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

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.

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.

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<0.001). Moreover, no significant relationship was observed between any dietary factor and NWO.

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.