BMI Points Research Articles

Preliminary Evidence of the Accuracy of Self-reported Weight, Height and Body Mass Index among Regular Exercisers in Fitness Centers

The present study examined the accuracy of self-reported weight, height and the consequent BMI, among people who exercised in Greek fitness centers. One hundred and ten individuals (88 males and 22 females) aged 19 to 61 years old voluntarily participated in the study. Weight and height were self-reported without knowledge that these variables would be subsequently measured. Comparison between self-reported and measured data showed that participants tended to under-report their weight, over-report their height resulting in significant BMI bias. Despite however the significant results, calculation of the effect sizes showed that these differences (0.58 kg for weight, 0.86 cm for height and 0.44 points of BMI) were in fact trivial (Cohen's d ranged from .04 to .13). It was concluded that self-reported weight and height from individuals involving in physical exercise can be trusted to reliably estimate BMI.

Evaluation of laparoscopic sleeve gastrectomy on weight loss and co-morbidity

Background The sleeve gastrectomy is a surgical technique to treat morbid obesity by both restrictive and probably hormonal action. Originally developed as a first stage to gastric bypass, it is more and more performed as a sole procedure. Therefore it is important to report results on weight loss and reduction in co-morbidity. Methods A consecutive series of 74 morbid obese patients were evaluated. Parameters were operative variables, complications, weight loss and the need for medication for co-morbidity at least six months postoperatively. Results Six procedures included the removal of a band and twice a vertical banded gastroplasty was performed previously. Median operating time diminished over time to 71 min. Three procedures were converted into open approach. Major complications were rhabdomyolysis (2), bleeding (2) and leakage (4). Four days was the mean hospital stay. The median follow-up was 12 months (range 6–33). The median percentage of excess weight loss was 49.6% (range 22–96%EWL). The median loss in BMI points was 23.1% (range 9–50%BMIL). Three quarters of the patients were able to diminish or stop their medication for diabetes, hypertension and hyperlipedemia. Conclusion The laparoscopic gastric sleeve is effective in reduction of both weight and co-morbidity and has potential as a sole procedure. Patient’s selection is, however, recommendable for initial surgical experience and longer follow-up will be necessary.

Neighborhood Food Environments and Body Mass Index: The Importance of In-Store Contents

Most public health studies on the neighborhood food environment have focused on types of stores and their geographic placement, yet marketing research has long documented the influence of in-store shelf-space on consumer behavior. This paper combines these two strands of research to test whether the aggregate availability of specific foods in a neighborhood is associated with the BMIs of its residents. Fielded from October 2004 to August 2005, this study combines mapping of retail food outlets, in-store surveys, and telephone interviews of residents from 103 randomly sampled urban census tracts in southeastern Louisiana. Linear shelf-space of fruits, vegetables, and energy-dense snack foods was measured in 307 food stores in the study tracts. Residential addresses, demographic information, and heights and weights were obtained from 1243 respondents through telephone interviews. Cumulative shelf-space of foods within defined distances of each respondent was calculated using observations from the in-store survey and probability-based assignments of shelf-space to all unobserved stores in the area. After controlling for sociodemographic variables, income, and car ownership, regression analysis, conducted in 2008, showed that cumulative shelf-space availability of energy-dense snack foods was positively, although modestly, associated with BMI. A 100-meter increase in shelf-space of these foods within 1 kilometer of a respondent's household was associated with an additional 0.1 BMI points. Fruit and vegetable shelf-space was not significantly related to BMI. Interventions that seek to improve the neighborhood food environment may need to focus on more than just increasing access to healthy foods, because the results suggest that the availability of energy-dense snack foods plays a role in weight status.

