Document Detail

Optimal scaling of weight and waist circumference to height for maximal association with DXA-measured total body fat mass by sex, age and race/ethnicity.
MedLine Citation:
PMID:  23207404     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Body mass index (BMI; weight (Wt)/height (Ht) (in kg m(-2)) and waist circumference (WC) are widely used as proxy anthropometric measures for total adiposity. Little is known about what scaling power of 'x' in both Wt(kg)/Ht(m)(x) and WC(m)/Ht(m)(x) is maximally associated with measured total body fat mass (TBFM). Establishing values for x would provide the information needed to create optimum anthropometric surrogate measures of adiposity.
OBJECTIVE: To estimate the value of 'x' that renders Wt/Ht(x) and WC/Ht(x) maximally associated with DXA-measured TBFM.
SUBJECTS: Participants of the NHANES 1999-2004 surveys, stratified by sex (men, women), race/ethnicity (non-Hispanic whites, non-Hispanic blacks, Mexican-Americans), and age(18-29, 30-49, 50-84 years).
METHODS: We apply a grid search by increasing x from 0.0-3.0 by increments of 0.1 to the simple regression models, TBFM=b0+b1*(Wt/Ht(x)) and TBFM=b0+b1*(WC/Ht(x)) to obtain an estimate of x that results in the greatest R(2), taking into account complex survey design features and multiply imputed data.
RESULTS: R(2)'s for BMI are 0.86 for men (N=6544) and 0.92 for women (N=6362). The optimal powers x for weight are 1.0 (R(2)=0.90) for men and 0.8 (R(2)=0.96) for women. The optimal power x for WC is 0, that is, no scaling of WC to height, for men (R(2)=0.90) or women (R(2)=0.82). The optimal powers for weight across nine combinations of race/ethnicity and age groups for each sex vary slightly (x=0.8-1.3) whereas the optimal scaling powers for WC are all 0 for both sexes except for non-Hispanic black men aged 18-29y (x=0.1). Although the weight-for-height indices with optimal powers are not independent of height, they yield more accurate TBFM estimates than BMI.
CONCLUSION: In reference to TBFM, Wt/Ht and Wt/Ht(0.8) are the optimal weight-for-height indices for men and women, respectively, whereas WC alone, without Ht adjustment, is the optimal WC-for-height index for both sexes. Thus, BMI, an index independent of height, may be less useful when predicting TBFM.
M Heo; G C Kabat; D Gallagher; S B Heymsfield; T E Rohan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-12-04
Journal Detail:
Title:  International journal of obesity (2005)     Volume:  37     ISSN:  1476-5497     ISO Abbreviation:  Int J Obes (Lond)     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-06     Completed Date:  2014-03-31     Revised Date:  2014-07-14    
Medline Journal Info:
Nlm Unique ID:  101256108     Medline TA:  Int J Obes (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1154-60     Citation Subset:  IM    
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MeSH Terms
Abdominal Fat / pathology
Absorptiometry, Photon
Adipose Tissue*
African Americans*
Aged, 80 and over
Body Height
Body Mass Index
Body Weight*
European Continental Ancestry Group*
Hispanic Americans*
Middle Aged
Nutrition Surveys*
Obesity / epidemiology*,  ethnology,  pathology
Predictive Value of Tests
Reproducibility of Results
Risk Factors
United States
Waist Circumference*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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