Comparison of Abdominal Muscle and Subcutaneous Fat Thickness and Core Stability between Normal Weight Non-Obesity, Normal Weight Obesity, and Obesity Groups in Young Korean Women
Abstract
Background: We compared abdominal muscle and subcutaneous fat thicknesses, and core stability among young Korean women with normal weight non-obesity (NWNO), normal weight obesity (NWO), and obesity (OB).
Methods: Between May and September 2024, fifty-seven female university students from K University in Gwangju, Republic of Korea, were classified into three groups (NWNO: n = 15, NWO: n = 20, and OB: n = 22) based on body mass index and body fat percentage. The thicknesses of the abdominal muscles, including the transverse abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) muscles, and of the subcutaneous fat were measured using real-time ultrasound imaging. Core stability was assessed using trunk extensor, trunk flexor, and side-bridge endurance tests. Data were analyzed using one-way ANOVA with a significance level of 0.05.
Results: Significant differences were observed in the thicknesses of the TrA (P = 0.002), EO (P = 0.001), and subcutaneous fat (P < 0.05) between groups. The OB group had the greatest TrA and subcutaneous fat thicknesses. The side-bridge endurance test revealed a significant difference in core stability (P = 0.002), with the OB group demonstrating the lowest core stability.
Conclusion: Although the OB group had the largest muscle thickness, it demonstrated lower core stability than the NWNO group. These results suggest that obesity might impair neuromuscular activation and muscle fiber recruitment, leading to functional limitations despite increased muscle mass. These findings emphasize the importance of preventing and managing normal-weight obesity in women in their 20s.
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7. David C, de Mello RB, Bruscato N, et al. (2017). Overweight and abdominal obe-sity association with all-cause and cardi-ovascular mortality in the elderly aged 80 and over: a cohort study. J Nutr Health Aging, 21(5):597-603.
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9. Kim J, Kang S, Kang H, et al. (2023). Nor-mal-Weight Obesity and Metabolic Syn-drome in Korean Adults: A Population-Based Cross-Sectional Study. Healthcare (Basel), 11(16):2303.
10. Kim S, Kyung C, Park JS, et al. (2015). Normal-weight obesity is associated with increased risk of subclinical ather-osclerosis. Cardiovasc Diabetol, 14:58.
11. 2024 InBody Report (2018-2022). InBody Report. https://inbody.com/assets/download/Annual%20Report_ENG_2024_web.pdf
12. He Q, Horlick M, Thornton J, et al. (2004). Sex‐specific fat distribution is not linear across pubertal groups in a multiethnic study. Obes Res, 12(4):725-733.
13. Hides J, Stanton W, Mendis MD, et al. (2011). The relationship of transversus abdominis and lumbar multifidus clini-cal muscle tests in patients with chronic low back pain. Man Ther, 16(6):573-577.
14. Mayer JM, Nuzzo JL, Chen R, et al. (2012). The impact of obesity on back and core muscular endurance in firefighters. J Obes, 2012:729283.
15. Górnicka M, Hamulka J, Wadolowska L, et al. (2020). Activity–inactivity patterns, screen time, and physical activity: the association with overweight, central obesity and muscle strength in Polish teenagers. Report from the ABC of healthy eating study. Int J Environ Res Public Health, 17(21):7842.
16. Tallis J, James RS, Seebacher F (2018). The effects of obesity on skeletal muscle contractile function. J Exp Biol, 221(Pt 13):jeb163840.
17. Daftari S, Retharejar S, Bedekar N, et al. (2015). Effects of aerobic exercise train-ing on respiratory muscle strength in overweight and obese individuals. Int J Ther Rehabil Res, 4(5):305.
18. Choi SJ, Files DC, Zhang T, et al. (2016). In-tramyocellular lipid and impaired myo-fiber contraction in normal weight and obese older adults. J Gerontol A Biol Sci Med Sci, 71(4):557-564.
19. Manderlier A, de Fooz M, Patris S, et al. (2022). Modifiable lifestyle-related prog-nostic factors for the onset of chronic spinal pain: A systematic review of lon-gitudinal studies. Ann Phys Rehabil Med, 65(6):101660.
20. Ferreira P, Ferreira M, Maher C, et al. (2010). Changes in recruitment of trans-versus abdominis correlate with disabil-ity in people with chronic low back pain. Br J Sports Med, 44(16):1166-1172.
21. Lee N, You J, Kim T, et al. (2015). Intensive abdominal drawing-in maneuver after unipedal postural stability in nonathletes with core instability. J Athl Train, 50(2):147-55.
