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This study aims to investigate the association between waist circumference and the development of hypertension based on a nationwide cohort Chinese population. A total of 5330 individuals free of hypertension at baseline were collected from the China Health and Retirement Longitudinal Study. The association between waist circumference and the development of hypertension was analyzed by an adjusted cox regression model and visualized by restricted cubic splines. Further, we applied the supervised machine learning methods to evaluate the importance of multiple variates for new‐onset hypertension. Additionally, the robustness of the association was assessed by a subgroup analysis. A total of 1490 individuals (28.0%) developed hypertension during a mean follow‐up of 3.32 years. The new‐onset hypertension was more observed in those with increased waist circumference (P for trend < .001). In the fully adjusted Cox regression, each 10 cm increase of waist circumference would result in an 18% elevated risk of hypertension. The random forest method and the Extreme Gradient Boosting method revealed waist circumference as an important feature to predict the development of hypertension. The sensitivity analysis indicated a consistent trend between waist circumference and new‐onset hypertension in all BMI categories. This study suggested high waist circumference as an independent risk factor for new‐onset hypertension based on a nationwide cohort of Chinese adults aged ≥45 years old. Our results supported that waist circumference should be routinely measured.

This study aimed to investigate the effects of long-term, individualised exercise at the maximal fat oxidation intensity (Fatmax) during different menstrual cycle phases on lipid metabolism and body composition in women with normal weight obesity. Randomised controlled trial. A total of 48 women with normal weight obesity (18–30 years) were recruited and randomly assigned to the follicular phase, luteal phase, or control groups. Following baseline testing, all participants completed an 8-week treadmill exercise intervention at individualised Fatmax intensities. The control group exercised four times weekly, whilst the follicular and luteal phase groups completed three additional sessions during the late follicular and mid-luteal phases, respectively. Pre- and post-intervention assessments included body morphology, fasting blood biomarkers, V̇O2max, and Fatmax intensity. After 8 weeks, both experimental groups showed significant improvements in V̇O2max (p < 0.01) and body composition. The follicular phase group showed greater reductions in body weight, body mass index (p < 0.05), waist and hip circumference, body fat percentage, and fat mass (p < 0.01) than the luteal and control groups. The luteal phase group also showed significant decreases in hip and waist circumference, body fat percentage, and fat mass (p < 0.05), along with an increased apolipoprotein A-I/apolipoprotein B ratio (p < 0.05). This study suggests that an 8-week individualised Fatmax exercise intervention is more effective in improving lipid metabolism indicators and body composition during the follicular phase of the menstrual cycle than during the luteal phase.

Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m2. The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.

Obesity has attained pandemic proportions across the world, and its prevalence in developing countries is also on the rise. Nevertheless, there is still a large gap in understanding the reasons behind a disproportionately high prevalence of diabetes as opposed to a lesser degree of obesity seen in individuals of South Asian origin. This research letter highlights the importance of identifying individuals with normal weight obesity, which may partially bridge this knowledge gap. We reviewed recently published evidence on normal weight obesity. Normal weight obesity is a common public health problem and may be prevalent in up to one-third of individuals of certain Asian ethnicities. Literature is emerging on its pathophysiology and association with metabolic diseases, such as type 2 diabetes mellitus, hypertension, and dyslipidemia. More recently, normal weight obesity was also identified as an independent strong predictor of cardiovascular mortality. However, evidence is particularly lacking on its appropriate management. Normal weight obesity is an underrecognized yet widely prevalent problem in individuals of Asian descent. Further research on pathogenic mechanisms, diagnostic modalities, and therapeutic options in individuals with normal weight obesity is needed to appropriately manage this condition.

Normal-weight obesity is defined as having high body fat but a normal body mass index (BMI). This study examined whether there are differences in habitual physical activity and diet between individuals with normal-weight obesity and obese or non-obesity. This study included 143 males aged 65–75 years, and they were classified into the following three groups according to BMI and visceral fat area (VFA): obese group (n = 27 (BMI: ≥25 kg/m2 and VFA: ≥100 cm2)), normal-weight obese group (n = 35 (BMI: <25 kg/m2 and VFA: ≥100 cm2)) and non-obese group (n = 81 (BMI: <25 kg/m2 and VFA < 100 cm2)). Lowered high-density lipoprotein cholesterol and elevated triglyceride and alanine transaminase were observed in the normal-weight obese group than in the non-obese group (all for p ≤ 0.04, effect size ≥ 0.50). No differences were found in physical activity and dietary habits between non-obese and normal-weight obese groups (all for p > 0.05). Although impaired lipid and liver function parameters were observed in older males with normal-weight obesity compared with older males with non-obesity, physical activity and dietary profiles in themselves were not shown these differences in the present study.

To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. School, university and population. Adolescents between 10 and 19 years old. A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).

Background There is metabolic heterogeneity in normal-weight individuals, however, there has been limited research in the Chinese population. This study aimed to investigate the prevalence, distribution and epidemiological determinants of metabolically obese but normal-weight (MONW) in a Chinese population. Methods A total of 17,876 normal-weight individuals were recruited from 37,815 individuals in Zhejiang province in southeastern China. Normal-weight was defined as a body mass index (BMI) of 18.5–23.9 kg/m 2 . Metabolically abnormal traits were assessed by metabolic syndrome criteria from the International Diabetes Federation (IDF) in 2015. MONW was defined as individuals who had at least two metabolically abnormal trait but normal weight. Multiple logistic regression was used to investigate MONW risk factors, adjusting for potential confounders. Results The prevalence of metabolic abnormality was 34.1% in normal-weight individuals, and the overall prevalence of MONW was 16.1% in the general population. Different MONW distributions were found between men and women depending on age. Compared with women, men had a significantly higher MONW prevalence among those aged < 45 years old, and there was a lower prevalence for those aged ≥50 years old. Higher BMI or waist circumference (WC), central obesity, menopause, and family histories of hypertension, diabetes, and cardiovascular diseases, increased MONW risk. Higher education levels, regular alcohol drinking, and balanced or vegetarian food preferences reduced MONW risk. Conclusions Normal-weight individuals have metabolic heterogeneity in China. The MONW distribution between men and women depends on age. BMI, WC, dietary factors, and family history of chronic diseases, are associated with metabolic status.

