Emergence of the obesity epidemic: 6-decade visualization with humanoid avatars

Abstract

Background Visualizations of the emerging obesity epidemic, such as with serial United States (US) color prevalence maps, provide graphic images that extend informative public health messages beyond those in written communications. Advances in low-cost 3D optical technology now allows for development of large image databases that include participants varying in race/ethnicity, body mass, height, age, and circumferences. When combined with contemporary statistical methods, these data sets can be used to create humanoid avatar images with pre-specified anthropometric features. Objective The current study aimed to develop a humanoid avatar series with characteristics of representative US adults extending over the past six decades. Methods 3D optical scans were conducted on a demographically diverse sample of 570 healthy adults. Image data was converted to principal components and manifold regression equations were then developed with body mass, height, age, and waist circumference as covariates. Humanoid avatars were generated for representative adults with these four characteristics as reported in Center for Disease Control surveys beginning in 1960-62 up to 2015-18. Results There was a curvilinear increase in adult US population body mass, waist circumference, and body mass index (BMI) in males and females across the nine surveys spanning six decades. A small increase in average adult population age was present between 1960 and 2018; height changes were inconsistent. A series of four avatars developed at approximately 20-year intervals for representative males and females reveal the changes in body size and shape consistent with the emergence of the obesity epidemic. An additional series of developed avatars portray the shapes and sizes of males and females at key BMI cut points. Conclusions New mathematical approaches and accessible 3D optical technology combined with increasingly available large and diverse data sets across the lifespan now makes unique visualization of body size and shape possible on a previously unattainable scale. The study is registered at: https://clinicaltrials.gov/ct2/show/NCT03637855

What Is a 2021 Reference Body?

“…Combining the organ/tissue level (as assessed by MRI and DXA) with the cellular and molecular model (as characterized by the 4C-model) adds physical characteristics (e.g., hydration and density) of organs and tissues and, thus, characterizes the composition of individual body components (i.e., their ‘quality’) where both masses as well as their ‘qualities’ impact metabolism [ 21 ]. Finally, combining in vivo BCA data with the avatar shape models can be used to characterize specific phenotypes, e.g., in patients with obesity [ 11 , 17 ].…”

“…Seventy-five fiducial points from the Civilian American and European Surface Anthropometry Resource Project were placed on the meshes by trained staff using Meshlab 1.3.2 (Consiglio Nazionale delle Ricerche, Rome, Italy). Principal component analysis was then performed to build the avatar shape models [ 17 ]. The avatar images were generated using manifold regression analysis based on specified values for weight, height, age and BMI [ 17 ].…”

“…Principal component analysis was then performed to build the avatar shape models [ 17 ]. The avatar images were generated using manifold regression analysis based on specified values for weight, height, age and BMI [ 17 ]. The avatar images were generated using R version 4.0.2 (R Core Teams, Vienna, Austria).…”

“…This is a secondary analysis of data obtained in studies published previously (see refs. [ 4 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 21 ]). The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of the Medical Faculty of the Christian-Albrechts-University of Kiel (see references published in the original papers) for studies involving humans.…”

Digital Anthropometry for Body Circumference Measurements: European Phenotypic Variations throughout the Decades

“…A recent study by Wong et al [ 57 ] generated anthropometric measurements in humanoid avatars generated on the basis of body mass, height, age, and waist circumference data from nine NHANES surveys spaced over several decades between 1960 and 1962 and 2015 and 2018. The resulting images show how drastically the average American’s body size and shape have changed over the last 40 years.…”