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The Visceral Adiposity Index (VAI) as a predictor for metabolic syndrome in a sample of older adults with obesity

Nutrition. 2026 Feb 10;147:113158. doi: 10.1016/j.nut.2026.113158. Online ahead of print.

ABSTRACT

OBJECTIVES: Metabolic syndrome (MetS) is a cluster of cardiometabolic-related conditions that occur together with obesity. Visceral adiposity specifically is an important risk factor for MetS. The visceral adiposity index (VAI) is a sex-specific estimate of visceral adiposity presence and dysfunction and while a reliable predictor of MetS, more research is needed to establish VAI cut-points across varying populations before it can be used as a clinical tool. The purpose of this secondary analysis was to assess the effectiveness of the VAI and other anthropometric indices to predict MetS and to create cut-points using a sample of older adults with obesity using data from the Calorie Restriction in Overweight SeniorS (CROSSROADS) Study.

METHODS: The CROSSROADS Study was a randomized controlled trial that investigated the effects of a 12-month diet and exercise intervention among older adults with obesity (ClinicalTrials.gov, #NCT00955903). For statistical analysis, Pearson’s chi-squared tests, Wilcoxon Signed-Rank Test, logistic regression, and receiver operative characteristic curve analyses were conducted.

RESULTS: VAI was significantly associated with MetS presence in this sample more than other anthropometric indices (P < 0.001). A previously established VAI cut-point of 2.261 had the highest Youden Index for all sub-samples except for the Black participants, where the newly established VAI cut-point of 1.58 determined in this study had the highest Youden Index.

CONCLUSIONS: Among a sample of older adults with obesity, VAI is significantly associated with MetS. However, further research is needed to evaluate population-specific VAI cut-points to assess for practical utility before being used in clinical settings.

PMID:41832848 | DOI:10.1016/j.nut.2026.113158

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