Comparison of Anthropometric Measures in US Military Personnel in the Classification of Overweight and Obesity

Abstract

Objective This study aimed to determine (1) the level of agreement between BMI, circumference‐based equation (CBE) measures, waist circumference (WC), and bioelectrical impedance analysis (BIA) measures and (2) whether BMI, CBE measures, or WC alone or in combination adequately reflects adiposity in military personnel compared with BIA. Methods BMI from measured height and weight (using military overweight cutoffs in men [BMI ≥ 27.5 kg/m2] and World Health Organization overweight cutoffs [BMI ≥ 25.0 kg/m2]), BMI body fat percentage (BF%), WC, CBE BF%, and BIA BF% were collected. Respondents (N = 389, 78% men) were categorized with normal fat versus overweight, obesity, or overfat. Levels of agreement and standard screening performance measures were compared between anthropometric measures and BIA. Results World Health Organization BMI and BIA BF% classified the most men and women with overweight/obesity; WC with BMI (BMI + WC) and WC alone classified the fewest men and women with overweight/obesity. Levels of agreement were all statistically significant and highest for BMI (men: Cohen's κ = 0.711; women: Cohen's κ = 0.814) and lowest for WC and BMI + WC (all Cohen's κ ≤ 0.270). BMI + CBE performed best overall (sensitivity = 50.9%, false discovery rate = 5.4%). Conclusions Our findings support BMI + CBE as an easy‐to‐implement combination to assess adiposity in the military.

New Concerns About Military Recruits with Metabolic Obesity but Normal Weight (“Skinny Fat”)

“…The suitability of the strategy, which the Army has followed for 35 years, is again confirmed by the recent analysis by Shams‐White et al in this issue of Obesity . This was tested against bioelectrical impedance as a criterion method for body fat estimation.…”

Military Body Composition Standards and Physical Performance: Historical Perspectives and Future Directions

“…As a result, each branch independently developed and implemented its circumference-based prediction equations, with varying degrees of success and agreement between methods (37). Over the past several decades, these circumference-based body fat estimation techniques have proven to be useful in the military setting for a variety of reasons, particularly because of their low cost and acceptable validity compared with laboratory techniques such as dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), or air displacement plethysmography (ADP) (31,99). Compared with other cost-effective methods such as skinfold assessments (which were briefly used by the army in an interim phase (37)), circumference measures are easier to learn and yield more precise results when performed by novice testers (49,86).…”

Comparisons of Baseline Obesity Prevalence and Its Association with Perceived Health and Physical Performance in Military Officers

“…In particular, false negative rates for WC and BMI ranged from 35% (WC in men) to 78% (BMI in women) [ 15 ]. Among active duty US military personnel, BMI in combination with WC was satisfactory at best in assessing obesity in comparison with BIA [ 16 ]. This could be attributed to the fact that BMI and WC evaluate longitudinal and transversal body dimensions as well as body mass relative to body size (kg per each m 2 of body size) [ 17 ].…”