Beyond body mass index

Am, Prentice; Jebb, Susan A.

doi:10.1046/j.1467-789x.2001.00031.x

Cited by 1,060 publications

(834 citation statements)

References 14 publications

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“…15 However, bio-impedance offers the opportunity to move beyond body mass index. 7 Its advantages are that it is relatively inexpensive, portable, simple and rapid to use. Its disadvantages are that it is less accurate than more sophisticated methods.…”

Section: Discussionmentioning

confidence: 99%

“…6 Although body mass index is simple to measure and has been a valuable tool in monitoring trends in obesity, it also has numerous disadvantages. 7 Principally, it does not distinguish between increased mass in the form of fat, lean tissue or bone, and hence can lead to significant misclassification. Since the pathology associated with obesity is driven by the excess fat mass 8 the ideal monitoring tool should directly assess adiposity.…”

Section: Introductionmentioning

confidence: 99%

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Body fat reference curves for children

McCarthy

Cole

Fry³

et al. 2006

Int J Obes

735

637

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Objective: To refine the diagnosis of childhood obesity by creating new sex-specific centile curves for body fat and to base these references on a simple and affordable method that could be widely adopted in clinical practice and surveys. Design: Body fat was measured by bio-impedance in 1985 Caucasian children aged 5-18 years from schools in Southern England. Smoothed centile charts were derived using the LMS method. Results: The new body fat curves reflect the known differences in the development of adiposity between boys and girls. The curves are similar by sex until puberty but then diverge markedly, with males proportionately decreasing body fat and females continuing to gain. These sex differences are not revealed by existing curves based on body mass index. We present charts in which cutoffs to define regions of 'underfat', 'normal', 'overfat' and 'obese' are set at the 2nd, 85th and 95th centiles. These have been designed to yield similar proportions of overweight/overfat and obese children to the IOTF body mass index cutoffs.Conclusions: Direct assessment of adiposity, the component of overweight that leads to pathology, represents a significant advance over body mass index. Our new charts will be published by the Child Growth Foundation for clinical monitoring of body fat, along with the software to convert individual measurements to Z-scores.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Body fat reference curves for children

McCarthy

Cole

Fry³

et al. 2006

Int J Obes

735

637

View full text Add to dashboard Cite

show abstract

“…[17][18][19] Even without body weight changes, the amount of fat significantly increases with age. 20 It has been shown that in men and women, in normal weight and in obese subjects, body weight tends to increase, peaking at about age 65 y in men and later in women, and then decreasing with further aging. 21 Body fat distribution also changes with age.…”

Section: Effects Of Aging On Body Composition and Fat Distributionmentioning

confidence: 99%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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“…BMI and WC are frequently used by researchers and clinicians to assess nutritional status and estimate body fat (Lean, 2000). However, the accuracy of BMI to predict body fat content has been repeatedly questioned because of the confounding effect of ageing, FFM and racial differences (Frankefield et al, 2001;Prentice and Jebb, 2001) and also in view of the fact that WC could offer a better estimate of the abdominal adiposity (Lean, 2000). However, in spite of the potential weaknesses of the BIA method in measuring body composition of Gambian subjects, we did find WC having a better sensitivity than BMI for the assessment of body fat in comparison to BIA (data not shown).…”

Section: Urbanization and Obesity In The Gambiamentioning

confidence: 99%

Urbanization and obesity in The Gambia: a country in the early stages of the demographic transition

et al. 2005

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Objective: To investigate the distribution of overweight and obesity and its relationship with socio-economic and behavioural factors in a developing-country population undergoing rapid nutritional transition. Design: Cross-sectional house-to-house survey in urban Gambia. Subjects: Four groups of 50 subjects were sampled as follows: young men (YM, 14-25 years), young women (YW, 14-25 years), older men (OM, 35-50 years) and older women (OW,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Measurements: Several socio-economic and behavioural factors were investigated. Composite indices for socio-economic status, education, healthy lifestyle and western influences were created. Body weight, height, waist and hip circumferences were measured and body mass index (BMI) was calculated. Body composition was assessed by leg-to-leg bioimpedance. Overweight was defined as BMI ¼ 25.0-29.9 kg/m 2 and obesity as BMIX30.0 kg/m 2 . Results: There were highly significant gender and age differences in overweight (YM ¼ 0%, YW ¼ 10%, OM ¼ 6% and OW ¼ 34%) and obesity (YM ¼ 0%, YW ¼ 4%, OM ¼ 6% and OW ¼ 50%). Only 16% of OW were neither overweight nor obese compared to 88% of OM. OW had a higher fat mass percent (38.4%) than other groups, while fat-free mass (kg) was significantly higher in males than females with YW having the lowest value. Young generations were more educated and more influenced by western ideals than OM and OW. Weight gain was not always associated with weight concern and many overweight/obese subjects did not perceive themselves as overweight. Conclusion: Social and behavioural changes are already creating a perceptible 'generational gap' among this population undergoing rapid transition. The improved education and current lean status of the younger adults offers opportunities for preventative interventions. These need to be specially targeted at women.

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Beyond body mass index

Cited by 1,060 publications

References 14 publications

Body fat reference curves for children

Body fat reference curves for children

Health consequences of obesity in the elderly: a review of four unresolved questions

Urbanization and obesity in The Gambia: a country in the early stages of the demographic transition

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