Abstract
BackgroundAs a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Accordingly, globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting.MethodsData from a cardiovascular disease risk factor assessment study in urban slums of Nairobi were analyzed. In the major study, data were collected from 5190 study participants. We considered four anthropometric markers of overweight and obesity: Body Mass Index, Waist Circumference, Waist to Hip Ratio, and Waist to Height Ratio. Pairwise correlations and kappa statistics were used to assess the relationship and agreement among these markers, respectively. Discordances between the indices were also analyzed.ResultsThe weighted prevalence of above normal body composition was 21.6 % by body mass index, 28.9 % by waist circumference, 45.5 % by waist to hip ratio, and 38.9 % by waist to height ratio. The overall inter-index correlation was +0.44. Waist to hip ratio generally had lower correlation with the other anthropometric indices. High level of discordance exists between body mass index and waist to hip ratio. Combining the four indices shows that 791 (16.1 %) respondents had above normal body composition in all four indices. Waist circumference better predicted hypertension and hyperglycemia while waist to height ratio better predicted hypercholesterolemia.ConclusionsThere exists a moderate level of correlation and a remarkable level of discordance among the four anthropometric indices with regard to the ascertainment of abnormal body composition in an urban slum setting in Africa. Waist circumference is a better predictor of cardio-metabolic risk.
Highlights
As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations
Given the difficulty of using ageadjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, Waist to Hip ratio (WHR) is the most useful measure of obesity to use to identify individuals with CVD risk factors [12]
The survey was conducted between May 2008 and April 2009 within the Nairobi Urban and Health Demographic Surveillance System (NUHDSS), which is run by the African Population and Health Research Center (APHRC)
Summary
As a result of both genetic and environmental factors, the body composition and topography of African populations are presumed to be different from western populations. Globally accepted anthropometric markers may perform differently in African populations. In the era of rapid emergence of cardio-vascular diseases in sub-Saharan Africa, evidence about the performance of these markers in African settings is essential. The aim of this study was to investigate the inter-relationships among the four main anthropometric indices in measuring overweight and obesity in an urban poor African setting. According to the 2013 Global Burden of Disease (GBD) study, obesity is already a major public health challenge in many middle income countries. Body mass index (BMI) has been utilized globally as a practical low-cost objective measure for tracking obesity, and large pooling studies have shown consistent increased risk for cardiometabolic disease and other chronic conditions as BMI reached more than 23 kg/m2 [4,5,6,7]. The proportion of body fat increases with age, whereas muscle mass decreases, but corresponding changes in height, weight and BMI may not reflect changes in body fat and muscle mass [8]
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