'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial

BackgroundThe prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence of overweight and health behaviour among children.Methods and designA cluster randomised controlled trial is conducted among 5-year-old children included by 44 Youth Health Care teams randomised within 9 Municipal Health Services. The teams are randomly allocated to the intervention or control group. The teams measure the weight and height of all children. When a child in the intervention group is detected with overweight according to the international age and gender specific cut-off points of BMI, the prevention protocol is applied. According to this protocol parents of overweight children are invited for up to three counselling sessions during which they receive personal advice about a healthy lifestyle, and are motivated for and assisted in behavioural change.The primary outcome measures are Body Mass Index and waist circumference of the children. Parents will complete questionnaires to assess secondary outcome measures: levels of overweight inducing/reducing behaviours (i.e. being physically active, having breakfast, drinking sweet beverages and watching television/playing computer games), parenting styles, parenting practices, and attitudes of parents regarding these behaviours, health-related quality of life of the children, and possible negative side effects of the prevention protocol. Data will be collected at baseline (when the children are aged 5 years), and after 12 and 24 months of follow-up. Additionally, a process and a cost-effectiveness evaluation will be conducted.DiscussionIn this study called 'Be active, eat right' we evaluate an overweight prevention protocol for use in the setting of Youth Health Care. It is hypothesized that the use of this protocol will result in a healthier lifestyle of the children and an improved BMI and waist circumference.Trial registrationCurrent Controlled Trials ISRCTN04965410

Association between functional FABP2 promoter haplotypes and body mass index: Analyses of 8072 participants of the KORA cohort study

Studies in relatively small cohorts provide preliminary evidence that functional fatty acid binding protein 2 (FABP2) promoter haplotypes are associated with type 2 diabetes and BMI. Here, we studied the influence of the haplotypes on BMI by using 8072 male and female participants of the Kooperative Gesundheitsforschung in der Region Augsburg (KORA) cohort. By linear regression analysis, we found in males a reduction of -0.39 BMI units (95% CI: -0.73, -0.05, p = 0.024) in homozygous FABP2 promoter haplotype B carriers. Carriers of haplotype B showed a significant decrease in BMI of -0.19 BMI units (95% CI: -0.35, -0.02, p = 0.027). In accordance, a significant reduction in BMI of the minor haplotype carriers in the BMI point categories of 25-30 (BMI units: -0.10, 95% CI: -0.18, -0.01, p = 0.03) and < 30 (BMI units: -0.37, 95% CI: -0.67, -0.07, p = 0.02) were found. In summary, the minor FABP2 promoter haplotype B contributes to a reduced BMI in men. This provides evidence that functional FABP2 contributes to multifactorialy regulated body weight.

Features of insulin secretion and insulin resistance in newly diagnosed type 2 diabetes of different body mass indices

To investigate insulin secretion function and insulin resistance in Chinese newly diagnosed type 2 diabetes (obese and non-obese patients) in order to provide evidence for clinical treatment. 408 newly diagnosed type 2 diabetes and 40 normal controls were recruited. Height, weight were measured, insulin and glucose of 0 min, 30 min, 60 min, 120 min during oral glucose tolerance test were examined. The patients with fasting glucose level greater than 8.3mmol/L were treatment with Gliclazide for 1 - 3 months. After normalization of the plasma glucose levels for more than 2 weeks, and withdraw this medication for 48 hours, then OGTT were repeated to assess IR and IS. The patients were divided into four groups based on fasting plasma glucose (DM1: FPG < 6.9mmol/L; DM2: 6.9 mmol/L < or = FPG < 8.3 mmol/L; DM3: 8.3 mmol/L < or = FPG < 9.7 mmol/L; DM4: FPG > or = 9.7 mmol/L). Every groups were further stratified to subgroups by cut point of BMI = 24 kg/m(2). Their insulin sensitivity and insulin secretion function compared between subgroups. (1) True insulin level in BMI > or = 24 (FPG < 6.9 mmol/L) subgroups were higher than control's (3.5 +/- 0.5 vs 3.2 +/- 0.6 natural logarithm) (P < 0.05). (2) In BMI > or = 24 subgroups, their insulin sensitivity were even worse than BMI < 24 groups', but their insulin secretion function were better at the same FPG level. (3) After intervention, the change of insulin sensitivity in BMI < 24 group was better than BMI > or = 24 group's (-4.7 +/- 0.9 vs -5.5 +/- 1.4 natural logarithm) (P < 0.05); but the change of insulin secretion function in BMI < 24 group was worse. (1) In newly diagnostic type 2 diabetes, insulin sensitivity and insulin secretion function were decreased with the increase of FPG, but they were different between obese and non-obese group. (2) Insulin secretion function was recovered better in obese group when eliminated glucose toxicity.

