Measures of body mass and of obesity from infancy to adulthood and their appropriate transformation

Gasser, Théo; Ziegler, Paula; Seifert, Burkhardt; Prader, A.; Molinari, Luciano; Largo, R. H.

doi:10.1080/03014469400003152

Cited by 40 publications

(20 citation statements)

References 15 publications

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“…It has been shown to be superior to the simpler index WT/height, 19 and is statistically robust because WT is normalised for height by raising height to the power 2 in most age groups. 3,4 In contrast, WT/height remains negatively correlated with height, 19 and is therefore inappropriate. The main limitation of BMI is that is not a direct index of adiposity, and does not reflect individual variability in total or central fatness satisfactorily.…”

Section: Discussionmentioning

confidence: 99%

“…1 In adults, the values 25 and 30 kg/m 2 have been used to categorise overweight and obesity, respectively, 1 while for children, these cutoffs have been extrapolated backwards to younger ages using standard deviation scores. 2 The statistical validity of BMI has been addressed previously, and it has been shown that the index of weight/height 2 satisfactorily adjusts weight for height for the majority of age groups, 3,4 whereas the simpler ratio weight/height fails to do so. Thus, BMI is highly correlated with weight but negligibly correlated with height, such that the index is independent of its denominator.…”

Section: Introductionmentioning

confidence: 99%

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

Wells

Victora

2005

Int J Obes

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BACKGROUND:To assess the relative metabolic load or risk imposed by fatness, fat mass (FM) is commonly expressed as a proportion of weight (% fat), while central adiposity is assessed using the ratio of triceps (TRI) to subscapular (SUBS) skinfolds. The statistical validity of these indices, defined as independence of the index from its denominator, has received inadequate evaluation. OBJECTIVE: To critically examine commonly used obesity indices, and to propose more appropriate approaches. DESIGN: Cross-sectional studies. SUBJECTS: In total, 148 infants; 2195 adult men aged 18 y. METHODS: log-log regression analysis was used to explore the relationships between FM and weight (WT) or fat-free mass (FFM) (adults), and between TRI and SUBS (infants and adults). RESULTS: The simple indices FM/WT, FM/FFM, TRI/SUBS and SUBS/TRI remained related to their denominators, showing their rankings of individuals to be biased by size or fatness. The appropriate power (p) by which to raise the denominator was determined from regression analyses, and differed from unity in all cases. Both skinfold ratios showed a nonlinear relationship with their denominators. CONCLUSION: Simple indices for evaluating whole-body or central adiposity are statistically flawed, and remain influenced by size or fatness of the subject. The index FM/WT is conceptually flawed because FM appears in both numerator and denominator, and the index FM/FFM p is preferable. Skinfold ratios are also problematic, and to evaluate central adiposity SUBS alone, or SUBS/ FFM p , may represent more appropriate approaches. These issues should be investigated in other studies in order to address possible influences of age, ethnicity, gender and nutritional status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Wells

Victora

2005

Int J Obes

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“…As in all individuals LMI and FMI must add up to BMI, this can be achieved by including BMI in regression models. BMI is statistically valid, 23 in that it successfully adjusts WT for HT. However, its use as a proxy for fatness is more controversial.…”

Section: C Modelmentioning

confidence: 99%

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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“…17 In early childhood n is near 2, so the best index is weight/height 2 . 19,20 The value of n increases during childhood and peaks during adolescence, reaching a value of three or so (namely weight/height 3 ), and then drops back to two in adulthood. 18,21 For much of Child and adolescent fatness C Power et al 508 childhood weight/height 2 is uncorrelated with height, but during adolescence it is positively correlated with height.…”

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confidence: 99%

Review: Measurement and long-term health risks of child and adolescent fatness

Power¹,

1997

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This paper reviews child and adolescent adiposity measures and associated long-term health risks. The ®rst section argues that anthropometric measures are practical for large scale epidemiological studies, particularly the body mass index. Limitations of this and other measures are presented. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This is based on a search for relevant literature in the following computerised databases: Medline (1985±96), BIDS (EMBASE and Science Citation Index 1985±96). The literature search revealed that the child to adult adiposity relationship is now well-documented, although methodological differences hinder comparisons. Nonetheless, consistently elevated risks of adult obesity are evident for fatter children, although the prediction of adult obesity from child and adolescent adiposity measures is only moderate. Fewer studies could be identi®ed in relation to long-term health risks of child and adolescent adiposity. It is therefore dif®cult to specify categories of risk associated with childhood adiposity without more information from long-term studies. Further evidence is also required to con®rm the suggestion from some studies that adult disease risks are associated with a change in adiposity from normal weight in childhood to obesity in adulthood. However, on the basis of the evidence available, it is argued that population-based approaches to the prevention of obesity are likely to be more effective than approaches targeted at fat children. Population-based approaches are desirable, ®rst because of the poor prediction of adult obesity from child and adolescent measures, and second, because risks of adult mortality and morbidity may be elevated for individuals who become overweight after adolescence.Keywords: body mass index; obesity; measures; childhood; adolescence; tracking; morbidity; mortality; review IntroductionPrevention of obesity is a public health priority, 1 with much of the concern focusing on childhood and adolescence. 2 Child and adolescent adiposity is of particular interest because of possible long-term associations with adult disease, but evidence on long-term relationships is fragmentary and an overview is needed that clari®es how they might occur.There are three main sections to this review. The ®rst provides a summary of the basic methods used to assess child and adolescent adiposity. This key issue is included here because it is essential that appropriate measures are used, for example, to investigate trends over time and over the life course. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This relationship is studied because of the concern that child and adolescent adiposity in¯uences adult disease primarily through its association with adiposity in adult life. Evidence is now available from several prospective and retrospective samples following subjects from childhood to adulthood. The speci®c questions of interest in this se...

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Measures of body mass and of obesity from infancy to adulthood and their appropriate transformation

Cited by 40 publications

References 15 publications

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

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

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

Review: Measurement and long-term health risks of child and adolescent fatness

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