The rise in global obesity and related health risks has highlighted the importance of precise body composition analysis, especially in individuals who appear healthy according to Body Mass Index (BMI). This study examines the diagnostic and prognostic significance of body composition indicators for assessing cardiometabolic risk in young women with normal weight obesity (NWO). The research included 330 women aged 18–24 years from northwestern Poland with normal BMI (18.5–24.9 kg/m 2 ), using dual-energy X-ray absorptiometry (DXA) for detailed body composition assessment. A key achievement of the study was establishing a new cut-off point for body fat percentage (PBF) at 35.78%, which effectively identified individuals at increased cardiometabolic risk. Results showed that 27.3% of participants were classified as having NWO and exhibited higher insulin levels, increased HOMA-IR scores, and a lipid profile indicative of greater cardiometabolic risk, including elevated total cholesterol, LDL-C, non-HDL-C, and triglycerides, alongside reduced HDL-C levels. The android-to-gynoid (A/G) fat ratio emerged as a significant predictor, correlating positively with insulin resistance and negatively with HDL-C levels. These findings highlight the limitations of BMI and underscore the need for comprehensive body composition analysis. Identifying the NWO phenotype early could prompt preventive lifestyle interventions, even in those with a normal BMI.

This study aimed to evaluate the relationship between lung function and body composition in cystic fibrosis (CF) and examine the presence of normal-weight obesity (NWO), a high body fat percentage with a normal body mass index (BMI), in this population. In a pilot, cross-sectional study, 32 subjects with CF and a reference group of 20 adults without CF underwent body composition analysis with air displacement plethysmography. NWO was defined as a BMI <25 kg/m2 and body fat >30% (for women) or >23% (for men). Lung function in subjects with CF was determined by the percentage of predicted forced expiratory volume in 1 s (FEV1% predicted). Despite lower BMI and fat-free mass index (P < 0.01), fat mass index and percent body fat did not differ between subjects with CF and the reference group. Among subjects with CF, FEV1% predicted was positively associated with fat-free mass index (β = 6.31 ± 2.93, P = 0.04) and inversely associated with fat mass index (β = −6.44 ± 2.93, P = 0.04), after adjusting for age, sex, and BMI. Ten subjects with CF (31%) had NWO, which corresponded with lower fat-free mass index and FEV1% predicted compared with overweight subjects (P = 0.006 and 0.004, respectively). Excess adiposity, particularly in the form of NWO, was inversely associated with lung function in CF. Larger prospective studies should be undertaken to confirm these findings and determine the long-term metabolic and clinical consequences of excess adiposity in CF. As the lifespan of individuals with CF increases, nutrition screening protocols, which primarily rely on BMI, may require reassessment. •Fat-free mass was positively associated with lung function in cystic fibrosis (CF).•Adiposity in subjects with CF was inversely associated with lung function.•Thirty percent of subjects with CF had normal-weight obesity (NWO).•Subjects with CF and NWO had reduced fat-free mass and reduced lung function.•Nutrition screening protocols that primarily rely on body mass index may require reassessment.

Normal weight obesity (NWO) is a subtype of obesity characterized by a normal weight but a high body fat percentage. However, its research in terms of metabolic health, particularly its relationship with mental health remains understudied. This study aims to explore the relationship between NWO and mental health status to provide more reliable information for future scientific research and clinical practice. This study recruited healthy people who received health checkups at a tertiary hospital in Beijing. General information of the participants was collected through a self-administered questionnaire. The mental health status of participants were assessed using the Symptom Checklist-90 (SCL-90) and the Stress Self-Assessment Questionnaire-53 (SSQ-53). False Discovery Rate (FDR) correction was applied using the Benjamini–Hochberg procedure implemented in R software. Pearson or Spearman correlation coefficients were used for correlation analysis. The A-test validation method is also employed for correlation calculations. The physiological status was assessed by collecting hematological indices. Binary logistic regression analysis assessed influencing factors associated with psychiatric symptoms. 1181 healthy participants were included, with 824 (69.8%) having abnormal body composition and 357 (30.2%) normal. The somatization factor scores in the NWO group were substantially higher than those in the normal group (FDR-adjusted P-value < 0.10). Compared with the normal group, the NWO group had more serious psychological stress abnormalities (FDR-adjusted P-value < 0.10). Results of correlation analysis indicate there might be a correlation between psychiatric symptoms and stress levels in NWO participants. Stress-related hematological indices were significantly different from those of the normal group. Middle/older age and NWO are independent factors associated with higher somatization symptoms cross-sectionally (P-value < 0.05). The NWO participants suffered higher stress levels and were highly associated with psychiatric symptoms, especially somatization. There might be a correlation between psychiatric symptoms and stress levels in NWO participants. Middle/older age and NWO are associated with higher somatization symptoms cross-sectionally.