, and had higher plasma interleukin-6 concentrations than nonobese patients. However, homeostatic model assessment for insulin resistance levels did not differ between the 2 groups. NWO patients showed a significant 3-fold higher risk of the composite outcome (HR 2.96, 95% CI: 1.13, 7.77; P<0.05) than did nonobese patients in the fully adjusted model. Preobese-obese patients were not at increased risk compared to nonobese patients. NWO was associated with the worst prognosis among the 3 different adiposity phenotypes in nondiabetic CKD patients. Our findings suggest the importance of using direct measures of adiposity for risk assessment in CKD patients who are normal-weight. This trial was registered at clinicaltrials.gov as NCT03285074.

Dual X-ray Absorptiometry Whole Body Composition of Adipose Tissue in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) may influence not only abdominal fat, but also whole body adiposity, since it is associated with chronic inflammation and disability. The study aims to evaluate the whole body adiposity of RA patients and to assess potential influences of disease specific measures. The study was designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. Each subject underwent on the same day clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. A total of 107 RA women and 104 matched controls were included. Compared to controls, the RA group had less physical activity and a higher prevalence of normal weight obesity. Overfat RA women had a significantly higher toll of inflammation, disease activity, glucocorticoid treatment and sedentary behavior. RA women with inflammation, glucocorticoid treatment and higher disease activity class had higher whole body and trunk adipose tissue indices and higher prevalence of overfat status. Glucocorticoid treatment, inflammation, disease duration and severity correlated with whole body adipose tissue and significantly predicted high adiposity content and overfat phenotypes. RA disease duration and severity are associated with higher whole body and regional adiposity. Low-dose glucocorticoid treatment seems to contribute to adiposity gain and redistribution. Clinicians may need to assess body composition and physical activity in RA patients in order to fully manage cardiovascular outcomes and quality of life.

Cardiometabolic risks profile of normal weight obese and multi-ethnic women in a developing country

ObjectivesTo determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours. MethodsThis was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration. Main outcome measureBody mass index, %BF, cardiometabolic risk factors, lifestyle behaviours. ResultsA total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3–22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73–4.04), hypertriglyceridemia (2.51, 1.47–4.29) and hypertension (1.63, 1.15–2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0–9.8). None of the lifestyle behaviours were significantly associated with NWO. ConclusionsWomen with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks.

Normal Weight Obesity and Mortality in United States Subjects ≥60 Years of Age (from the Third National Health and Nutrition Examination Survey)

Current body mass index (BMI) strata likely misrepresent the accuracy of true adiposity in older adults. Subjects with normal BMI with elevated body fat may metabolically have higher cardiovascular and overall mortality than previously suspected. We identified 4,489 subjects aged ≥60 years (BMI = 18.5 to 25 kg/m(2)) with anthropometric and bioelectrical impedance measurements from the National Health and Nutrition Examination Surveys III (1988 to 1994) and mortality data linked to the National Death Index. Normal weight obesity (NWO) was classified in 2 ways: creation of tertiles with highest percentage of body fat and body fat percent cutoffs (men >25% and women >35%). We compared overall and cardiovascular mortality rates, models adjusted for age, gender, smoking, race, diabetes, and BMI. The final sample included 1,528 subjects, mean age was 70 years, median (interquartile range) follow-up was 12.9 years (range 7.5 to 15.3) with 902 deaths (46.5% cardiovascular). Prevalence of NWO was 27.9% and 21.4% in men and 20.4% and 31.3% in women using tertiles and cutoffs, respectively. Subjects with NWO had higher rates of abnormal cardiovascular risk factors. Lean mass decreased, whereas leptin increased with increasing tertile. There were no gender-specific differences in overall mortality. Short-term mortality (<140 person-months) was higher in women, whereas long-term mortality (>140 person-months) was higher in men. We highlight the importance of considering body fat in gender-specific risk stratification in older adults with normal weight. In conclusion, NWO in older adults is associated with cardiometabolic dysregulation and is a risk for cardiovascular mortality independent of BMI and central fat distribution.

Analysis of obesity prevalence in students from Novi Sad

Apart from assessing the nutrition status, the diagnosis of obesity also includes the assessment of mass and distribution of adipose tissue which provides revealing of latent types of obesity that hold higher health risks. The aim of our study was to assess the nutritional status and to analyze the prevalence of normal weight obesity and abdominal obesity in students from the University of Novi Sad. The body mass index, waist circumference and body fat mass were assessed in the group of 371 students from the University of Novi Sad (their average age being 22.9 +/- 2.5 y). One-fifth of the study sample students were found to be overweight and obese, i.e. 21% and 1.1%, respectively. The frequency of overweight and obesity was higher in male respondents (overweight: 41.67% vs. 6.05%; obesity: 1.92% vs. 0.46%). Among the survey respondents, there were 4.6% of underweight students, all of whom were female students. Body fat was found to be increased in 11% of the students, the frequency being higher in the males. The phenomenon of obesity in normal body mass was recorded in 7% of the respondents, being more frequent in female students. The total of 5.6% of female students and 5.8% of male students had abdominal obesity. The survey results indicate the necessity and obligation to direct attention to regular and complete diagnostics of obesity in order to determine the size of fat body mass and its distribution. The presence of obesity in normal body mass among young, student population requires the comprehensive, detailed and timely diagnosis and treatment of this disease.

Normal weight obesity: Relationship with lipids, glycaemic status, liver enzymes and inflammation

Background and aims Normal weight obesity (NWO) is defined as an excessive body fat associated with a normal body mass index (BMI) and has been associated with early inflammation, but its relationship with cardiovascular risk factors await investigation. Methods and results Cross-sectional study including 3213 women and 2912 men aged 35–75 years to assess the clinical characteristics of NWO in Lausanne, Switzerland. Body fat was assessed by bioimpedance. NWO was defined as a BMI < 25 kg/m 2 and a % body fat > = 66 th gender-specific percentiles. The prevalence of NWO was 5.4% in women and less than 3% in men, so the analysis was restricted to women. NWO women had a higher % of body fat than overweight women. After adjusting for age, smoking, educational level, physical activity and alcohol consumption, NWO women had higher blood pressure and lipid levels and a higher prevalence of dyslipidaemia (odds-ratio = 1.90 [1.34–2.68]) and fasting hyperglycaemia (odds-ratio = 1.63 [1.10–2.42]) than lean women, whereas no differences were found between NWO and overweight women. Conversely, no differences were found between NWO and lean women regarding levels of CRP, adiponectin and liver markers (alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transferase). Using other definitions of NWO led to similar conclusions, albeit some differences were no longer significant. Conclusion NWO is almost nonexistent in men. Women with NWO present with higher cardiovascular risk factors than lean women, while no differences were found for liver or inflammatory markers. Specific screening of NWO might be necessary in order to implement cardiovascular prevention.