Dietary and lifestyle characteristics associated with normal-weight obesity: the National FINRISK 2007 Study

Abstract

The aim of the present study was to compare the lifestyle (leisure-time physical activity, smoking habits and alcohol consumption) and dietary (energy-yielding nutrients, dietary fibre and foods) factors of Finns with a new syndrome called normal-weight obesity (NWO) with those of lean and overweight Finns. The representative population-based study included 4786 participants (25 -74 years) from the National FINRISK 2007 Study with a health examination and questionnaires. Food intake was assessed using a validated FFQ. NWO was defined to include those with a normal BMI (, 25 kg/m 2 ) but excessive body fat (for men $ 20 % and for women $ 30 %) according to WHO definitions. The proportion of participants with a normal BMI was 28 % in men and 42 % in women. Of these, 34 % of the men and 45 % of the women had the NWO syndrome (among all the participants, 10 and 19 %, respectively). The waist circumference of the NWO participants was between that of the lean and overweight participants. Some potential risk factors, such as physical inactivity, (ex)-smoking and alcohol consumption, were related to NWO. In general, the intakes of energy-yielding nutrients were not associated with NWO. Instead, some healthy dietary factors (e.g. low intakes of meat and soft drinks) as well as unhealthy factors (e.g. low intakes of root vegetables, cereals and fish and high intake of confectionery) were related to NWO. The findings might explain why the NWO participants were of normal weight, but had an excessive body fat percentage. In conclusion, the proportion of normal-weight participants with an excessive body fat percentage was surprisingly high. The identification of NWO people may be of importance because although they appear lean, they have some unhealthy lifestyle and dietary habits related to obesity and overall health.Key words: Diet: Lifestyle: Obesity: Physical activity: SurveysThe proportion of obese adults has reached an epidemic scale all around the world (1) , moving steadily away from the Healthy People 2010 goal of 15 % obesity prevalence (BMI $ 30 kg/m 2 ) (2) . For example, the prevalence of obesity has reached 20 -30 % in European countries, 30 % in the USA and 70 % in Polynesia (1) . Nearly 70 % of the Finnish working-age men and half of the women are classified as at least overweight (BMI $ 25 kg/m 2 ) and over 20 % of them as obese (3) . The WHO has estimated that there will be about 1·5 billion overweight and obese people worldwide by 2015 if the current trends continue (4) .BMI has been the most commonly used anthropometric measure to diagnose obesity and predict the risk of chronic diseases. Waist circumference has also been used to assess abdominal obesity. However, it has been reported that there are some obese subjects with normal metabolic indicators, such as blood lipid and glucose concentrations (metabolically healthy obese), as well as subjects who are metabolically obese but of normal weight (5,6) . Furthermore, a new syndrome called normal-weight obesity (NWO) has recently been identified amo...

Health Behavior and Metabolic Risk Factors Associated with Normal Weight Obesity in Adolescents

“…While NWO studies with actual fitness measures are few, physical inactivity has been suggested to be associated with NWO in former studies [12, 25, 31]. Fewer studies have investigated the associations between dietary intake and NWO and, in agreement with our findings, an association has seldom been found with either amount of energy, the proportion of macronutrients or single nutrients [31, 32].…”

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

“…There seemed to be a declining trend in physical activity as body fat increased, however this did not reach statistical significance. Dietary patterns characterised by low dietary fibre intake, high intake of meat, soft drinks and confectionery have been related to NWO [16]. However, our results showed no significant associations between fruit and vegetable consumption with cardiometabolic outcomes.…”

“…Smoking, physical inactivity and alcohol intake were reported to contribute to cardiometabolic abnormalities [16,27]. Smoking and alcohol were not included in our analyses as less than 0.1% of the respondents reported these behaviours.…”

“…Lifestyle factors associated with NWO include physical inactivity, unhealthy diet, smoking, alcohol consumption and short sleep duration [16]. Literature is replete with evidence that regular physical activity is related to lower odds of metabolic syndrome.…”

Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study

“…In all cohorts, body weight, height, BMI and waist and hip circumferences were measured as previously described [23,26,27].…”