Appropriateness of current thresholds for obesity-related measures among Aboriginal people

Lear, Scott A.; Humphries, Karin H.; Fröhlich, Jiří; Birmingham, C. Laird

doi:10.1503/cmaj.070302

Cited by 35 publications

(25 citation statements)

References 24 publications

(13 reference statements)

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“…As such, individuals, and ethnic groups, with greater percentage body fat may be at an increased risk for hypertension through this system. The mitigation of hypertension risk differences between aboriginal and white populations supports the use of white obesity definitions for aboriginal populations as similar risks for the same obesity measure were identified, as previously identified by Lear et al [36]. Among East Asian populations, the lower obesity recommendations [37][38][39][40] are also supported by this investigation as an increased risk at the same obesity measure was identified.…”

Section: Resultssupporting

confidence: 84%

The relationship between hypertension and obesity across different ethnicities

Foulds

Bredin

Warburton

2012

Journal of Hypertension

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Section: Resultssupporting

confidence: 84%

The relationship between hypertension and obesity across different ethnicities

Foulds

Bredin

Warburton

2012

Journal of Hypertension

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“…In addition, the WC criteria might be expected to be slightly smaller in our study because we conducted measurements in the supine position, instead of the upright position as in the general population, and this would be associated with diminished gravitational effects on abdominal distension. The concept of using a population-specific cutoff is not new and, in fact, has already been proposed for different ethnicity, 52,53 gender, and age categories. 54 The main limitation of this study is the fairly small sample size.…”

Section: Discussionmentioning

confidence: 99%

Waist Circumference Is the Best Index for Obesity-Related Cardiovascular Disease Risk in Individuals with Spinal Cord Injury

Ravensbergen

Lear

Claydon

2014

Journal of Neurotrauma

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Obesity is an important identifier of cardiovascular disease (CVD) risk, but is challenging to determine accurately in individuals with spinal cord injury (SCI). Body mass index (BMI) is used worldwide as a simple indicator of obesity, but is difficult to measure in individuals with SCI. Furthermore, standard BMI cutoffs underestimate obesity in this population. Therefore, we aimed to identify the best marker of obesity in individuals with SCI, considering both practicality, and ability to detect adiposity and CVD risk. Five anthropometric measures were evaluated: BMI; waist circumference (WC); waist-to-height ratio (WHtR); waist-to-hip ratio; and neck circumference. We evaluated relationships between these measures and abdominal and total body-fat percentage, seven cardiovascular metabolic risk factors (fasting insulin, glucose, glucose tolerance, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol), and the Framingham risk score. BMI, WC, and WHtR were correlated with abdominal fat percentage. WC and WHtR were correlated with five metabolic risk factors as well as the Framingham risk score. WC is a more practical measure for an SCI population. The optimal cutoff for identifying adverse CVD risk in individuals with SCI was identified as WC ‡ 94 cm, with 100% sensitivity and 79% specificity. We propose that WC is a simple, more sensitive alternative to BMI in this population that is easy to use in multiple settings. The cutoff provides a simple tool to predict adverse CVD risk profiles that can be used to guide risk management, as well as as a practical aid for individuals with SCI to maintain a healthy body composition.

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“…For a given amount of weight gain, some populations may be prone to accumulate adipose tissue in the subcutaneous adipose depots, whereas other populations may be more likely to accumulate adipose tissue in the visceral cavity. Ethnicity, therefore, critically needs to be considered in the identification of high-risk cases of obesity, especially in the definition of cut-off values of anthropometric measurements (250,300,303).…”

Section: E Ethnicitymentioning

confidence: 99%

Pathophysiology of Human Visceral Obesity: An Update

Tchernof

Després

2013

Physiological Reviews

1,924

1,613

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LTchernof A, Després J-P. Pathophysiology of Human Visceral Obesity: An Update. Physiol Rev 93: 359 -404, 2013; doi:10.1152/physrev.00033.2011.-Excess intra-abdominal adipose tissue accumulation, often termed visceral obesity, is part of a phenotype including dysfunctional subcutaneous adipose tissue expansion and ectopic triglyceride storage closely related to clustering cardiometabolic risk factors. Hypertriglyceridemia; increased free fatty acid availability; adipose tissue release of proinflammatory cytokines; liver insulin resistance and inflammation; increased liver VLDL synthesis and secretion; reduced clearance of triglyceride-rich lipoproteins; presence of small, dense LDL particles; and reduced HDL cholesterol levels are among the many metabolic alterations closely related to this condition. Age, gender, genetics, and ethnicity are broad etiological factors contributing to variation in visceral adipose tissue accumulation. Specific mechanisms responsible for proportionally increased visceral fat storage when facing positive energy balance and weight gain may involve sex hormones, local cortisol production in abdominal adipose tissues, endocannabinoids, growth hormone, and dietary fructose. Physiological characteristics of abdominal adipose tissues such as adipocyte size and number, lipolytic responsiveness, lipid storage capacity, and inflammatory cytokine production are significant correlates and even possible determinants of the increased cardiometabolic risk associated with visceral obesity. Thiazolidinediones, estrogen replacement in postmenopausal women, and testosterone replacement in androgen-deficient men have been shown to favorably modulate body fat distribution and cardiometabolic risk to various degrees. However, some of these therapies must now be considered in the context of their serious side effects. Lifestyle interventions leading to weight loss generally induce preferential mobilization of visceral fat. In clinical practice, measuring waist circumference in addition to the body mass index could be helpful for the identification and management of a subgroup of overweight or obese patients at high cardiometabolic risk.

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Appropriateness of current thresholds for obesity-related measures among Aboriginal people

Cited by 35 publications

References 24 publications

The relationship between hypertension and obesity across different ethnicities

The relationship between hypertension and obesity across different ethnicities

Waist Circumference Is the Best Index for Obesity-Related Cardiovascular Disease Risk in Individuals with Spinal Cord Injury

Pathophysiology of Human Visceral Obesity: An Update

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