Comparison of different anthropometric measures in the adult population in Serbia as indicators of obesity: data from the National Health Survey 2013

Abstract

Objective: The present study aimed to compare different indicators of obesity in the Serbian adult population. Design: Cross-sectional study. A stratified, two-stage, national-representative random sampling approach was used for the selection of the survey sample. Data sources were questionnaires created according to the European Health Interview Survey questionnaire. Measurements of weight, height and waist circumference (WC) were performed using standard procedures. Anthropometric measures included BMI, WC and waist-to-height ratio (WHtR). Setting: Data for the study were obtained from the 2013 National Health Survey, performed in line with the EUROSTAT recommendations for performance of the European Health Interview Survey. Subjects: Adults aged ≥20 years. Results: According to BMI, out of the whole studied population (12 460 adults of both sexes) 2·4 % were underweight, 36·4 % overweight and 22·4 % obese. Using WC and WHtR as measures of adiposity showed that 22·5 % and 42·8 % of participants were overweight and 39·8 % and 25·3 % were obese, respectively. Men and women differed significantly in all variables observed. Overweight was more frequent in men and obesity in women regardless of adiposity measure used. Conclusions: In spite of strong correlations between BMI, WC and WHtR, substantial discrepancies between these three measures in the assessment of overweight and obesity were found, especially in some age groups. Which of these anthropometric measures should be used, or whether two or all three of them should be applied, depends on their associations with cardiovascular or some other disease of interest. Keywords Anthropometric measuresObesity Adults Cross-sectional study Overweight and obesity are increasing in prevalence, representing a growing public health problem worldwide. According to WHO estimates, more than 50 % of the adult population in the WHO European Region is overweight and more than 20 % is clinically obese (1) . Data from the National Health Survey in 2013 show that 56·3 % of the adult population in Serbia (≥20 years old) is overweight, subdivided as 35·1 % pre-obese (BMI = 25·0-29·9 kg/m 2 ) and 21·2 % obese (BMI ≥ 30·0 kg/m 2 ) (2) . Obesity, and in particular abdominal obesity, predisposes people to a series of risk factors for chronic non-communicable diseases. It is often associated with conditions such as dyslipidaemia, arterial hypertension, insulin resistance and diabetes, which contribute to the occurrence of cardio-and cerebrovascular events (3,4) . These chronic non-communicable diseases account for the highest burden of disease in Serbia (5) .Different anthropometric methods are used for the assessment of excess body fat. BMI is an index widely used to diagnose obesity and to identify patients at increased risk of adiposity-related adverse health outcomes. Guidelines generally suggest that those within the

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