Overweight and obesity in adults with cystic fibrosis: An Italian multicenter cohort study

•The prevalence of overweight in adults with CF in Italy is common.•Overweight in CF is correlated with better lung function.•Overweight patients with CF are more likely to have less severe pulmonary exacerbations.•Overweight patients with CF are more likely to have high cholesterol blood levels and systemic hypertension. Over the last decades aggressive interventions have been successful to improve nutritional outcomes in people with cystic fibrosis (CF). As a result, with improvement of life expectancy and new CFTR modulators, overweight and obesity are progressively becoming a source of concern for adult population and in developed countries. This was a multicenter, observational, cross-sectional study of 321 adults with CF at three large CF centers in Italy. Patients were divided into three groups according to BMI classes, overweight and obesity (OW) group including patients with BMI ≥25 kg/m2, normal weight (NW) group with BMI 18.6–24.9 kg/m2 and underweight (UW) group with BMI ≤18.5 kg/m2. We demonstrated that prevalence of OW in adults with CF in Italy is 22%. OW status is independently associated with male sex (OR 3.520, P = 0.001), pancreatic sufficiency (OR 2.873, P = 0.014) and older age at diagnosis (1.015, P = 0.042). BMI correlated with ppFEV1 (r = 0.337; P