Childhood BMI trajectories and the risk of developing young adult-onset diabetes

The aim of this study was to examine the effects of childhood BMI growth dynamics on the risk of developing young adult-onset type 1 and type 2 diabetes. Finnish national healthcare registers were used to identify individuals with diabetes diagnosed between 1992 and 1996 at 15-39 years of age. Non-diabetic control participants were chosen from the National Population Registry. Anthropometric measurements were obtained from the original child welfare clinic records. Only the case-control pairs with sufficient growth data recorded were included in the analyses (218/1,388 for type 1 diabetes [16%] and 64/1,121 for type 2 diabetes [6%]). Two developmental stages in BMI growth (the points of infancy maximum BMI and the BMI rebound) were examined, and conditional logistic regression was applied to the variables of interest. The risk for type 1 diabetes increased 1.19-fold per 1 kg/m(2) rise in the infancy maximum BMI (p = 0.02). In addition, there was a 1.77-fold increase in the risk for type 2 diabetes per 1 kg/m(2) rise in the level of BMI at the BMI rebound (p = 0.04). Higher values of BMI at these points corresponded to a larger BMI gain from birth to that developmental stage. Age at the infancy maximum BMI or age at the BMI rebound did not affect the risk for either type of diabetes. The BMI gain in infancy among individuals who subsequently developed young adult-onset type 1 diabetes was faster than that of those who remained healthy. The excess BMI gain in individuals who developed young adult-onset type 2 diabetes could already be seen during early childhood.

Der Magenballon – eine retrospektive Kohortenanalyse mit 634 Patienten

Hintergrund: Der temporÄre Einsatz eines Magenballons zur Behandlung der Adipositas Grad1 und 2 nimmt weltweit zu; bei der Adipositas Grad 3 wird der Magenballon als adjuvantes Hilfsmittel zur prÄoperativen Gewichtsreduktion implantiert. Ziel dieser retrospektiven Kohorten analyse ist, die Wirksamkeit des Magenballons auf Gewichtsreduzierung und das Risikoprofil der Methode zu evaluieren. Methoden: Retrospektive Kohortenanalysen aus 4 Adipositas-Zentren, in denen der Magenballon seit 2001 regelmÄßig implantiert wurde. Ergebnisse: Von Februar2001 bis April 2008 wurde bei 634 Patienten ein Magenballon implantiert (BIBTM Intragastric Balloon System; Allergan Medical, Irvine, CA, USA). Die Geschlechterverteilung war 31,5% MÄnnerzu 68,5% Frauen; das Durchschnittsalter betrug 41,5 Jahre. Das durchschnittliche Ausgangsgewicht lag bei 126 kg. Der initiale BMI bei Implantation des Magenballons war 42,5 kg/m². Die Implantation der Prothese war in allen FÄllen unkompliziert. Der durchschnittliche Gewichtsverlust lag bei 20,75 kg bzw. 7,05 BMI-Punkten.

A Proposal of Combined Evaluation of Waist Circumference and BMI for the Diagnosis of Metabolic Syndrome

We performed a receiver operator characteristic (ROC) curve analysis of 3915 men and 2032 women. Subjects who were diagnosed with two or more factors among high blood pressure, hyperglycaemia or high triglyceride and/or low HDL were classified as the metabolic syndrome group. By performing a ROC curve analysis, we have determined the cut-off point of waist circumference (WC) and BMI to define metabolic syndrome and further calculated the sensitivity and specificity of these two factors for the diagnosis. Cut-off point for the diagnosis of metabolic syndrome was 85 cm (men) and 80 cm (women) in WC and 24 (men) and 23 (women) in BMI. By combining these two factors, the sensitivity for the diagnosis increased to more than 80%. We conclude that it is beneficial to combine both WC and BMI for diagnosis of metabolic syndrome.

Variance of the SGK1 Gene Is Associated with Insulin Secretion in Different European Populations: Results from the TUEF, EUGENE2, and METSIM Studies

