Normal-weight obesity and low muscle mass in college students: Associations with physical activity and bone health

OBJECTIVE: ). PARTICIPANTS: Eighty-seven students (85% female; mean age 20.9 years) with normal-range BMI from California Polytechnic State University, San Luis Obispo. METHODS: Dual-energy X-ray absorptiometry assessed body composition and bone mineral density. Low muscle mass was defined as appendicular lean mass index z-score ≤ -1.0. Multivariable regression examined predictors of muscle mass and bone outcomes. Despite normal BMI, 61% had elevated triglycerides. CONCLUSIONS: BMI-based screening may underestimate health risk. Body composition and lifestyle assessment may improve early identification.