Prevalence of obesity and the relationship between the body mass index and body fat: cross-sectional, population-based data

Background

Anthropometric measures such as the body mass index (BMI) and waist circumference are widely used as convenient indices of adiposity, yet there are limitations in their estimates of body fat. We aimed to determine the prevalence of obesity using criteria based on the BMI and waist circumference, and to examine the relationship between the BMI and body fat.

Methodology/Principal Findings

This population-based, cross-sectional study was conducted as part of the Geelong Osteoporosis Study. A random sample of 1,467 men and 1,076 women aged 20–96 years was assessed 2001–2008. Overweight and obesity were identified according to BMI (overweight 25.0–29.9 kg/m²; obesity ≥30.0 kg/m²) and waist circumference (overweight men 94.0–101.9 cm; women 80.0–87.9 cm; obesity men ≥102.0 cm, women ≥88.0 cm); body fat mass was assessed using dual energy X-ray absorptiometry; height and weight were measured and lifestyle factors documented by self-report. According to the BMI, 45.1% (95%CI 42.4–47.9) of men and 30.2% (95%CI 27.4–33.0) of women were overweight and a further 20.2% (95%CI 18.0–22.4) of men and 28.6% (95%CI 25.8–31.3) of women were obese. Using waist circumference, 27.5% (95%CI 25.1–30.0) of men and 23.3% (95%CI 20.8–25.9) of women were overweight, and 29.3% (95%CI 26.9–31.7) of men and 44.1% (95%CI 41.2–47.1) of women, obese. Both criteria indicate that approximately 60% of the population exceeded recommended thresholds for healthy body habitus. There was no consistent pattern apparent between BMI and energy intake. Compared with women, BMI overestimated adiposity in men, whose excess weight was largely attributable to muscular body builds and greater bone mass. BMI also underestimated adiposity in the elderly. Regression models including gender, age and BMI explained 0.825 of the variance in percent body fat.

Conclusions/Significance

As the BMI does not account for differences in body composition, we suggest that gender- and age-specific thresholds should be considered when the BMI is used to indicate adiposity.     

Familial aggregation and genome-wide linkage analysis of carotid artery plaque: the NHLBI family heart study

OBJECTIVE: To evaluate familial and genetic influences on carotid artery plaque, a qualitative marker of the systemic burden of atherosclerosis. METHODS: The design was a cross-sectional study of 2,223 members of 525 randomly-ascertained families and 2,514 members of 589 high coronary heart disease (CHD) risk families from 4 U.S. communities. RESULTS: The prevalence of plaque was 33, 36, and 47%, respectively, among probands with 0, 1, and 2 or more first-degree relatives with a history of CHD. There was evidence of sibling aggregation of plaque in random families (OR = 1.89; 95% CI: 1.44, 2.48), but associations were substantially attenuated when adjusted for major cardiovascular disease risk factors. A genome scan with 420 microsatellite markers revealed no regions of significant or suggestive linkage for plaque in 342 affected sibling pairs, although suggestive linkage (LOD score: 2.43) was found on chromosome 2p11.2 (D2S1790) in pairs aged 55 years or younger. Other markers with nominal evidence for linkage (p < 0.05) were found on chromosomes 2p25, 2q24-q32, 6q21-q23, 7p12-p21, 7q11-q21, 8q24, 12q12-q13, 18p11, 21q21 and Xp11, Xq12, and Xq24. CONCLUSIONS: There was modest familial aggregation of carotid artery plaque, but a genome-wide scan indicated no regions of significant or suggestive linkage.     

Living alone and alcohol-related mortality: a population-based cohort study from Finland

Background

Social isolation and living alone are increasingly common in industrialised countries. However, few studies have investigated the potential public health implications of this trend. We estimated the relative risk of death from alcohol-related causes among individuals living alone and determined whether this risk changed after a large reduction in alcohol prices.

