Work

Prevalence of masked obesity and its association with body composition and lifestyle factors in young adults: a cross-sectional analysis

Year: 2026

Type: article

Abstract: Objectives: This study aims to investigate the prevalence of masked obesity among vocational college students, evaluate the predictive efficacy of the muscle-to-fat ratio (MFR), and explore the associations between masked obesity and lifestyle factors. Methods: A cross-sectional study was conducted with 320 students from Fujian Health College. A self-developed structured questionnaire was used to collect data on demographic characteristics and health-related behaviors. Body composition indicators were measured via a bioelectrical impedance analysis (InBody 770c). According to different combinations of body mass index (BMI) and body fat percentage (BF%), they were divided into the following 8 groups: (1) under weight with low body fat group (UW-L); (2) Under weight with high body fat group (UW-H); (3) Normal weight with low body fat group (NW-L); (4) Normal weight with high body fat group (NW-H); (5) Overweight with low body fat group (OW-L); (6) Overweight with high body fat group (OW-H); (7) Obese with low body fat group (OB-L); (8) Obese with high body fat group (OB-H). Among them, the two types of UW-H and NW-H together constitute masked obesity. Results: The prevalence of masked obesity was as high as 33.9% in the normal-weight population, and 5.8% in the underweight population. MFR demonstrates better diagnostic efficacy in the detection of masked obesity (AUC = 0.861), and is superior to BMI. After adjusting for confounding factors, excessive sleep duration was associated with masked obesity (OR = 6.887, 95% CI: 1.417-33.473), while no significant association was found between sleep quality and physical activity and masked obesity. Conclusions: Compared with the traditional obesity index BMI, MFR is more effective in identifying masked obesity in young adults.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1854278

Authors: Yimei Li, Tao Zhang, Luowen Chen

Institution: Fujian Health College

Language: English

Topic: Obesity, Physical Activity, Diet

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801