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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health and Nutrition
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1490937
This article is part of the Research Topic Holistic Approaches to Understanding Obesity and Metabolic Diseases in Urban Environments View all 6 articles

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

Provisionally accepted
Sara Ebrahimi Sara Ebrahimi 1Farideh Shiraseb Farideh Shiraseb 2Maryam Ladaninezhad Maryam Ladaninezhad 2Azimeh Izadi Azimeh Izadi 3*Negin Navaei Negin Navaei 4*Khadijeh Mirzaei Khadijeh Mirzaei 2*
  • 1 Deakin University, Geelong, Australia
  • 2 Tehran University of Medical Sciences, Tehran, Tehran, Iran
  • 3 Medical Department, Orchid Pharmed Company, Tehran, Iran
  • 4 Life University, Marietta, Ohio, United States

The final, formatted version of the article will be published soon.

    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 analysed 278 women referred to health centres 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.

    Keywords: lifestyle risk score, Obesity phenotypes, Metabolically healthy obesity, Metabolically unhealthy obesity, Healthy lifestyle

    Received: 04 Sep 2024; Accepted: 24 Jan 2025.

    Copyright: © 2025 Ebrahimi, Shiraseb, Ladaninezhad, Izadi, Navaei and Mirzaei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Azimeh Izadi, Medical Department, Orchid Pharmed Company, Tehran, Iran
    Negin Navaei, Life University, Marietta, 30060, Ohio, United States
    Khadijeh Mirzaei, Tehran University of Medical Sciences, Tehran, 1417863181, Tehran, Iran

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