HypothesisSerum- and Glucocorticoid-inducible Kinase 1 (SGK1) is involved in the regulation of insulin secretion and may represent a candidate gene for the development of type 2 diabetes mellitus in humans.MethodsThree independent European populations were analyzed for the association of SGK1 gene (SGK) variations and insulin secretion traits. The German TUEF project provided the screening population (N = 725), and four tagging SNPs (rs1763527, rs1743966, rs1057293, rs9402571) were investigated. EUGENE2 (N = 827) served as a replication cohort for the detected associations. Finally, the detected associations were validated in the METSIM study, providing 3798 non-diabetic and 659 diabetic (type 2) individuals.ResultsCarriers of the minor G allele in rs9402571 had significantly higher C-peptide levels in the 2 h OGTT (+10.8%, p = 0.04; dominant model) and higher AUCC-Peptide/AUCGlc ratios (+7.5%, p = 0.04) compared to homozygous wild type TT carriers in the screening population. As interaction analysis for BMI×rs9402571 was significant (p = 0.04) for the endpoint insulin secretion, we stratified the TUEF cohort for BMI, using a cut off point of BMI = 25. The effect on insulin secretion only remained significant in lean TUEF participants (BMI≤25). This finding was replicated in lean EUGENE2 rs9402571 minor allele carriers, who had a significantly higher AUCIns/AUCGlc (TT: 226±7, XG: 246±9; p = 0.019). Accordingly, the METSIM trial revealed a lower prevalence of type 2 diabetes (OR: 0.85; 95%CI: 0.71–1.01; p = 0.065, dominant model) in rs9402571 minor allele carriers.ConclusionsThe rs9402571 SGK genotype associates with increased insulin secretion in lean non-diabetic TUEF/EUGENE2 participants and with lower diabetes prevalence in METSIM. Our study in three independent European populations supports the conclusion that SGK variability affects diabetes risk.

Detection of cardio-metabolic risk by BMI and waist circumference among a population of Guatemalan adults.

BMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting. To evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1,325 Guatemalan adults (44 % stunted: 162 cm men). Cardio-metabolic risk factors were systolic/diastolic blood pressure 85 mmHg, glucose 5 mmol/l, TAG 7 mmol/l, ratio of total cholesterol to HDL-cholesterol 0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used. Areas under the ROC curve were in the range of 005978 for WC among men and 006472 among women, respectively. Optimal cut-off points for BMI were 242651 kg/m2 stunted; 242656 kg/m2 among women (262769 kg/m2 non-stunted). Optimal cut-off points for WC were 879134 cm stunted; 889333 cm among women (909486 cm non-stunted). Optimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.

Assessing Body Composition With DXA and Bioimpedance: Effects of Obesity, Physical Activity, and Age

This study evaluated to what extent dual-energy X-ray absorptiometry (DXA) and two types of bioimpedance analysis (BIA) yield similar results for body fat mass (FM) in men and women with different levels of obesity and physical activity (PA). The study population consisted of 37-81-year-old Finnish people (82 men and 86 women). FM% was estimated using DXA (GE Lunar Prodigy) and two BIA devices (InBody (720) and Tanita BC 418 MA). Subjects were divided into normal, overweight, and obese groups on the basis of clinical cutoff points of BMI, and into low PA (LPA) and high PA (HPA) groups. Agreement between the devices was calculated by using the Bland-Altman analysis. Compared to DXA, both BIA devices provided on average 2-6% lower values for FM% in normal BMI men, in women in all BMI categories, and in both genders in both HPA and LPA groups. In obese men, the differences were smaller. The two BIA devices provided similar means for groups. Differences between the two BIA devices with increasing FM% were a result of the InBody (720) not including age in their algorithm for estimating body composition. BIA methods provided systematically lower values for FM than DXA. However, the differences depend on gender and body weight status pointing out the importance of considering these when identifying people with excess FM.

Dual Burden of Malnutrition among Chinese Children and Adolescents Aged 2–18 Years

The increase in overnutrition among children globally has been documented but it is important to note that undernutrition remains as a serious problem. Fifteen‐year trends in China were studied among children and adolescents aged 2–18 years with five rounds of the China Health and Nutrition Survey (collected in 1991, 1993, 1997, 2000, and 2004). Age and gender‐specific cutoff points for BMI from the National Center for Health Statistics (NCHS) references were used to define undernutrition (BMI &lt; 5 percentiles), and overweight and obesity (BMI ≥ 85 percentiles). The results showed that the prevalence of childhood overweight and obesity increased in the past 15 years from 9.1% in 1991 to15.9% in 2004, while the prevalence of undernutrition decreased slowly from 13.5% to 11% during the same period. The prevalence of overweight and obesity increased much faster in rural areas (from 8% to 15.9%) where malnutrition is still prevalent compared to their urban counterparts. The prevalence of overweight and obesity has increased most rapidly in older adolescents (from 2.2% to 10.3%), while undernutrition increased in the same age group as well (from 11.7% to 15.4%). More exploration is needed to understand these increases among both undernutrition and overweight and obesity among adolescents.

