Validity of the Body Adiposity Index in Predicting Body Fat in Adults: A Systematic Review

Validity of non-traditional measures of obesity compared to total body fat across the life course: A systematic review and meta-analysis

IntroductionTraditional obesity measures including body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio have limitations. The primary objective of this study was to identify and review the validity of non-traditional obesity measures, using measures of total body fat as the reference standard, that have been used across multiple life stages. MethodsWe conducted a systematic review and searched MEDLINE, Embase, and PsycINFO. We included observational studies published from 2013 to October 2023 among "the general population" for any life stage that reported the validity of non-traditional obesity measures compared to total body fat reference standards. Separate meta-analyses were performed to pool correlation coefficients and mean differences for non-traditional obesity measures that were evaluated at multiple life stages. ResultsA total of 123 studies were included, and 55 validated non-traditional obesity measures were identified. Of these, 13 were evaluated at multiple life stages. Two-dimensional (2D) digital imaging technologies, three-dimensional (3D) body scanners, relative fat mass (RFM), and mid-upper arm circumference had high or moderate validity (pooled correlation coefficient >0.70). Pooled mean differences were small (<6%) between total body fat percentage from reference standards and from RFM, 2D digital imaging technologies, 3D body scanners, and the body adiposity index. Heterogeneity (I2) was >75% in most meta-analyses. ConclusionNumerous validated non-traditional obesity measures were identified; relatively few were evaluated at multiple life stages and did not consider health risks associated with adiposity. More research is needed to define valid obesity measures across all life stages that assess health and adiposity.

Novel genomic variants related to visceral adiposity index (VAI) and body adiposity index (BAI) in Indian sib-pairs

BACKGROUND

Obesity is among the leading public health threats globally. Over the last few years, visceral adiposity index (VAI), and body adiposity index (BAI), derived from anthropometric, and biochemical measures, have gained importance as a measure of obesity. However, unlike other common indices like body mass index, and waist circumference, the genetic predisposition of VAI, and BAI under-examined.

METHODS

2265 sib-pairs from Indian Migration Study were used for examining the association of genetic variants from the Cardio-Metabochip array with VAI, and BAI. Mixed linear regression models were run, and all inferences were based on the within-sib component of the Fulker's association models. Gene-environment/lifestyle interaction analyses were also undertaken.

RESULTS

rs6659428 at LOC400796 | SEC16B (β = 0.26, SE = 0.05), and rs7611535 at DRD3 | LOC645180 (β = 0.18, SE = 0.04) were associated with VAI at suggestive significance value of <8.21 × 10-6. For BAI, rs73300702 at JAZF1-AS1 (β = 0.27, SE = 0.06), was the top hit at p value < 8.21 × 10-6. Further, rs6659428 showed marginal effect modification with rural/urban location (β = 0.26, SE = 0.13, p value = 0.047), and rs73300702 with physical activity (β = -0.29,SE = 0.14, p value = 0.034).

CONCLUSION

We report three novel genetic loci for VAI, and BAI in Indians that are important indicators of adiposity. These findings need to be replicated and validated with larger samples from different ethnicities. Further, functional studies for understanding the biological mechanisms of these adiposity indices need to be undertaken to understand the underlying pathophysiology.

Association of different obesity indices with nephrolithiasis in community-dwelling older adults

BACKGROUND AND OBJECTIVE

Obesity has been linked to various conditions, including nephrolithiasis. Given the rising prevalence of both nephrolithiasis and obesity in older adults, this study aimed to examine the association of different obesity-related indices with nephrolithiasis.

METHODS

This cross-sectional study included 2419 individuals (mean age 69.34 ± 6.40; 51.92 % female) from the Bushehr Elderly Health (BEH) program, a population-based measured using Dual-energy X-ray absorptiometry (DXA), while nephrolithiasis history was assessed through medical records. The associations between obesity-related indices and nephrolithiasis were analyzed using multivariable logistic regression models, adjusted for relevant confounders.

RESULTS

Among the 2419 participants, 212 (8.76 %) had a history of nephrolithiasis. In the overall population, only the android-to-gynoid fat mass (FM) ratio was significantly associated with nephrolithiasis (odds ratio [OR] 3.28, 95 % Confidence Interval [CI] 1.06-10.18). In females, the trunk-to-limb FM ratio (OR 2.62, 95 % CI 1.10-6.23) and the visceral adipose index (VAI) (OR 1.092, 95 % CI 1.005-1.187) were associated with nephrolithiasis. In males, only the body adipose index (BAI) was significantly associated with nephrolithiasis (OR 1.082, 95 % CI 1.017-1.151).

