Body composition and the monitoring of non-communicable chronic disease risk.

J C K Wells,M K Shirley

doi:10.1017/gheg.2016.9

Abstract

There is a need for simple proxies of health status, in order to improve monitoring of chronic disease risk within and between populations, and to assess the efficacy of public health interventions as well as clinical management. This review discusses how, building on recent research findings, body composition outcomes may contribute to this effort. Traditionally, body mass index has been widely used as the primary index of nutritional status in children and adults, but it has several limitations. We propose that combining information on two generic traits, indexing both the 'metabolic load' that increases chronic non-communicable disease risk, and the homeostatic 'metabolic capacity' that protects against these diseases, offers a new opportunity to improve assessment of disease risk. Importantly, this approach may improve the ability to take into account ethnic variability in chronic disease risk. This approach could be applied using simple measurements readily carried out in the home or community, making it ideal for M-health and E-health monitoring strategies.

Highlights

For most of human history, the primary cause of morbidity and mortality was infectious disease
BMI is a very simple proxy for body composition, and its limitations as an index of adiposity are well established [5], so why should it be able to index broader patterns of health status and disease risk? We have previously suggested that the utility of BMI derives from it indexing both current weight, and completed growth [55]
Increase in grip strength of 0.86 kg per kg increase in birth weight

Summary

Introduction

For most of human history, the primary cause of morbidity and mortality was infectious disease. Lower birth weight (indexing reduced metabolic capacity) and higher BMI or adiposity (indexing metabolic load) independently increases disease risk. Where birth weight data are available, it is clear that they provide valuable information on chronic disease risk.

Objectives

Results

Conclusion