Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel

Qingqing Zhu,Wenbo Shu,Ziliang Ye,Qiongying Deng,Liqian Huang,Chunyan Li,Binbin Huang,Qiaoli Li,Lin Xu,Peng Liu

doi:10.1186/s40101-020-00236-8

Abstract

BackgroundThe rising prevalence of obesity in military personnel has raised great concerns. Previous studies suggest that body mass index (BMI)- and waist-to-hip ratio (WHR)-based obesity classifications in US military personnel and firefighters have high false negative and subsequently cause obesity misclassification.ObjectiveTo determine whether BMI and WHR could reflect the fat mass of Chinese military personnel.MethodsThree hundred fifty-three male Chinese military personnel and 380 age-matched male adults were recruited. Obesity classification was defined by BMI, WHR, and body fat percentage (BFP).ResultsChinese military personnel had extremely low obesity rate determined by either BFP (0.3%) or BMI (0.6%). By combining overweight and obese individuals, BMI- and WHR-determined prevalence of overweight/obesity was 22.4% and 17.0% compared to BFP-based standard (4.0%) (P < 0.05). In reference to BFP, BMI and WHR have high false-positive rate compared to the control group. Further analysis showed that Chinese military personnel consisted of high percentage of BFPlowBMIhigh and/or BFPlowWHRhigh subpopulations. Eighty-one percent of BMIhigh and 78.3% of WHRhigh of them were BFP low.ConclusionsChinese military personnel has extremely low obesity rate. BMI and WHR have high false-positive rates in reference to BFP, which cannot accurately reflect the mass of adipose tissue and leads to obesity misclassification.

Highlights

The rising prevalence of obesity in military personnel has raised great concerns
Since the means of body mass index (BMI) and waist-to-hip ratio (WHR) but not body fat percentage (BFP) were higher in military personnel compared to control adults, we determined the obesity prevalence defined by different methods; BMI, WHR, and BFP
BMI, WHR, and BFP classifications were shown in Table 2. 0.3% of military personnel but 2.4% of control adults were obese based on BFP criteria, respectively (P < 0.05)

Summary

Introduction

The rising prevalence of obesity in military personnel has raised great concerns. The rising prevalence of obesity remains a growing public concern, and it is considered the fifth most important risk factor contributing to global death [1] Obesity and overweight lead to multiple health dysfunctions including cardiovascular diseases, cancers, and metabolic syndromes as well as increased risk of mortality [2, 3]. To maintain the physical fitness of the fighting force, military personnel mostly is subjected to active and intense military trainings [11], which contribute to the changes of individual body composition. Individuals in the structural physical training programs of either US or Italian Army experienced beneficial changes of body composition, along with body fat reduction and muscle mass increase [12, 13]. The effects of military training on body composition vary by different factors, such as age, body-shape [14], and length of military service [15]

Methods

Results

Discussion

Conclusion