The Current Status of Adult Overweight and Obesity in Urban and Suburban Areas of Liaoning, China

To describe status of adult overweight and obesity in urban and suburb areas of Liaoning, we used data from China Health and Nutrition Survey, including 8119 adults: 4745 in urban areas and 3374 in suburb areas. Overweight, obesity, and abdominal obesity were defined by WHO recommended cutoff points of BMI and waist circumference. The prevalence of overweight was 30.6%, obesity 6.1% and abdominal obesity 43.0%. They increased with age in urban areas, but prevalence of overweight peaked at 40~49 yrs and obesity at 50~59 yrs in suburb areas. Prevalence of obesity and abdominal obesity varied among occupations, with highest in retired people and lowest in inexperienced labor workers, but not among different education levels and difference income groups. In conclusion, obesity distribution in Liaoning province differs from other provinces in China. Whether the causes are unique or just a function of higher income and greater economic development remains to be studied.

Development of hyperinsulinemia and insulin resistance during the early stage of weight gain

Obesity is associated with insulin resistance and hyperinsulinemia, which is considered to be a core component in the pathophysiology of obesity-related comorbidities. As yet it is unknown whether insulin resistance and hyperinsulinemia already develop during weight gain within the normal range. In 10 healthy male subjects the effect of intentional weight gain by 2 BMI points was examined on insulin. C-peptide and glucose levels following a meal, 75 g of glucose, and a two-step hyperglycemic clamp increased plasma glucose by 1.38 and 2.75 mmol/l, respectively. Baseline insulin, C-peptide, and glucose concentrations were significantly higher after weight gain from 21.8 to 23.8 kg/m(2) BMI within 4(1/2) mo. Calculations of insulin secretion and clearance indicate that reduced insulin clearance contributes more to post-weight gain basal hyperinsulinemia than insulin secretion. Following oral or intravenous stimulation insulin concentrations were significantly higher post-weight gain during all three test conditions, whereas C-peptide and glucose levels did not differ. Calculations of insulin secretion and clearance demonstrated that higher stimulated insulin concentrations are entirely due to clearance but not secretion. Despite significantly higher insulin levels, the rate of intravenous glucose required to maintain the defined elevation of glucose levels was either identical (1.38 mmol/l) or even significantly lower (2.75 mmol/l) following weight gain. The present study demonstrates for the first time that insulin resistance already develops during weight gain within the normal range of body weight. The associated basal and stimulated hyperinsulinemia is the result of differentiated changes of insulin secretion and clearance, respectively.

Maternal Obesity Is Associated With Younger Age at Obesity Onset in U.S. Adolescent Offspring Followed Into Adulthood

The objective was to test the hypothesis that maternal obesity is associated with younger age of offspring's obesity onset. We used prospective, nationally representative, longitudinal data collected across Waves I (1995; 12 to 20 years), II (1996; 13 to 20 years), and III (2001; 18 to 28 years) of the National Longitudinal Study of Adolescent Health (N = 14,654; 49% female). Interval regression analysis was used to assess the association between maternal obesity and age at offspring's obesity onset (International Obesity Task Force BMI >or=30 equivalent age- and sex-specific cut-off points for adolescents and BMI >or=30 for young adults) using self-reported heights and weights, adjusting for race/ethnicity, sex, parental education, and family income, accounting for complex sampling design. The net effect of having an obese mother varied by race/ethnicity and was associated with a significantly earlier age at obesity onset (p = 0.0001) for whites [beta= -8.1 year, 95% confidence interval (CI), -9.3; -6.9)], blacks (beta = -10.8 years, 95% CI, -12.4; -9.2), Hispanics (beta = -7.0 years, 95% CI, -9.2; -4.8), and Asians (beta = -8.6 years, 95% CI, -13.3; -3.9). Earlier obesity onset (<18 years) was associated with increased severity at young adulthood (mean BMI, 36.0 +/- 0.3 kg/m(2)) vs. onset after age 18 (mean BMI, 34.4 +/- 0.2 kg/m(2); p = 0.0001). There were no sex differences in the association of maternal obesity to age at obesity onset. Having an obese mother was associated with earlier age at obesity onset across all race/ethnic groups, particularly non-Hispanic blacks. Early obesity onset has important health consequences because of its association with more severe adult obesity.

