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Nutritional status, dietary intake and adiposity of normal-weight individuals with clustered metabolic risk factors in the UK population

In recent years, a number of novel adiposity proxies, such as the ‘A Body Shape Index’ (ABSI), Body Roundness Index (BRI) and Waist-hip-height ratio (WHHR) have been applied as an alternative to Body Mass Index (BMI), which has been challenged as proxy indicator of CM risk12. The ‘thin outside, fat inside’ (TOFI) obesity phenotype is characterised by BMI 18·5–24·9 kg/m (normal weight), whilst manifesting a cluster of health-detrimental CM abnormalities3. The aim of this study was to investigate associations between dietary intake, nutritional status and CM risk in the normal weight UK population with and without clustered CM risk factors and to verify the suitability of novel adiposity proxies for the identification of TOFIs. Using the National Diet and Nutrition Survey (NDNS) Rolling Programme 2008/09–2011/12 (unweighted data) a subsample (n 227) of the normal weight population was analysed. Variation in nutritional status was investigated by the existence of the cluster CM risk4. Beside energy and nutrient intake, emerging (carotenoids)5 and more established (e.g. plasma Vitamin D, ferritin and dietary carbohydrates6 correlates of CM risk were investigated. Traditional (waist circumference (WC)) and novel (ABSI, BRI and WHHR) measures of adiposity were also compared amongst groups using an independent t-test.