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Abstract

Understanding the interplay between physiological markers and cognitive-behavioral traits is essential to identifying pathological contributors to adiposity. Poor health literacy, specifically the inability to gauge energy intake, is linked to maladaptive dietary behaviors, potentially exacerbating the accumulation of body fat percentage (BF%) and visceral adipose tissue (VAT). PURPOSE: To examine the extent to which body mass index (BMI), blood pressure (BP), and the perceived inaccuracy of food caloric content predict BF% and VAT in young women. METHODS: Nineteen young women (20.1 ± 0.9 years) participated in this cross-sectional study. Body composition (BF%, VAT) was assessed via Bioelectrical Impedance Analysis (BIA), and resting blood pressure was measured manually. Caloric perception was evaluated using a visual battery of 20 food images (10 healthy, 10 unhealthy, and 1 control). The percentage of inaccuracy (%Inaccuracy) was calculated as the average deviation from actual caloric values attained from a validated database of food calorimetric estimates. Two identical hierarchical linear regression models were utilized to identify the independent contributions of BMI, BP, and %CaloricInaccuracy for unhealthy foods in predicting BF% and VAT, respectively. Statistical significance was set at p < 0.05. RESULTS: Participants demonstrated high levels of estimation error, with a 61.4 ± 15.0% and 59.4 ± 23.8% prediction inaccuracy for healthy and unhealthy foods, respectively. The final regression models, which included BMI, Diastolic BP, and unhealthy food prediction inaccuracy, significantly predicted adiposity. The model explained 68% of the total variability in BF% [F(3,15) = 13.492, p < .001] and 73% of the variance in VAT [F(3,15) = 17.438, p < .001]. CONCLUSION: In young women, the cognitive inability to accurately estimate the energy density of unhealthy foods serves as a potent, independent predictor of visceral fat accumulation, distinct from body mass alone. These results highlight a critical cognitive-behavioral link in the etiology of adiposity: poor caloric literacy may act as a “silent” driver of metabolic dysfunction by masking true energy intake. Consequently, effective obesity prevention and management strategies should extend beyond simple anthropometric monitoring to include targeted education on energy density estimation, aiming to realign cognitive perceptions with physiological reality.

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