Lower BMI cut-off value to define obesity in Hong Kong Chinese: an analysis based on body fat assessment by bioelectrical impedance

Ko, G. T. C.; Tang, Joyce; Chan, Juliana C.N.; Sung, Rita Y T; Wu, Morris M. F.; Wai, H. P. S.; Chen, Raymond

doi:10.1079/bjn2000251

Cited by 162 publications

(127 citation statements)

References 17 publications

Supporting

Mentioning

118

Contrasting

Order By: Relevance

“…11 Some studies showed that Asians have lower BMI but higher PBF than Caucasians, and that some Asian population's morbidity and mortality of obesity-related diseases are relatively high at a relatively low BMI level. [12][13][14] From those perspectives, the WHO expert consultation recently reported that the universal BMI criteria for adult obesity are not suitable for Asian populations, although no recommendation for new, clear, BMI cutoff points was given for any Asian population. 15 From this perspective, variations in criteria among various ethnic populations should be considered in evaluating obesity in children.…”

Section: Discussionmentioning

confidence: 99%

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Yoo

Lee

et al. 2006

Int J Obes

View full text Add to dashboard Cite

Objectives: To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children. Design: Statistical comparative analysis for anthropometric measures. Subjects: Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.573.4 kg/m 2 ). Measurements: Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity. Results: The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m 2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (Po0.01) and 0.915 (Po0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m 2 for all age groups in both boys and girls. Conclusion: The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Yoo

Lee

et al. 2006

Int J Obes

View full text Add to dashboard Cite

show abstract

“…A study of 5153 Chinese subjects aged 18 -90 y (median age 50.7 y) examining BMI values corresponding to different centiles of body fat (measured by impedance) concluded that overweight should be defined as 23 rather than 25 kg=m 2 , and obesity 26 kg=m 2 rather than 30 kg=m 2 . 12 Thus anthropometric values obtained in this study could serve as indicators for risk of mortality in Usefulness of waist circumference in the elderly J Woo et al Figure 2 Likelihood ratio for mortality at 36 months or to have hypertension or diabetes for various BMI cut-off values. Usefulness of waist circumference in the elderly J Woo et al elderly Chinese populations.…”

Section: Discussionmentioning

confidence: 99%

Is waist circumference a useful measure in predicting health outcomes in the elderly?

Woo

et al. 2002

Int J Obes

View full text Add to dashboard Cite

OBJECTIVE:To examine the effect of age on the relationship between body mass index (BMI) and waist circumference (WC), and the usefulness of BMI, WC and waist -hip ratio (WHR) in predicting mortality and cardiovascular risk in the elderly population. DESIGN: Longitudinal observational study of 36 months duration. SUBJECTS AND METHOD: A stratified random sample of 2032 Chinese subjects (990 male, 1033 female) mean age (s.d.) 80.1 (7.5), interviewed and examined at baseline and after 36 months. Deaths and presence of diabetes mellitus and hypertension were documented. A younger data set of 1010 subjects (500 male, 510 female), mean age (s.d.) 45.5 (11.6), was used for comparison of the BMI -WC relationship between younger and older subjects. In predicting outcomes using different values of BMI, WC and WHR, receiver operating characteristic curve analysis was used to derive cut-off values with optimal sensitivity and specificity, and the likelihood ratios for mortality, diabetes and hypertension for different anthropometric values were plotted. RESULTS: The waist circumference values corresponding to BMI values of 25 and 30 kg=m 2 were higher in elderly (92 and 103 cm for men; 88 and 99 cm for women) compared with younger subjects (85 and 97 cm for men; 78 and 88 cm for women). BMI and WC are inversely associated with mortality, in both men and women, positively associated with diabetes in men but not in women. WC was positively associated with hypertension in men and women. WHR was not associated with any outcome measures. The anthropometric measurement at the point of intersection of the likelihood curves for mortality and diabetes may be considered the optimum value, being BMI ¼ 21 kg=m 2 for men and 25 kg=m 2 for women, WC between 80 and 85 cm, and WHR 0.88 -0.90. CONCLUSION: Waist measurement values for predicting health outcomes in elderly people aged 70 y and over are different compared with younger subjects, and have similar predictive accuracy compared with body mass index. Waist -hip ratio is not a useful predictor.

show abstract

“…Current literature indicate that the BMI cut-off value for obesity as recommended by WHO (1998) at 30 kg=m 2 for adults could be too high in some Asian population groups (Wang et al, 1994;Gurrici et al, 1998;Deurenberg et al, 1998;Gallagher et al, 2000;Deurenberg-Yap et al, 2000;He et al, 2001;Ko et al, 2001). For example, Indonesians (Guricci et al, 1998), Singaporeans (Deurenberg-Yap et al, 2000) and Hong Kong Chinese (Ko et al, 2001;He et al, 2001) have 5 -7% more body fat percentage compared with Caucasians with the same BMI.…”

Section: Introductionmentioning

confidence: 99%

“…For example, Indonesians (Guricci et al, 1998), Singaporeans (Deurenberg-Yap et al, 2000) and Hong Kong Chinese (Ko et al, 2001;He et al, 2001) have 5 -7% more body fat percentage compared with Caucasians with the same BMI. This higher body fat percentage coincides with higher relative risks for cardiovascular risk factors at lower levels of BMI, providing more evidence for the need to lower the BMI cut-off value for obesity in these populations (Ko et al, 1999;Steering Committee, 2000;Deurenberg-Yap et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Differences in body composition between Singapore Chinese, Beijing Chinese and Dutch children

et al. 2003

View full text Add to dashboard Cite

Objectives: To compare the relationship between body mass index (BMI) and body fat percentage (BF%) in children of different ethnic background. Design: Cross-sectional observational study. Settings: The study was performed in three different locations, Singapore, Beijing and Wageningen (The Netherlands). Subjects: In each centre 25 boys and 25 girls, aged 7 -12 y, were selected. They were matched on age, sex and body height. Methods: Body weight and body height was measured following standardized procedures. The body mass index (BMI) was calculated as weight=height squared (kg=m 2 ). Body fat was measured by densitometry in Beijing and Wageningen and by dual energy X-ray absorptiometry (DXA) in Singapore. The DXA measurements in Singapore were validated against densitometry. Results: There were no significant differences in BF% or BMI within each gender group across the three study sites. However, after controlling for (non-significant) differences in age and BF%, the Singapore children had a lower (mean AE s.e.) BMI (15.6 AE 0.3) than the Beijing 17.6 AE 0.3) and Wageningen (16.9 AE 0.3) children. For the same BMI, age and sex the Singapore children had a significant higher BF% (24.6 AE 0.7) than the Beijing (19.2 AE 0.8) and Wageningen (20.3 AE 0.7) children. Conclusions: The study strongly suggests that the relationship between BF% and BMI (or weight and height) is different among children of different ethnic background. Consequently growth charts and BMI cut-off points for underweight, overweight and obesity in children may have to be ethnic-specific.

show abstract

Lower BMI cut-off value to define obesity in Hong Kong Chinese: an analysis based on body fat assessment by bioelectrical impedance

Cited by 162 publications

References 17 publications

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

Is waist circumference a useful measure in predicting health outcomes in the elderly?

Differences in body composition between Singapore Chinese, Beijing Chinese and Dutch children

Contact Info

Product

Resources

About