Methods and Findings

We conducted a population-based natural experimental study of a change in the price of alcohol that occurred because of new laws enacted in Finland in January and March of 2004, utilising national registers. The data are based on an 11% sample of the Finnish population aged 15–79 y supplemented with an oversample of deaths. The oversample covered 80% of all deaths during the periods January 1, 2000–December 31, 2003 (the four years immediately before the price reduction of alcohol), and January 1, 2004–December 31, 2007 (the four years immediately after the price reduction). Alcohol-related mortality was defined using both underlying and contributory causes of death. During the 8-y follow-up about 18,200 persons died due to alcohol-related causes. Among married or cohabiting people the increase in alcohol-related mortality was small or non-existing between the periods 2000–2003 and 2004–2007, whereas for those living alone, this increase was substantial, especially in men and women aged 50–69 y. For liver disease in men, the most common fatal alcohol-related disease, the age-adjusted risk ratio associated with living alone was 3.7 (95% confidence interval 3.3, 4.1) before and 4.9 (95% CI 4.4, 5.4) after the price reduction (p<0.001 for difference in risk ratios). In women, the corresponding risk ratios were 1.7 (95% CI 1.4, 2.1) and 2.4 (95% CI 2.0, 2.9), respectively (p ≤ 0.01). Living alone was also associated with other mortality from alcohol-related diseases (range of risk ratios 2.3 to 8.0) as well as deaths from accidents and violence with alcohol as a contributing cause (risk ratios between 2.1 and 4.7), both before and after the price reduction.

Conclusions

Living alone is associated with a substantially increased risk of alcohol-related mortality, irrespective of gender, socioeconomic status, or the specific cause of death. The greater availability of alcohol in Finland after legislation-instituted price reductions in the first three months of 2004 increased in particular the relative excess in fatal liver disease among individuals living alone. Please see later in the article for the Editors'' Summary     

Familial genetic risk factors in premature cardiovascular disease: a family study

Cardiovascular disease (CVD) is closely associated with familial predisposition. The aim of the present study was to investigate predisposing risk factors in the family of a young patient who underwent coronary artery bypass graft surgery due to CVD. The father and uncle of the patient died at an early age due to myocardial infarction. Various stages of CVD were identified in both of the patient’s brothers (28 and 32 years of age). Biochemical tests (fasting blood glucose, lipid profile, urea, creatinine and liver enzymes) and a complete blood count (haemoglobin, haematocrit, white blood cell count, and platelet count) were performed. Physiological coagulation inhibitory factors (protein C, protein S, and antithrombin III), prothrombotic genetic risk factors (factor V Leiden, plasminogen activator inhibitor-1, methylenetetrahydrofolate reductase A1C and C6T, angiotensin-converting enzyme, β-fibrinogen, glycoprotein IIIa and factor XIII) and homocysteine levels were evaluated in all cases. Defects were observed in many genetic factors and in the systems regulated by these factors. The results were compatible with those reported in the literature. In conclusion, it is possible to determine a specific family history in young adults with CVD. From this perspective, the emergence of more serious CVD may be prevented by providing disease-related information to the other family members and implementing preventive measures.     

Compulsive buying: Relationship with body mass index

Objective:

Compulsive buying has historically been associated with various self‐regulatory disturbances, including eating pathology (e.g., binge eating). Therefore, a relationship between scores on a measure of compulsive buying, the Compulsive Buying Scale (CBS), and body mass index (BMI) in adulthood was hypothesized.

Design and Methods:

Using a self‐report survey methodology in a cross‐sectional consecutive sample of convenience of 373 obstetrics/gynecology patients, correlations between CBS scores and BMI, both generally and with regard to race were examined.

Results:

A modest general correlation between CBS scores and BMI (r = 0.17, P < 0.01) was found. However, when these data were examined by race, CBS scores and BMI were significantly related among Caucasian women (r = 0.25, P < 0.01), but not in African American women (r = 0.04, P = n.s.).

Conclusions:

Findings indicate that compulsive buying is associated with increasing BMI in adulthood, particularly among Caucasian women.     

The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study

Background  

Obesity causes or exacerbates a host of medical conditions, including cardiovascular, pulmonary, and endocrine diseases. Recently obesity in elderly women was associated with greater risk of dementia, white matter ischemic changes, and greater brain atrophy. The purpose of this study was to determine whether body type affects global brain volume, a marker of atrophy, in middle-aged men and women.     

Income and body mass index in Europe

The problem of obesity is alarming public health authorities around the world. Therefore, it is important to study its determinants. In this paper, we explore the empirical relationship between household income and body mass index (BMI) in nine European Union countries. Our findings suggest that, in general, the association is negative for women and nonexistent for men. Moreover, once we decompose household income into “own labor earnings” and “other household income”, we find that the different relationship for men and women appears to be driven by the negative relationship between BMI and “own labor earnings” for women.     

