Abdominal adiposity values associated with established body mass indexes in white, black and hispanic Americans. A study from the Third National Health and Nutrition Examination Survey

Abstract

PURPOSE: To determine whether white, black and hispanic young (17 ± 39 y) and middle-aged (40 ± 59 y) adults, and elderly (60 ± 90 y) Americans have the same values of abdominal adiposity (estimated from waist circumference (WC) at the established levels of overweight (body mass index, BMI 25 ± 29.9 kgam 2 ) and obesity (BMI ! 30 kgam 2 ). METHODS: Data (n 16,120) from the US Third National Health and Nutrition Survey were utilized. Age-adjusted linear regression analyses were used to estimate gender-and ethnic-speci®c WC values corresponding to overweight and obesity. Receiver operating characteristic (ROC) curves were also employed to determine the choices of WC values corresponding to the established BMI cut-off points. With ROC, gender-and ethnic-speci®c cut-off points producing the best combination of sensitivity and speci®city were selected as optimal thresholds for WC values corresponding to the established BMI cut-off points. RESULTS: WC values associated with the established BMI were lower in blacks and hispanics compared with whites. In men, the WC values that corresponded to overweight ranged from 89 to 106 cm, from 84 to 95 cm, and from 87 to 97 cm in whites, blacks and hispanics, respectively. The corresponding values for obesity ranged from 99 to 110 cm, from 96 to 107 cm, and from 97 to 108 cm. The WC values that corresponded to overweight in women ranged from 82 to 91 cm, from 81 in to 90 cm, and from 83 to 92 cm in whites, blacks and hispanics, respectively. The analogous values for obesity ranged from 94 to 101 cm, from 93 to 100 cm, and from 94 to 101 cm. CONCLUSIONS: The lack of higher WC values in blacks (particularly women) and hispanics at the same levels of BMI for whites challenges previously held assumptions regarding the role of abdominal adiposity in cardiovascular disease experienced by non-whites. De®ning the anthropometric variables that satisfactorily describe reasons for ethnic differences in cardiovascular disease is one of the challenges for future research.

Depressive Symptoms and Well-being of Individuals with Obesity; Race and Gender Differences

“…Using 6 years of health and retirement survey (HRS), Carter and Assari showed that the association between sustained obesity and depressive symptoms are seen in White women, but not Black men, Black women, or White men (37 Our findings explain why actual weight has a smaller effect on perceived weight and weight control behaviors for Blacks (14,15,(40)(41)(42)(43)(44). In a study on a community sample, same amount of increase in obesity was accompanied with a smaller increase in intention for weight loss in Blacks compared to Whites (14).…”

The impact of fat distribution on the severity of nonalcoholic fatty liver disease and metabolic syndrome

“…32 Interestingly, 59 of these 94 subjects had a WC greater than the 95% confidence limits for that predicted on the basis of age, sex, race, and BMI. 33 This indicated that although many subjects had abdominal obesity, this was commensurate with BMI, age, sex, and race in 35 (37%) subjects, while the other 59 (63%) subjects had an enlargement of abdominal girth that was beyond that predicted simply on the basis of their height and weight. Those with abdominal obesity defined by absolute WC had a significantly higher grade of cytologic ballooning (0.94 versus 0.71 Values are expressed as the mean Ϯ SD.…”

“…31 Based on WC, the presence of abdominal obesity was defined in 2 ways: (1) WC Ͼ102 cm for men and Ͼ88 cm for women (Adult Treatment Panel III criteria) 32 and (2) WC greater than the 95% confidence limits for the mean value predicted from age, sex, race, and BMI. 33 The latter method was used to evaluate if there was abdominal obesity out of proportion to the degree of generalized obesity. Dorsocervical Lipohypertrophy.…”

Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

“…Interestingly, epidemiological studies of cardiovascular risk factors have suggested that Hispanics are frequently more obese and insulin resistant compared with non-Hispanic whites (NHWs) and often, as a result, have higher triglyceride levels and lower HDL cholesterol levels (5)(6)(7)(8)(9)(10)(11)(12)(13). This apparent decreased rate of cardiovascular disease (CVD) in Hispanics, despite evidence of increased levels of several traditional and nontraditional risk factors, has been described as the "Hispanic paradox" (14,15).…”