Abstract
Anthropometric adiposity measures (AAMs) such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used to evaluate obesity status. Country-specific cutoff values of AAMs would provide more accurate estimation of obesity prevalence. This cross-sectional study was designed to determine the optimal cutoff values for AAMs, BMI, WC, hip circumference (HC), and WHR, of Sri Lankan adult women. The study was conducted in Galle, Sri Lanka, with 350 healthy community-dwelling middle-aged women aged 30–60 years, divided into two groups (Group A, n = 175 and Group B, n = 175). Total body fat percentage (TBFP) (kg) was measured with DXA. Body weight (kg), height (m), and WC and HC (cm) were measured. BMI (kg/m2) and WHR were calculated. Optimal cutoff values were determined by area under curve (AUC) in Receiver-Operating Characteristic (ROC) curve analysis using TBFP as the criterion at the TBFP level of 33% and 35% using the women in Group A. Then, the prevalence of obesity was determined in Group B while comparing the prevalence based on the cutoff values recommended by the World Health Organization (WHO) for Asians and the newly developed cutoff values for Sri Lankan women. Optimal cutoff values of AAMs which correspond to TBFP 33% are BMI, 24.5 kg/m2; WC, 80 cm; HC, 95 cm; and WHR, 0.83. TBFP 35% corresponds to the optimal cutoff values of BMI, 25.0 kg/m2; WC, 85 cm; HC, 100 cm; and WHR, 0.83. Prevalence of obesity (number, %) according to the WHO and newly defined cutoff values that correspond to TBFP 33% and 35% were as follows: BMI = 83 (47.4%), 98 (56.0%), 83 (47.4%); WC = 106 (60.6%), 106 (60.6%), 72 (41.1%); and WHR = 140 (80.0%), 106 (60.6%), 106 (60.6%). The observed cutoff values of BMI and WC in this study were within the ranges of those described by the WHO for Asian populations which correspond to the 33% and 35% TBFP levels, respectively. However, the WHR cutoff value of WHO (Asians) is lower when compared to the newly determined value for Sri Lankan females while overestimating the prevalence. More studies are needed to confirm these values before clinical use.
Highlights
Noncommunicable diseases (NCDs) have become a major health concern worldwide
Basic characteristics of Groups A and B are shown in Table 1. e characteristics, age, menopausal status, physical activity (PA), calorie consumption, Anthropometric adiposity measures (AAMs), and Total body fat percentage (TBFP), of the two groups were not different (p > 0.05), indicating that the two groups were similar with regard to their basic characteristics
E optimal cutoff values of body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) derived from 33% to 35% TBFP are shown in Table 3, obtained with the maximum sensitivity and specificity derived through maximum Youden’s index
Summary
Noncommunicable diseases (NCDs) have become a major health concern worldwide. Apart from genetic factors and improper lifestyles, obesity has been identified as the major contributor of certain NCDs such as insulin resistance, dyslipidemia, and high blood pressure [1]. e World Health Organization (WHO) defines obesity as a disease characterized by the excessive accumulation of body fat [2], and currently it is considered a major public health problem leading to serious social, psychological, and physical problems.Anthropometric adiposity measures (AAMs) such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are the commonly used surrogates of body fat content in clinical practice [3]. Noncommunicable diseases (NCDs) have become a major health concern worldwide. Apart from genetic factors and improper lifestyles, obesity has been identified as the major contributor of certain NCDs such as insulin resistance, dyslipidemia, and high blood pressure [1]. E World Health Organization (WHO) defines obesity as a disease characterized by the excessive accumulation of body fat [2], and currently it is considered a major public health problem leading to serious social, psychological, and physical problems. Hip circumference (HC) has been used [4]. All these measurements include the lean tissue and bones; they are not direct measures of fat content.
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