CONCLUSION

In this study, the android-to-gynoid FM ratio in the total population, the trunk-to-limb FM ratio and VAI in females, and BAI in males were significantly associated with nephrolithiasis. Monitoring and managing these indices may enhance quality of life for elderly individuals by facilitating early diagnosis of nephrolithiasis and preventing stone formation.

The association between frailty and body composition among the elderly: Birjand Longitudinal Aging Study (BLAS)

Background

This study aims to assess the possible relationship between frailty and anthropometric indices in older adults using data from the first phase of the Birjand Longitudinal Aging Study (BLAS).

Methods

In this cross-sectional study, we assessed the association between frailty (Frailty index (FI) and Fried frailty phenotype) and body composition indices in 1364 participants aged ≥ 60 years (September 2018 to April 2019). Analysis was conducted using one-way ANOVA and ordinal logistic regression.

Results

Participants were categorized as frail (n = 164), non-frail (n = 415), and pre-frail (n = 785) based on FI. A significant positive association was observed between the frailty and body mass index (BMI) (OR: 1.04, 95% CI:1.01- 1.07), waist circumference (WC) (OR: 1.02, 95% CI: 1.01- 1.03), waist-to-hip ratio (WHR) (OR: 2.36, 95% CI 1.05- 5.27) and waist-to-height ratio (WHtR) (OR: 1.27, 95%CI: 1.09- 1.47). Body shape index, body roundness index, and body adiposity index showed no significant association with frailty. Moreover, a BMI greater than 29 kg/m2 increased the odds of frailty and prefrailty by 79% (OR = 1.79, 95%CI = 1.30- 2.46, P < 0.001).

Conclusion

Results of this study showed that the risk of frailty increases as BMI and abdominal obesity indices increase. Therefore, BMI and abdominal obesity indices (WC, WHR, and WHtR) could serve as suitable tools for evaluating frailty in the elderly. However, additional studies are needed to evaluate the utility of the newly developed anthropometric indices in older adults.

Body Composition Evaluation and Clinical Markers of Cardiometabolic Risk in Patients with Phenylketonuria

Cardiovascular diseases are the main cause of mortality worldwide. Patients with phenylketonuria (PKU) may be at increased cardiovascular risk. This review provides an overview of clinical and metabolic cardiovascular risk factors, explores the connections between body composition (including fat mass and ectopic fat) and cardiovascular risk, and examines various methods for evaluating body composition. It particularly focuses on nutritional ultrasound, given its emerging availability and practical utility in clinical settings. Possible causes of increased cardiometabolic risk in PKU are also explored, including an increased intake of carbohydrates, chronic exposure to amino acids, and characteristics of microbiota. It is important to evaluate cardiovascular risk factors and body composition in patients with PKU. We suggest systematic monitoring of body composition to develop nutritional management and hydration strategies to optimize performance within the limits of nutritional therapy.

Role of Growth Hormone in Adipose Tissue Insulin Resistance Amelioration After Bariatric Surgery in Adults with Obesity

Background: Bariatric surgery has a significant effect on weight loss and improves adipose tissue insulin resistance (adipose-IR); however, the underlying mechanism remains unclear. This study aimed to investigate the effect of growth hormone (GH) on adipose-IR improvement after bariatric surgery in patients with obesity. Methods: A prospective cohort study with 1-year follow-up was conducted in the China-Japan Friendship Hospital. Pre- and postoperative variables, including the body mass index (BMI), glucose and lipid metabolic indicators, and the adipose-IR index, were collected and analyzed at baseline and 3, 6, and 12 months after surgery in patients with obesity. Results: In total, seventy-two patients, including 25 males and 47 females, were included in the analysis. Furthermore, bariatric surgery resulted in a sharp decline in BMI (kg/m2) (from 39.45 ± 0.51 to 32.00 ± 0.63 at 3 months, 28.73 ± 0.56 at 6 months, and 27.25 ± 0.68 at 12 months) and adipose-IR index (mmol/L × pmol/L) (from 163.8 ± 9.38 to 94.39 ± 16.63, 43.71 ± 5.13, and 27.92 ± 2.67) and an increase in GH (ng/mL) (from 0.16 ± 0.02 to 0.61 ± 0.10, 1.02 ± 0.19, and 0.89 ± 0.20). Partial correlation analyses were performed with reduced BMI as a control, and elevated GH levels (ΔGH) were found to be positively correlated with reduced adipose-IR (absolute value of Δadipose-IR) index at 3 months (r = 0.413, P = 0.005), 6 months (r = 0.432, P < 0.001), and 12 months (r = 0.375, P = 0.031) after bariatric surgery. Conclusions: Bariatric surgery induces GH elevation and adipose-IR amelioration in patients with obesity. GH might be a potential metabolic regulator associated with adipose-IR improvement in patients with obesity after bariatric surgery.

