Young Japanese Underweight Women with “Cinderella Weight” Are Prone to Malnutrition, including Vitamin Deficiencies

Abstract

Undernutrition among young women at “Cinderella weight” is socially important in Japan. To determine the nutritional status of Cinderella-weight women, we conducted an exploratory cross-sectional study on the health examination results of employees aged 20 to 39 (n = 1457 and 643 for women and men, respectively). The percentage of underweight women was found to be much higher than that of men (16.8% vs. 4.5%, respectively). In underweight women (n = 245), handgrip strength (22.82 ± 5.55 vs. 25.73 ± 5.81 kg, p < 0.001), cholesterol level (177.8 ± 25.2 vs. 194.7 ± 31.2 mg/dL, p < 0.05), and lymphocyte count (1883 ± 503 vs. 2148 ± 765/μL, p < 0.001) were significantly lower than in overweight women (n = 116). Then, the BMI < 17.5 group (n = 44) was referred to the outpatient nutrition evaluation clinic. Lower prealbumin, cholesterol, and lymphocyte levels were also observed in 34%, 59%, and 32% of the patients, respectively. Regarding dietary characteristics, 32% of the underweight women in this study skipped breakfast, and 50% had low dietary diversity scores. Lower total energy intake, carbohydrate and fiber intake, and Ca and Fe intake were also observed in 90% of the patients. Deficiencies in vitamin B1, B12, D, and folate were diagnosed in 4.6%, 25%, 14%, and 98% of the patients, respectively. Thus, young underweight women may be prone to malnutrition.

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

“…A low BMI is also associated with anemia, low sex hormone concentrations, low bone density, hypotension, and feelings of fatigue and malaise [1]. We have also reported that young women who are underweight are predisposed to deficiencies in vitamins B1, B12, and D and folate [2]. This change was also observed in underweight women older than 40 years.…”

“…Young women in Japan have lower body masses than women in Western countries [1][2][3][4][5]. The health risks associated with underweight individuals are generally underestimated in comparison with those associated with overweight individuals in routine practice, especially in preventive medicine.…”

“…Women are more likely to be underweight than men are, and those who are underweight are at a higher risk of a number of conditions, including osteoporosis, thinning skin, dry skin, hair loss, poor dental health, anemia, immune deficiencies, infertility, premature birth, and early menopause [1]. Moreover, underweight women are at a higher risk of vitamin deficiency, such as vitamin D, vitamin B 12 , and vitamin B 1 , and folate deficiency [2]. Furthermore, being underweight is associated with a greater risk of all-cause mortality than at normal weight [6].…”

Development and Validation of the Meiji Nutritional Profiling System (Meiji NPS) to Address Dietary Needs of Adults and Older Adults in Japan

“…Iron-deficiency anemia is a serious health issue due to the desire for thinness among young women in Japan [66]. Underweight young women in Japan also exhibit a low intake of dietary fiber, calcium, iron, and vitamin D [67]. Thus, protein, dietary fiber, calcium, iron, and vitamin D were deemed the main nutrients to encourage in the Meiji NPS.…”