Indices of whole-body and central adiposity for evaluating the metabolic load of obesity

Wells, Jonathan C. K.; Victora, Cesar G

doi:10.1038/sj.ijo.0802899

Cited by 62 publications

(66 citation statements)

References 20 publications

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“…As discussed previously, [19][20][21][22] this is not the most informative way to express body composition data. An alternative approach involves adjusting both LM and FM for height, generating the lean mass index (LMI ¼ LM/HT 2 ) and fat mass index (FMI ¼ FM/HT 2 ).…”

Section: C Modelmentioning

confidence: 98%

“…26 Equally, %fat provides a problematic ranking of fatness as discussed previously. 22 Garrow and Webster 27 argued that when assessing the validity of BMI as a proxy for fatness, the optimum index of fatness to use as the reference is FMI, as both indices are adjusted for height. The extent to which BMI reflects FMI is of course determined by the contribution to WT of LM.…”

Section: C Modelmentioning

confidence: 99%

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A simplified approach to analysing bio-electrical impedance data in epidemiological surveys

et al. 2006

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Background: Bio-electrical impedance analysis (BIA) is widely used to estimate body composition. It is simple, quick and cheap, but less accurate than other methods. It has potential epidemiological value, but has conventionally required validation before application. Aims: To develop a simple method of expressing weight, height and impedance data that avoids the need for populationspecific validation equations in order to facilitate epidemiological application. Methods: Body composition was measured using the four-component model in young adults (43 males, 90 females). Impedance (R) was measured hand-foot and foot-foot. Lean mass and fat mass were adjusted for height to give lean mass index (LMI) and fat mass index (FMI). Based on theoretical principles, we generated the index 1/R, which provides an index of body water adjusted for height. Sex-specific regression models were used to investigate the relationships between (a) 1/R and LMI, and (b) body mass index (BMI) adjusted for 1/R and FMI. The success of this approach was evaluated in relation to the conventional BIA approach, using correlation analysis. Results: 1/R was a highly significant predictor of LMI. BMI adjusted for 1/R was a significant predictor of FMI. Our approach performed as well as the conventional approach for LMI, but not for FMI. Discussion: Direct use of BIA data, rather than their combination with population-specific equations for the prediction of total body water, proved successful at ranking individuals of both sexes in terms of LMI and FMI. The index 1/R may prove particularly valuable in epidemiological studies where ranking of LMI is required.

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Section: C Modelmentioning

confidence: 98%

Section: C Modelmentioning

confidence: 99%

A simplified approach to analysing bio-electrical impedance data in epidemiological surveys

et al. 2006

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“…27 FMI is preferred to percentage fat as an index of fatness, as HT is a more appropriate aspect of body size than weight to adjust for. However, it is also useful to consider fatness in relation to the mass of metabolically active tissue, 28 so using log-log analysis the ratio FM/LM n was also calculated, where the power of n was 2.7. These values were multiplied by 10 000 to improve clarity.…”

Section: Methodsmentioning

confidence: 99%

Fetal, infant and childhood growth: relationships with body composition in Brazilian boys aged 9 years

et al. 2005

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BACKGROUND: Early growth rate has been linked to later obesity categorised by body mass index (BMI), but the development of body composition has rarely been studied. METHODS: We tested the hypotheses that (1) birthweight and weight gain in (2) infancy or (3) childhood are associated with later body composition, in 172 Brazilian boys followed longitudinally since birth. Growth was assessed using measurements of weight and height at birth, 6 months, and 1 and 4 y. Measurements at 9 y comprised height, weight and body composition using foot-foot impedance. RESULTS: Birthweight was associated with later height and lean mass (LM), but not fatness. Weight gain 0-6 months was associated with later height and LM, and with obesity prevalence according to BMI, but not with fatness. Weight gain 1-4 y was associated with later fatness and LM. Weight gain 4-9 y was strongly associated with fatness but not LM. Early growth rate did not correlate positively with subsequent growth rate. CONCLUSIONS: Early rapid weight gain increased the risk of later obesity, but not through a direct effect on fatness. Childhood weight gain remained the dominant risk factor for later obesity. The reported link between early growth and later obesity may be due partly to hormonal programming, and partly to the contribution of LM to obesity indices based on weight and height. Whether our findings apply to other populations requires further research.

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“…Many ratios are statistically flawed, since dividing one variable by another does not necessarily achieve an appropriate adjustment of the numerator for the denominator, as discussed previously. 22 The approach we adopted was as follows. First, girth data were log-transformed using natural logarithms.…”

Section: Methodsmentioning

confidence: 99%

Body shape in American and British adults: between-country and inter-ethnic comparisons

Wells¹,

Cole

Bruner³

et al. 2007

Int J Obes

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Background: Recent studies indicate differences between British and American white adults, and between income and ethnic groups within the United States, in the population distribution of lifestyle diseases. Differential prevalence of obesity has been suggested as a contributing factor; however, the conventional approach to categorizing obesity, body mass index, is confounded by ethnic variability in physique. Objective: To compare indices of shape between white British and American adults, and between white, African and Hispanic American adults. Design: Analysis of two large National Sizing Surveys, using identical study design and three-dimensional (3D) body-scanning instrumentation, on adults aged 17 þ years from the UK (3907M and 4710F white), and from the USA (1744M and 3329F white, 709M and 1106F African and 639M and 839F Hispanic). Outcome measures: Weight, height, body circumferences. Results: In the United States, socio-economic status was associated with increasing height and decreasing waist girth in white and Hispanic, but not African Americans. Compared to white British, white Americans had larger weight and girths, especially waist girth in men. Relative to white Americans, African Americans had smaller relative waist girth, but larger thigh girth, whereas Hispanic Americans had larger relative waist girth. Conclusions: Body shape of white American adults differs from that of their UK counterparts. Within Americans, ethnic differences in body shape closely track reported differences in prevalence of the metabolic syndrome, implicating variability in central abdominal fat as a key contributing factor. 3D photonic scanning offers a novel approach for categorizing risk of the metabolic syndrome and monitoring treatment success.

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Indices of whole-body and central adiposity for evaluating the metabolic load of obesity

Cited by 62 publications

References 20 publications

A simplified approach to analysing bio-electrical impedance data in epidemiological surveys

A simplified approach to analysing bio-electrical impedance data in epidemiological surveys

Fetal, infant and childhood growth: relationships with body composition in Brazilian boys aged 9 years

Body shape in American and British adults: between-country and inter-ethnic comparisons

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