22. Smidt GL (1999). The reliability and validi-ty of the Biering-Sorensen test in asymp-tomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine, 24(20):2085-9
23. McGill SM, Childs A, Liebenson C (1999). Endurance times for low back stabiliza-tion exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil, 80(8):941-944.
24. Haley SM, Fragala-Pinkham MA (2006). In-terpreting change scores of tests and measures used in physical therapy. Phys Ther, 86(5):735-743.
25. Sung ES, Han A, Hinrichs T, et al. (2022). Impact of body mass index on muscle strength, thicknesses, and fiber composi-tion in young women. Int J Environ Res Public Health, 19(16):9789.
26. Rostami M, Yekta AHA, Noormoham-madpour P, et al. (2013). Relations be-tween lateral abdominal muscles thick-ness, body mass index, waist circumfer-ence and skin fold thickness. Acta Med Iran, 51(2):101-6.
27. Springer BA, Mielcarek BJ, Nesfield TK, et al. (2006). Relationships among lateral abdominal muscles, gender, body mass index, and hand dominance. J Orthop Sports Phys Ther, 36(5):289-297.
28. Lee HG, Park SK, Cho KP, et al, (2007). Ef-fects of Body Fat Rate on Body Com-position and Basic Fundamental Physi-cal Fitness in Healthy 20-year-old Wom-en. J Korean Soc Health Sci, 12(1).
29. Ki SK, Park HA (2017). Analysis of Deter-minants of Obesity associated with Health Related Physical Fitness Level among Female Middle School Students. Korea J Sports Sci, 26(3):1279-1290.
30. Choi SJ, Park SM, Kwak YS (2014). Compar-ison of the Thigh Composition and its Functional Contractility in Obese and Nonobese Elderly Patients. J Life Sci, 24(10):1125-1131.
31. Alvarez GE, Beske SD, Ballard TP, et al. (2002). Sympathetic neural activation in visceral obesity. Circulation, 106(20):2533-2536.
32. Park SH, Lee MM (2021). Effects of pro-gressive neuromuscular stabilization ex-ercise on the support surface on patients with high obesity with lumbar instability: A double-blinded randomized con-trolled trial. Medicine (Baltimore), 100(4):e23285.
2. Khanna D, Peltzer C, Kahar P, et al. (2022). Body mass index (BMI): a screening tool analysis. Cureus, 14(2): e22119.
3. Villareal DT, Apovian CM, Kushner RF, et al. (2005). Obesity in older adults: tech-nical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr, 82(5):923-934.
4. Martinez KE, Tucker LA, Bailey BW, et al. (2017). Expanded normal weight obesity and insulin resistance in US adults of the National Health and Nutrition Ex-amination Survey. J Diabetes Res, 2017:9502643.
5. Liu D, Zhong J, Ruan Y, et al. (2021). The association between fat-to-muscle ratio and metabolic disorders in type 2 diabe-tes. Diabetol Metab Syndr, 13:129.
6. Kapoor N, Furler J, Paul TV, et al. (2019). Thomas N, Oldenburg B. Normal weight obesity: an underrecognized problem in individuals of South Asian descent. Clin Ther, 41(8):1638-1642.
7. David C, de Mello RB, Bruscato N, et al. (2017). Overweight and abdominal obe-sity association with all-cause and cardi-ovascular mortality in the elderly aged 80 and over: a cohort study. J Nutr Health Aging, 21(5):597-603.
8. Kapoor N, Lotfaliany M, Sathish T, et al. (2020). Prevalence of normal weight obesity and its associated cardio-metabolic risk factors–Results from the baseline data of the Kerala Diabetes Prevention Program (KDPP). PLoS One, 15(8):e0237974.
9. Kim J, Kang S, Kang H, et al. (2023). Nor-mal-Weight Obesity and Metabolic Syn-drome in Korean Adults: A Population-Based Cross-Sectional Study. Healthcare (Basel), 11(16):2303.
10. Kim S, Kyung C, Park JS, et al. (2015). Normal-weight obesity is associated with increased risk of subclinical ather-osclerosis. Cardiovasc Diabetol, 14:58.
11. 2024 InBody Report (2018-2022). InBody Report. https://inbody.com/assets/download/Annual%20Report_ENG_2024_web.pdf
12. He Q, Horlick M, Thornton J, et al. (2004). Sex‐specific fat distribution is not linear across pubertal groups in a multiethnic study. Obes Res, 12(4):725-733.
