Kaczmarek Maria
Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland.
Front Nutr. 2025 Jul 21;12:1637885. doi: 10.3389/fnut.2025.1637885. eCollection 2025.
Normal-weight obesity (NWO), which is defined as excess body fat despite a normal body mass index (BMI), is increasingly recognized as a cardiometabolic risk factor. However, data on its prevalence and associated factors in adolescent populations is limited.
To estimate the prevalence of NWO among Polish adolescents and to identify individual and contextual correlates using a multidimensional ecological framework.
Data were drawn from the cross-sectional, population-based ADOPOLNOR study and included 4,037 adolescents (49.6% boys) aged 10-18 years with a normal BMI, as classified by the International Obesity Task Force (IOTF). Body composition was assessed via bioelectrical impedance analysis. NWO was defined as a fat mass percentage (FM%) at or above the 85th percentile for age and sex, based on national reference values. Logistic regression was used to identify factors associated with NWO.
The prevalence of NWO was 16.5%, which was slightly higher in girls (17.3%) than in boys (15.8%). Adolescents with NWO had significantly higher FM%, fat mass index and fat-to-muscle mass ratio ( < 0.001; ≈ 0.57-0.63), highlighting the limitations of BMI in detecting excess adiposity. Multivariate logistic regression analysis revealed that female sex (OR = 1.23, = 0.046), older age (OR = 1.60, = 0.014), family history of obesity (OR = 1.84, = 0.003) and dieting for weight loss (OR = 1.81, = 0.004) were risk factors for NWO. Protective factors included high family affluence (OR = 0.79, = 0.017), high dietary quality (OR = 0.53, < 0.001), regular mealtimes (OR = 0.65, = 0.028) and high physical activity (OR = 0.53, < 0.001).
NWO affects a significant proportion of adolescents and cannot be detected by BMI alone. Routine body composition assessment and the promotion of healthy behaviors are therefore essential for early identification and prevention.
正常体重肥胖（NWO）被定义为尽管体重指数（BMI）正常但体脂过多，它日益被视为一种心血管代谢风险因素。然而，关于其在青少年人群中的患病率及相关因素的数据有限。
估计波兰青少年中NWO的患病率，并使用多维生态框架确定个体和环境相关因素。
数据取自基于人群的横断面ADOPOLNOR研究，包括4037名10至18岁BMI正常的青少年（49.6%为男孩），由国际肥胖特别工作组（IOTF）分类。通过生物电阻抗分析评估身体成分。根据国家参考值，NWO被定义为年龄和性别的脂肪量百分比（FM%）处于或高于第85百分位数。使用逻辑回归确定与NWO相关的因素。
NWO的患病率为16.5%，女孩（17.3%）略高于男孩（15.8%）。患有NWO的青少年的FM%、脂肪量指数和脂肪与肌肉量之比显著更高（<0.001；≈0.57 - 0.63），突出了BMI在检测肥胖方面的局限性。多变量逻辑回归分析显示，女性（比值比[OR]=1.23，P = 0.046）、年龄较大（OR = 1.60，P = 0.014）、肥胖家族史（OR = 1.84，P = 0.003）和为减肥而节食（OR = 1.81，P = 0.004）是NWO的风险因素。保护因素包括家庭富裕程度高（OR = 0.79，P = 0.017）、饮食质量高（OR = 0.53，P < 0.001）、用餐时间规律（OR = 0.65，P = 0.028）和身体活动量高（OR = 0.53，P < 0.001）。
NWO影响相当比例的青少年，且不能仅通过BMI检测出来。因此，常规身体成分评估和促进健康行为对于早期识别和预防至关重要。
