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Nutrition during the early life cycle

Cardiometabolic risk in adolescents with normal weight obesity



Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were carried out on the topic with adolescents.


To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents.


Cross-sectional study, with 506 normal weight adolescents aged 10–19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype.


NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27–1.47), WHR (OR = 25.89;95%CI = 10.43–64.26) and android fat (OR = 1.49;95%CI = 1.36–1.63); insulin resistance (OR = 4.09;95%CI = 1.72–9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50–9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21–15.08); uric acid (OR = 1.81;95%CI = 1.29–2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47–7.81), total cholesterol (OR = 2.77;95%CI = 1.22–6.29), and in at least one (OR = 1.87;95%CI = 1.04–3.37) or two (OR = 6.61;95%CI = 1.45–30.19) components of MS.


NWO is associated with the presence of cardiometabolic risk factors in adolescents.

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We thank all adolescents who participated in this study and their parents/guardians and the Coordination of Improvement of Higher Level Personnel (CAPES, Brazil, funding code 001) for the master’s scholarship granted to BCC. This study received support from the National Council for Scientific and Technological Development (CNPq) (scholarship no. 485986 / 2011-6) and the Research Support Foundation of the State of Minas Gerais (FAPEMIG) (scholarship no. APQ-01618-10). CNPq and FAPEMIG did not participate in the design, analysis, or writing of the article.

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Authors and Affiliations



BCC was responsible for the analysis and interpretation of the data, conducted the literature search, as well as wrote the manuscript. SEP acted in the conception and design of the study, as well as the critical review of the paper. SAVR and LLJ participated in the analysis and interpretation of data, as well as the critical review of the paper. ERF and FRF participated in the conception of the study design, data collection, as well as the critical review of the paper. PFF participated in the conception of the study design, data collection, and writing of the article. All authors have read and approved the final manuscript.

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Correspondence to Bruna Clemente Cota.

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The authors declare no competing interests.

Ethics approval

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all the procedures involving human subjects were approved by the Ethics Committee on Human Research of the Federal University of Viçosa (case number 0140/2010). Moreover, this project was presented to the Municipal Department of Education, the Regional Superintendent of Education, and principals of schools. All participants, as well as their responsible parents/guardians, were informed about the objectives of the research, and written informed consent was obtained from the parents of all adolescents.

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Cota, B.C., Priore, S.E., Ribeiro, S.A.V. et al. Cardiometabolic risk in adolescents with normal weight obesity. Eur J Clin Nutr 76, 863–870 (2022).

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