13. Hides J, Stanton W, Mendis MD, et al. (2011). The relationship of transversus abdominis and lumbar multifidus clini-cal muscle tests in patients with chronic low back pain. Man Ther, 16(6):573-577.
14. Mayer JM, Nuzzo JL, Chen R, et al. (2012). The impact of obesity on back and core muscular endurance in firefighters. J Obes, 2012:729283.
15. Górnicka M, Hamulka J, Wadolowska L, et al. (2020). Activity–inactivity patterns, screen time, and physical activity: the association with overweight, central obesity and muscle strength in Polish teenagers. Report from the ABC of healthy eating study. Int J Environ Res Public Health, 17(21):7842.
16. Tallis J, James RS, Seebacher F (2018). The effects of obesity on skeletal muscle contractile function. J Exp Biol, 221(Pt 13):jeb163840.
17. Daftari S, Retharejar S, Bedekar N, et al. (2015). Effects of aerobic exercise train-ing on respiratory muscle strength in overweight and obese individuals. Int J Ther Rehabil Res, 4(5):305.
18. Choi SJ, Files DC, Zhang T, et al. (2016). In-tramyocellular lipid and impaired myo-fiber contraction in normal weight and obese older adults. J Gerontol A Biol Sci Med Sci, 71(4):557-564.
19. Manderlier A, de Fooz M, Patris S, et al. (2022). Modifiable lifestyle-related prog-nostic factors for the onset of chronic spinal pain: A systematic review of lon-gitudinal studies. Ann Phys Rehabil Med, 65(6):101660.
20. Ferreira P, Ferreira M, Maher C, et al. (2010). Changes in recruitment of trans-versus abdominis correlate with disabil-ity in people with chronic low back pain. Br J Sports Med, 44(16):1166-1172.
21. Lee N, You J, Kim T, et al. (2015). Intensive abdominal drawing-in maneuver after unipedal postural stability in nonathletes with core instability. J Athl Train, 50(2):147-55.
22. Smidt GL (1999). The reliability and validi-ty of the Biering-Sorensen test in asymp-tomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine, 24(20):2085-9
23. McGill SM, Childs A, Liebenson C (1999). Endurance times for low back stabiliza-tion exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil, 80(8):941-944.
24. Haley SM, Fragala-Pinkham MA (2006). In-terpreting change scores of tests and measures used in physical therapy. Phys Ther, 86(5):735-743.
25. Sung ES, Han A, Hinrichs T, et al. (2022). Impact of body mass index on muscle strength, thicknesses, and fiber composi-tion in young women. Int J Environ Res Public Health, 19(16):9789.
26. Rostami M, Yekta AHA, Noormoham-madpour P, et al. (2013). Relations be-tween lateral abdominal muscles thick-ness, body mass index, waist circumfer-ence and skin fold thickness. Acta Med Iran, 51(2):101-6.
27. Springer BA, Mielcarek BJ, Nesfield TK, et al. (2006). Relationships among lateral abdominal muscles, gender, body mass index, and hand dominance. J Orthop Sports Phys Ther, 36(5):289-297.
28. Lee HG, Park SK, Cho KP, et al, (2007). Ef-fects of Body Fat Rate on Body Com-position and Basic Fundamental Physi-cal Fitness in Healthy 20-year-old Wom-en. J Korean Soc Health Sci, 12(1).
29. Ki SK, Park HA (2017). Analysis of Deter-minants of Obesity associated with Health Related Physical Fitness Level among Female Middle School Students. Korea J Sports Sci, 26(3):1279-1290.
30. Choi SJ, Park SM, Kwak YS (2014). Compar-ison of the Thigh Composition and its Functional Contractility in Obese and Nonobese Elderly Patients. J Life Sci, 24(10):1125-1131.
31. Alvarez GE, Beske SD, Ballard TP, et al. (2002). Sympathetic neural activation in visceral obesity. Circulation, 106(20):2533-2536.
32. Park SH, Lee MM (2021). Effects of pro-gressive neuromuscular stabilization ex-ercise on the support surface on patients with high obesity with lumbar instability: A double-blinded randomized con-trolled trial. Medicine (Baltimore), 100(4):e23285.
| Files | ||
| Issue | Vol 54 No 12 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Core Core stability Obesity Muscle thickness | ||
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How to Cite
1.
Lee N, Park S-H. Comparison of Abdominal Muscle and Subcutaneous Fat Thickness and Core Stability between Normal Weight Non-Obesity, Normal Weight Obesity, and Obesity Groups in Young Korean Women. Iran J Public Health. 2025;54(12):2670-2679.