BMI and Waist Circumference as Indicators of Health Among Samoan Women

High rates of obesity and chronic disease make establishment of effective indicators of risk for chronic disease important. The objective was to examine adequacy of anthropometric cut-off points as indicators of risk for chronic disease among Samoan women in Hawaii. A cross-sectional survey of 55 Samoan women 18 to 28 years of age that included blood lipids, cholesterol, and glucose (including after a 2-hour oral glucose test); anthropometry (weight, height, waist circumference); and DXA of body composition. Using the Centers for Disease Control and Prevention (CDC)/World Health Organization (WHO) cut-off points for BMI, 22% of women were overweight and 58% were obese. Cholesterol, lipid, and glucose values were all linearly related to DXA body fat, BMI, and waist circumference. BMI and waist circumference at WHO/NIH cut-off points predicted levels of blood lipids and glucose that indicate elevated risk for disease. WHO/NIH cut-off points for BMI and waist circumference reflect risk indicators of chronic disease among young Samoan women in Hawaii.

Minimum Waist and Visceral Fat Values for Identifying Japanese Americans at Risk for the Metabolic Syndrome

Hayashi et al. (1) reported from cross-sectional data that the optimal cut points of intra-abdominal fat area, waist circumference, and BMI were 96 cm2, 90 cm, and 25 kg/m2, respectively, for Japanese men and 75 cm2, 84 cm, and 23 kg/m2, respectively, for Japanese women, identifying subjects with two or more nonadipose components of the metabolic syndrome (1). They criticized the arbitrary and inconsistent methodology used by the Examination Committee of Criteria for Obesity Disease in Japan to derive the peculiar cut points of waist circumference (85 cm for men and 90 cm for women) …

New International Measuring Stick for Defining Obesity in Non-Europeans

Body mass index (BMI) is a useful way of classifying the degree of excess weight in an individual. Defining BMI cut points at which adverse cardiovascular outcomes, diabetes mellitus, and other comorbidities are more likely to occur affords clinically relevant guidelines for patient care. Expert panels from both the National Institutes of Health and the World Health Organization1–3 have developed such cut points, which define overweight as a BMI (weight [in kilograms]/height [in meters squared]) of 25.0 to 29.9 kg/m2, mild or grade I obesity as a BMI of 30 to 34.9 kg/m2, grade II or more severe obesity as a BMI of 35 to 39.9 kg/m2, and extreme or grade III obesity as a BMI ≥40 kg/m2. Epidemiological studies focusing on persons of European descent have verified that these cut points are, indeed, associated with incremental risk for cardiovascular events and all-cause death.4–6 An awareness that appropriate BMI cut points for Asians may differ from those of Europeans has been largely based on observations that cardiovascular and metabolic risk in Asians occur at a lower BMI than in Europeans. For example, there is increasing evidence of a high prevalence of type 2 diabetes mellitus and elevated cardiovascular risk in certain Asian countries, despite an average BMI in these countries that is <25 kg/m2.7,8 Even for Asian-Americans, the prevalence of diabetes mellitus after adjustment for BMI is 60% higher than in their European counterparts.9 Article p 2111 The definition of clinically useful BMI cut points in Asian populations has been difficult, at least in part because of the limitations of previously used methodologies. Two general methodological approaches have been taken in the past to derive these BMI cut points in Asians: (1) recalculation of BMI cut …

Categorization of Low Cardiorespiratory Fitness Using Obesity Indices in Non-smoking Singaporean Women*

To revisit cut-off values of BMI, waist circumference (WC), and waist-to-stature ratio (WSR) based on their association with cardiorespiratory fitness (CRF). The derived cut-off points were compared with current values (BMI, 25.0 kg/m(2); WC, 80 cm) as recommended by the World Health Organization. Anthropometric indices were measured in a cross sectional study of 358 Singaporean female employees of a large tertiary hospital (63% Singaporean Chinese, 28% Malays, and 9% Indians). CRF was determined by the 1-mile walk test. Receiver operating characteristic curves were constructed to determine cut-off points. The cut-off points for BMI, WC, and WSR were 23.6 kg/m(2), 75.3 cm, and 0.48, respectively. The areas under the curve of BMI, WC, and WSR were 0.68, 0.74, and 0.74, respectively. For a given BMI, women with low CRF had higher WSR compared with women with high CRF. These findings provide convergent evidence that the cut-off points for Singaporean women were lower than the World Health Organization's criteria but were in good agreement with those reported for Asians.