A Novel Metabolic Risk Classification System Incorporating Body Fat, Waist Circumference, and Muscle Strength

<b>Background:</b> As metabolic diseases continue to rise globally, there is a growing need to improve risk assessment strategies beyond traditional measures such as BMI and waist circumference, which may fail to identify individuals at risk. This study develops and validates a novel metabolic risk classification system that incorporates body fat percentage (%BF), waist circumference (WC), and grip strength (GS) in Mexican adults. It aims to improve risk stratification and evaluate the association with metabolic syndrome. <b>Methods</b>: This cross-sectional study involved 300 young adults (18-22 years) from a university in Mexico City, utilizing body composition (%BF) and anthropometric measures (WC, GS) to categorize them into four risk groups: protective, low risk, increased risk, and high risk. A retrospective cohort of 166 adults (18-65 years) with complete clinical records was used for validation. <b>Results</b>: The inclusion of GS in the risk assessment significantly shifted the distribution in the young adult cohort, reducing the "no risk" category (15.5% males, 11.6% females) and expanding the higher-risk categories (70.2% males, 69% females). Metabolic parameters such as fasting glucose, triglycerides, HDL cholesterol, and blood pressure worsened progressively across the risk categories (<i>p</i> < 0.001). The high-risk group exhibited a markedly increased odds ratio for metabolic syndrome at 28.23 (10.83-73.6, <i>p</i> < 0.001), with no cases in the protective and low-risk groups. <b>Conclusions</b>: Integrating grip strength with %BF and WC into a risk classification system substantially enhances metabolic risk stratification, identifies at-risk individuals not previously detected, and confirms a protective group. This validated system provides a robust tool for early detection and targeted interventions, improving public health outcomes in metabolic health.