Association of elevated body mass index and hypertension with mortality: the CroHort study

Aim of this study was to investigate association of elevated body mass index and hypertension with general mortality in the cohort from Croatian Adult Health Cohort Study (CroHort). Risk of death according to body mass index (BMI) and blood pressure category, in period 2003/08, was calculated for 7,490 respondents, out of which 6,682 were alive and 808 were dead in 2008. Among men aged 65 and more, elevated BMI was associated with lower risk of death, in accordance with obesity paradox recorded in some previous studies which showed that older men with higher BMI have lower risk of death. Among women aged 50-64 years, being hypertensive was associated with increased risk of death compared to normotensive respondents. Despite obesity paradox which should be further explored, activities on primary and secondary prevention of excess weight and hypertension should be encouraged as means to prevent premature mortality in Croatian population.     

Familial aggregation of nasal conditioning capacity.

In our previous studies on nasal conditioning, we observed a large variability among individuals to condition inspired air. Although we previously investigated various physiological parameters (age, sex, nasal mucosal temperature, heart rate, blood pressure, and nasal volume) that might underlie these differences, we have been unable to explain this variability. Many proteins and molecules, which are under genetic control and could affect nasal conditioning, are involved in water transport,. In this study, we hypothesized that familial factors may contribute to the differences in nasal conditioning capacity (NCC). We performed a prospective study of 47 sibling pairs. Cold dry air was delivered to the nose, and the total water gradient (TWG) was calculated to determine the NCC. We found a highly significant intraclass correlation of 0.53 (P < 0.0001) between sibling pairs for the TWG. These results suggest that there is a familial basis for nasal conditioning and a large enough genetic component to search for genes explaining the observed correlation.     

Brief communication: Body mass index,body adiposity index,and percent body fat in asians

Human obesity is a growing epidemic throughout the world. Body mass index (BMI) is commonly used as a good indicator of obesity. Body adiposity index (BAI = hip circumference (cm)/stature (m)^1.5 ? 18), as a new surrogate measure, has been proposed recently as an alternative to BMI. This study, for the first time, compares BMI and BAI for predicting percent body fat (PBF; estimated from skinfolds) in a sample of 302 Buryat adults (148 men and 154 women) living in China. The BMI and BAI were strongly correlated with PBF in both men and women. The correlation coefficient between BMI and PBF was higher than that between BAI and PBF for both sexes. For the linear regression analysis, BMI better predicted PBF in both men and women; the variation around the regression lines for each sex was greater for BAI comparisons. For the receiver operating characteristic (ROC) analysis, the area under the ROC curve for BMI was higher than that for BAI for each sex, which suggests that the discriminatory capacity of the BMI is higher than the one of BAI. Taken together, we conclude that BMI is a more reliable indicator of PBF derived from skinfold thickness in adult Buryats. Am J Phys Anthropol 152:294–299, 2013. © 2013 Wiley Periodicals, Inc.     

Associations of body mass index and waist:hip ratio with hypertension.

Canada Fitness Survey data for people aged 20 to 69 years were analysed by means of linear discriminant analysis to determine the effect of age, weight relative to height (body mass index) and weight distribution (waist:hip ratio) on hypertension (defined as diastolic blood pressure of 90 mm Hg or more) for both sexes separately. All three variables had independent effects on hypertension, but partial correlation coefficients indicated that the contribution of waist:hip ratio was secondary to that of body mass index. The association of measurements of body fat (five skinfold measurements) with hypertension was also examined; overall these measurements gave no advantage over the more simply measured body mass index. The results confirm the importance of assessing the predominant location of body fat and the body mass index when examining excess weight in relation to disease.     

A new body shape index predicts mortality hazard independently of body mass index

Background

Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC.

Methods and Findings

We considered a USA population sample of 14,105 non-pregnant adults () from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of per standard deviation of ABSI [95% confidence interval: –]), whereas elevated death rates were found for both high and low values of BMI and WC. (–) of the population mortality hazard was attributable to high ABSI, compared to (–) for BMI and (–) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up.

Conclusions

Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.