PLoS One. 2026 Feb 23;21(2):e0343062. doi: 10.1371/journal.pone.0343062. eCollection 2026.
ABSTRACT
BACKGROUND: In the Region of the Americas, particularly in low- and middle-income countries such as Peru, cardiovascular disease (CVD) remains one of the leading causes of mortality. A positive association has also been described between body fat percentage and CVD risk.
OBJECTIVE: To evaluate the association between obesity, defined by Relative Fat Mass (RFM, an anthropometric indicator that estimates total body fat), and 10-year cardiovascular risk estimated by the Framingham risk score.
METHODS: A cross-sectional study was conducted using data from the Food and Nutrition Surveillance by Life Stages survey (2017-2018) in Peru. Obesity was the exposure variable defined by RFM. The RFM was also analyzed both as a continuous and categorical variable. Generalized linear models of the gamma family with a logarithmic link were applied and stratified by sex.
RESULTS: Data from 651 adults were analyzed. The prevalence of obesity was 78.2% in women and 42.7% in men. After adjusting for age, poverty, fruit and vegetable consumption, and altitude of residence, obesity defined by RFM was associated with higher estimated Framingham risk scores in both sexes (Women: β: 0.48; 95% CI: 0.32-0.63; Men: β: 0.39; 95% CI: 0.23-0.56. Similar results were observed when RFM was analyzed as a continuous variable and in tertiles.
CONCLUSION: Obesity defined by RFM was positively associated with estimated 10-year cardiovascular risk in both sexes, with stronger association in women. These results suggest that RFM may serve as a useful tool for assessing estimated 10-year cardiovascular risk, with implications for the design of public health interventions in Peru.
PMID:41729888 | DOI:10.1371/journal.pone.0343062