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The Association Between the Lifestyle Risk Score and Metabolically Healthy and Unhealthy Obesity Phenotype in Iranian Women With Overweight and Obesity: A Cross-Sectional Study Publisher Pubmed



Ebrahimi S1 ; Shiraseb F2 ; Ladaninezhad M2 ; Izadi A3 ; Navaei N4 ; Mirzaei K2
Authors
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Authors Affiliations
  1. 1. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
  2. 2. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  3. 3. Medical Department, Orchid Pharmed Company, Tehran, Iran
  4. 4. Department of Nutrition, College of Graduate and Undergraduate Studies, Life University, Marietta, GA, United States

Source: Frontiers in Public Health Published:2025


Abstract

Background: The evidence shows that all women with obesity do not develop metabolic complications thus, they may be metabolically healthy. The lifestyle factors in combination may influence obesity phenotypes including metabolically healthy and unhealthy obesity. While previous studies examined associations between single lifestyle factors and obesity phenotype, no previous study has examined associations between lifestyle risk score (LRS) and obesity phenotypes. This study for the first time created the LRS which is a combination of lifestyle factors and investigated the LRS in relation to various obesity phenotypes among women with overweight and obesity. Methods: This cross-sectional study analyzed 278 women referred to health centers of the Tehran University of Medical Sciences. A multistage sampling method was used to recruit the participants. The LRS was created based on diet, physical activity (PA), sleep, obesity, and sociodemographic characteristics. A binary logistic regression analysis was used to evaluate the association between obesity phenotypes and LRS. Results: Women with higher LRS had higher body mass index (BMI) and high-sensitivity C-reactive protein (hs-CRP) while had lower high-density lipoprotein cholesterol (HDL-C), PA, education levels, sleep quality, vegetables, grains and legumes intake. Furthermore, women with higher LRS were more likely to experience metabolically unhealthy obesity (MUO). Conclusion: This study found significant associations between higher LRS and an increased likelihood of MUO. Further prospective studies are needed to advance our understanding of the relationship between lifestyle and obesity. Copyright © 2025 Ebrahimi, Shiraseb, Ladaninezhad, Izadi, Navaei and Mirzaei.
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