Table 1_The relationship between early adulthood obesity and sarcopenic obesity among middle-aged and older adults in the United States.doc

Objective This study aimed to explore the relationship between early adulthood obesity and sarcopenic obesity (SO) among middle-aged and older adults in the United States. Methods This retrospective study was conducted involving adults aged 50–69 years in the United States. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) during the periods 1999–2006 and 2011–2018. Height and weight at the age of 25 years were measured. Body mass index (BMI) at the age of 25 years (BMI 25 ) was calculated. Healthy weight, overweight, and obesity at the age of 25 years (healthy weight 25 , overweight 25 , and obesity 25 ) were defined as BMI 25 18.5 to less than 25 kg/m 2 , 25 to less than 30 kg/m 2 , and 30 kg/m 2 or greater, respectively. SO was determined by dividing appendicular skeletal muscle mass by weight (ASM/Wt) and percentage of fat mass [FM (%)]. Results The prevalence of SO was 5.4, 8.5, and 16.5% in healthy weight 25 , overweight 25 , and obesity 25 groups, respectively. After adjusting for confounding factors, the prevalence of SO in the overweight 25 group and the obesity 25 group was 1.161 times (95%CI: 0.898–1.500, p = 0.254) and 2.286 times (95%CI: 1.651–3.165, p < 0.001) higher, respectively, compared to the healthy weight 25 group. Conclusion This study demonstrates that obesity in early adulthood is closely associated with an increased risk of sarcopenic obesity among middle-aged and older adults.