Reduced Growth Hormone Predicts Worsening Adipose Tissue Insulin Resistance in Adults with Obesity

OBJECTIVES

Adipose tissue distribution and glucose metabolism differ from adults with normal weight to adults with obesity. Growth hormone (GH) is closely related to obesity. Few studies have investigated the role of GH in adipose tissue insulin resistance (Adipo-IR). Herein, we investigated GH level and Adipo-IR in adults ranging from normal weight to obesity and the potential association between GH and Adipo-IR.

METHODS

A total of 1,017 participants had their body mass index (BMI), GH, and Adipo-IR evaluated. Based on the BMI, participants were assigned to five groups from normal weight to class 3 obesity; based on the GH level tertiles, participants were divided into low-, medium-, and high-GH groups.

RESULTS

In total, the GH level was negatively correlated with the BMI and Adipo-IR index (r = -0.32 and -0.22, respectively; both p < 0.001). The GH level gradually decreased, and Adipo-IR progressively increased from normal weight to class 3 obesity (all p < 0.001). Compared with the low-GH group, the reductions in the BMI, homeostasis model assessment of insulin resistance index, and homeostasis model assessment of β-cell function were more significant in both medium-GH and high-GH groups (all p < 0.05). Additionally, the Adipo-IR index in the high-GH group was significantly lower than that in the low-GH group (p < 0.001). For the multivariate regression analysis, serum GH concentration was an independent protective factor against Adipo-IR (β = -0.013, 95% CI: -0.025 to -0.001, p = 0.028).

CONCLUSIONS

A marked suppression of GH level occurs in the adults with severe obesity. GH might be an important metabolic regulator associated with Adipo-IR.

Performance of Body Adiposity Index and Relative Fat Mass in Predicting Bioelectric Impedance Analysis-Derived Body Fat Percentage: A Cross-Sectional Study among Patients with Type 2 Diabetes in the Ho Municipality, Ghana

Objective

The study sought to determine the diagnostic accuracy of body adiposity index (BAI) and relative fat mass (RFM) to predict BIA-derived BFP among patients with type 2 diabetes in the Ho municipality. Materials and Method. This hospital-based cross-sectional study involved 236 patients with type 2 diabetes. Demographic data, including age and gender were obtained. Height, waist circumference (WC), and hip circumference (HC) were measured using standard methods. BFP was estimated on a bioelectrical impedance analysis (BIA) scale. The validity of BAI and RFM as alternative estimates for BIA-derived BFP was evaluated based on mean absolute percentage error (MAPE), Passing-Bablok regression, Bland-Altman plots, receiver-operating characteristic curve (ROC), and kappa statistics analyses. A p value less than 0.05 was considered statistically significant.

Results

BAI showed systematic bias in estimating BIA-derived BFP in both genders, but this was not evident between RFM and BFP among females (t = -0.62; p = 0.534). While BAI showed "good" predictive accuracy in both genders, RFM exhibited "high" predictive accuracy for BFP (MAPE: 7.13%; 95% CI: 6.27-8.78) among females according to MAPE analysis. From the Bland-Altman plot analysis, the mean difference between RFM and BFP was acceptable among females [0.3 (95% LOA: -10.9 to 11.5)], but both BAI and RFM recorded large limits of agreement and low Lin's concordance correlation coefficient with BFP (Pc < 0.90) in the two gender populations. The optimal cut-off, sensitivity, specificity, and Youden index for RFM were >27.2, 75%, 93.75%, and 0.69, respectively, while those of BAI were >25.65, 80%, 84.37%, and 0.64, respectively, among males. Among females, the values for RFM were >27.26, 92.57%, 72.73%, and 0.65, whereas those of BAI were >29.4, 90.74%, 70.83%, and 0.62, respectively. The accuracy of discriminating between BFP levels was higher among females [BAI (AUC: 0.93) and RFM (AUC: 0.90)] compared to males [BAI (AUC: 0.86) and RFM (AUC: 0.88)].

Conclusion

RFM had a better predictive accuracy of BIA-derived BFP in females. However, both RFM and BAI failed as valid estimates for BFP. Furthermore, gender-specific performance in the discrimination of BFP levels for RFM and BAI was observed.

