Abstract
ABSTRACTBackground: Body mass index (BMI) has some limitations for nutritional diagnosis since it does not represent an accurate measure of body fat and it is unable to identify predominant fat distribution. Aim: To develop a BMI based on the ratio of trunk mass and height. Methods: Fifty-seven patients in preoperative evaluation to bariatric surgery were evaluated. The preoperative anthropometric evaluation assessed weight, height and BMI. The body composition was evaluated by bioimpedance, obtaining the trunk fat free mass and fat mass, and trunk height. Trunk BMI (tBMI) was calculated by the sum of the measurements of the trunk fat free mass (tFFM) and trunk fat mass (tFM) in kg, divided by the trunk height squared (m2)). The calculation of the trunk fat BMI (tfBMI) was calculated by tFM, in kg, divided by the trunk height squared (m2)). For the correction and adjustment of the tBMI and tfBMI, it was calculated the relation between trunk extension and height, multiplying by the obtained indexes. Results: The mean data was: weight 125.3±19.5 kg, height 1.63±0.1 m, BMI was 47±5 kg/m2) and trunk height was 0.52±0,1 m, tFFM was 29.05±4,8 kg, tFM was 27.2±3.7 kg, trunk mass index was 66.6±10.3 kg/m², and trunk fat was 32.3±5.8 kg/m². In 93% of the patients there was an increase in obesity class using the tBMI. In patients with grade III obesity the tBMI reclassified to super obesity in 72% of patients and to super-super obesity in 24% of the patients. Conclusion: The trunk BMI is simple and allows a new reference for the evaluation of the body mass distribution, and therefore a new reclassification of the obesity class, evidencing the severity of obesity in a more objectively way.
Highlights
The World Health Organization (WHO) considers obesity as the greatest threat to public health nowadays
Obesity is a multifactorial disease, mainly characterized by excessive body fat related to the development of important comorbidities such as type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, arterial hypertension and metabolic syndrome[1,8,12,15,25]
Severe obesity is characterized by excessive body fat, increased total body water and reduced lean mass[3]
Summary
The World Health Organization (WHO) considers obesity as the greatest threat to public health nowadays. Obesity is a multifactorial disease, mainly characterized by excessive body fat related to the development of important comorbidities such as type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, arterial hypertension and metabolic syndrome[1,8,12,15,25]. Severe obesity is characterized by excessive body fat, increased total body water and reduced lean mass[3]. In recent years, there has been increasing debate about the development of different BMI cutoffs for different ethnic groups, due to the growing evidence that associations between BMI, body fat percentage and body fat distribution differ between populations and, the health risks increase below the 30 kg/m2 cutoff[15], that defines obesity in the current WHO classification[2,27]
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