Health risks looming for Japanese women aiming for ‘Cinderella weight’ due to malnutrition, warns study

A study published in Nutrients has evaluated the nutritional intake of underweight young women in Japan, who have what’s known as “Cinderella weight,” defined as a Body Mass Index (BMI) value of 18.0. While overweight and obesity are well-known risk factors for cardiometabolic disease, underweight is often overlooked. The researchers found that malnutrition in these Cinderella-weight women can lead to risks associated with undernutrition, such as osteoporosis, menstrual irregularities and infertility, as well as an increased risk of developing cardiovascular disease, diabetes, and nutritional deficiencies affecting growth and development.

To conduct the study, the team examined the proportion and characteristics of underweight women aged 20 to 39 who underwent physical examinations at work and attended an outpatient dietary assessment clinic between August 2022 and February 2023. Pregnant women and patients with anorexia were excluded from the analysis. The researchers assessed dietary intake diversity using the Dietary Variety Score (DDS) and the CONUT score based on cholesterol and albumin levels and lymphocyte counts to screen undernourished individuals.

The results showed that underweight women had significantly lower grip strength, cholesterol levels, and lymphocyte counts compared to overweight women. Additionally, 32% of underweight women skipped breakfast and 50% had low DDS scores. Deficiencies of folic acid, vitamin B, vitamin B12, and vitamin B1 were observed in 98%, 14%, 25%, and 4.60% of individuals, respectively. Furthermore, among all the women who participated in the study, 75% and 91% of individuals aged 40-65 and 20-39, respectively, met the Global Leadership Initiative on Malnutrition (GLIM) criteria.

The findings of the study suggest that young, underweight Japanese women are malnourished, leading to potential risks such as anemia, decreased albumin levels, increased HbA1c levels, decreased lymphocytes, decreased cholesterol, and slight increases in CONUT scores. These risks, combined with reduced food intake, reduced total energy intake, and skipping breakfast, as well as deficiencies of various nutrients, including protein, carbohydrates, dietary fiber, omega-3 and n-6 ​​PUFAs, calcium, and zinc, Vitamin B1, B12, D, and folic acid, could lead to significant health problems.

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