Curcumin Offers No Additional Benefit to Lifestyle Intervention on Cardiometabolic Status in Patients with Non-Alcoholic Fatty Liver Disease

Cardiovascular disease (CVD) is the leading cause of death in patients with non-alcoholic fatty liver disease (NAFLD). Curcumin has been shown to exert glucose-lowering and anti-atherosclerotic effects in type 2 diabetes. Hence, we investigated curcumin’s effects on atherogenesis markers, fatty liver, insulin resistance, and adipose tissue-related indicators in patients with NAFLD. In this secondary analysis of a 12-week randomized controlled trial, fifty-two patients with NAFLD received lifestyle modification. In addition, they were randomly allocated to either the curcumin group (1.5 g/day) or the matching placebo. Outcome variables (assessed before and after the study) were: the fatty liver index (FLI), hepatic steatosis index (HSI), fatty liver score (FLS), BMI, age, ALT, TG score (BAAT), triglyceride glucose (TyG) index, Castelli risk index-I (CRI-I), Castelli risk index-II (CRI-II), TG/HDL–C ratio, atherogenic coefficient (AC), atherogenic index of plasma (AIP), lipoprotein combine index (LCI), cholesterol index (CHOLINDEX), lipid accumulation product (LAP), body adiposity index (BAI), visceral adiposity index (VAI), metabolic score for visceral fat (METS-VF), visceral adipose tissue (VAT), and waist-to-height ratio (WHtR) values. The TyG index decreased in the curcumin group and increased in the placebo group, with a significant difference between the groups (p = 0.029). However, a between-group change was not significant after adjustment for multiple testing. Other indices were not significantly different between the groups either before or after multiple test correction. After the intervention, there was a lower number of patients with severe fatty liver (FLI ≥ 60) and metabolic syndrome in the curcumin group compared to the placebo (p = 0.021 and p = 0.012, respectively). In conclusion, curcumin offers no additional cardiometabolic benefits to lifestyle intervention in patients with NAFLD.

Forced Sedentariness and Sports Activity as Factors Differentiating Anthropometric Characteristics, Indices, and Body Composition in People with Disabilities

Simple Summary

People with disabilities, especially those with musculoskeletal disabilities, are prone to leading forced sedentary lifestyles due to their limitations. Inactivity or reduced physical activity affect their body composition and physique. There are also athletes among people with disabilities. The sports they practice can compensate for physical inactivity in everyday life. The aim of our study was to demonstrate that forced sedentariness and varied sports activity are factors differentiating between anthropometric characteristics, indices, and body composition of individuals with disabilities, including Polish Para athletes (track and field athletes, sitting volleyball players, and wheelchair rugby players). It was found that non-athletes had the highest levels of obesity indices compared to Para athletes. Furthermore, in the group of Polish Para athletes, sitting volleyball players had the highest values of obesity indices. The results of the present study indicate that forced sedentariness and sports activity among individuals with disabilities differentiate body structure and physique.

Abstract

Introduction: Although the assessment of physique and body composition poses methodological, technical, and interpretative difficulties, it is of great importance for the health of people with disabilities. The aim of the study was to demonstrate that sedentariness and sports activity are factors differentiating anthropometric characteristics, indices, and body composition in people with physical disabilities. Materials and methods: Fifty-eight people were examined: 48 elite Polish Para athletes, including Paralympic track and field athletes (PTF, n = 8), sitting volleyball players (SV, n = 15), wheelchair rugby players (WR, n = 25), and individuals with cervical spinal cord injury (CSCI, n = 10). Body mass (BM), body height (BH), body length (BL), waist circumference (WC), hip circumference (HC), body fat percentage (%FT), and visceral fat rating (VFR) were measured. Furthermore, BMI, BMIcorrected, and body adiposity index (BAI) were evaluated. Results: The highest WC, BAI, %FT, and VFR were found for the CSCI group. The type of sport significantly differentiated between anthropometric features, indices, and body composition of the athletes. Sitting volleyball players achieved the highest mean BM (83.9), WC (92.9), HC (103.7), BMI (24.5), BAI (23.4), and VFR (12.6). The highest %FT (28.9) was found in wheelchair rugby players. Conclusions: The results of the present study indicate that forced sedentariness and sports activity among individuals with disabilities differentiate body structure and physique.

Prediction of body fat in adolescents: validity of the methods relative fat mass, body adiposity index and body fat index

OBJECTIVE

To verify the validity of anthropometric methods body adiposity index (BAI), relative fat mass (RFM) and body fat index (BFI) to estimate body fat percentage (%BF) in adolescents.

