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Objectives: To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine
its associations with cardiometabolic risks and lifestyle behaviors.
Methods: This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia.
Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass
index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels.
Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that
included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration.
Main outcome measure: Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviors.
Results: A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3�22.5). NWO was more
prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73�4.04),
hypertriglyceridemia (2.51, 1.47�4.29) and hypertension (1.63, 1.15�2.31) compared to women with lower % body fat after adjusted
for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0�9.8). None of the lifestyle
behaviors were significantly associated with NWO.
Conclusions: Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidemia and increased blood
pressure.