Visceral Adiposity and Lower-Body Strength and Endurance in Women: Correlations Using BIA and the Chair Stand Test

Background: Visceral adipose tissue (VAT) around internal organs is strongly related to metabolic disorders. While its metabolic effects are well-established, its influence on musculoskeletal function, particularly lower-body strength and endurance in women, remains underexplored. Lower-body strength is essential for mobility, independence, and fall prevention. The 30 s chair stand test (30CST) is a reliable measure of lower-body function, and bioelectrical impedance analysis (BIA) offers a non-invasive method for evaluating VAT. Despite its potential, BIA remains underutilized in clinical practice. Integrating these tools could provide critical insights into how VAT affects functional health and guide evidence-based interventions. Objective: To examine the relationship between visceral adiposity, quantified by visceral fat rating (VFR) via BIA, and lower-body strength and endurance assessed by the 30CST in women. Methods: A cross-sectional study of 131 Saudi women examined VAT using BIA with VFR as a VAT marker. Lower-body strength and endurance were evaluated using the 30CST. Spearman's rank correlation was employed to explore relationships between VFR and 30CST. Results: The median age was 56 (IQR 45-61). The median VFR was 10 (IQR 7-12), and the median 30CST score was 8 (IQR 7-10). In the entire sample, a significant negative correlation was observed between VFR and 30CST performance (r = -0.4106, p < 0.0001). Women with obesity (n = 73) had significantly higher VFR (12, IQR 10-13) compared to women without obesity (n = 58), who had a median VFR of 7 (IQR 6-9) (p < 0.0001). In contrast, women with obesity had significantly lower 30CST (8, IQR 6-9) compared to those without obesity (9, IQR 8-11) (p = 0.0004). Additionally, the entire sample had significant negative correlations between 30CST and age, weight, BMI, %BF, FM, and FFM (p < 0.05). Conclusions: Elevated visceral fat is associated with lower lower-body strength and endurance in women, highlighting the value of routine visceral fat assessment for guiding musculoskeletal health evaluation and management.