METHODS

A cross-sectional study was carried out with 420 Brazilian adolescents aged 15-19 years, stratified by age (< 18 years, n = 356; ≥ 18 years, n = 64) and sex (boys, n = 216; girls, n = 204). The Anthropometric measurements height, body weight, hip circumference and waist circumference were collected to calculate the %BF by BAI, RFM, BFI methods. Subsequently, %BF was measured by dual emission X-ray absorptiometry (DXA), adopted as a reference method. In the statistical analysis of the data, the Pearson correlation test and the paired t test between %BF obtained by the equations and by the DXA were performed. The method validation criterion was that 68% of individuals should be within an acceptable error range of ± 3.5% of BF and Cohen's Kappa index ≥ 0.61. Additionally, the Bland-Altman graphical analysis was performed.

RESULTS

All methods showed a high correlation with DXA. For the Kappa index, only the RFM reached the criterion in the total sample (0.67) and in the sample < 18 years (0.68). None of the methods reached the criterion of 68% of the sample within the error range of ± 3.5% of BF.

CONCLUSION

The BAI, RFM and BFI equations were not valid for predicting BF in the studied sample according to the criteria adopted regardless of sex or age.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Biological Well-Being during the "Economic Miracle" in Spain: Height, Weight and Body Mass Index of Conscripts in the City of Madrid, 1955-1974

Typifying historical populations using anthropometric indicators such as height, BMI and weight allows for an analysis of the prevalence of obesity and malnutrition. This study evaluates secular changes in height, weight and body mass for men cohorts at 21 years old, born between 1934 and 1954 who were called up between 1955 and 1974, in the city of Madrid, Spain. In this study we prove the hypothesis that anthropometric variables increase thanks to improvement in diet and significant investments in hygiene and health infrastructure during the 1960s. The results of our analysis show a positive secular change in the trends for height (an increase of 4.67 cm), weight (6.400 kg) and BMI (0.90 Kg/m2), the result of a recovery in standards of living following the war and the autarchy of the 1940s. We also observed a slight trend towards obesity and a reduction in underweight categories at the end of the period is also observed. In conclusion, the secular trends of anthropometric variables in the city of Madrid reflect the recovery of living standards after the deterioration of the nutritional status suffered during the Spanish Civil War (1936-1939) and the deprivation of the autarchic period.

Generalized Equations for Predicting Percent Body Fat from Anthropometric Measures Using a Criterion Five-Compartment Model

INTRODUCTION

Anthropometric-based equations are used to estimate percent body fat (%BF) when laboratory methods are impractical or not available. However, because these equations are often derived from two-compartment models, they are prone to error due to assumptions regarding fat-free mass composition. The purpose of this study was to develop a new anthropometric-based equation for the prediction of %BF, using a five-compartment (5C) model as the criterion measure.

METHODS

A sample of healthy adults (52.2% female; age, 18 to 69 y; body mass index [BMI], 15.7 to 49.5 kg·m-2) completed hydrostatic weighing, dual-energy X-ray absorptiometry, and bioimpedance spectroscopy measurements for calculation of 5C %BF (%BF5C), as well as skinfolds and circumferences. %BF5C was regressed on anthropometric measures using hierarchical variable selection in a random sample of subjects (n = 279). The resulting equation was cross-validated in the remaining participants (n = 78). New model performance was also compared to several common anthropometric-based equations.

RESULTS

The new equation [%BFNew = 6.083 + (0.143 × SSnew) - (12.058 × Sex) - (0.150 × Age) - (0.233 × BMI) + (0.256 × Waist) + (0.162 × Sex×Age)] explained a significant proportion of variance in %BF5C (R2 = 0.775, SEE = 4.0%). Predictors included sum of skinfolds (SSnew, midaxillary, triceps, and thigh) and waist circumference. The new equation cross-validated well against %BF5C when compared to other existing equations, producing a large intraclass correlation coefficient (ICC = 0.90), small mean bias and limits of agreement (0.4 ± 8.6%), and small measures of error (SEE = 2.5%).

CONCLUSION

%BFNew improved on previous anthropometric-based equations, providing better overall agreement and less error in %BF estimation. The equation described in this study may provide an accurate estimate of %BF5C in healthy adults when measurement is not practical.

Sex Differences in the Effect of Testosterone on Adipose Tissue Insulin Resistance From Overweight to Obese Adults

OBJECTIVE

Adipose tissue distribution and glucose metabolism differ between men and women. Few studies have investigated sex differences in adipose tissue insulin resistance (adipose-IR). Herein, we investigated sex differences in adipose-IR in adults ranging from overweight to obese and the potential factors associated with sex differences in adipose-IR.

METHODS

A total of 424 adults had their body mass index (BMI), adipose-IR, and sex hormones evaluated. Based on BMI, males and females were assigned to 4 groups.

RESULTS

In total, males (n = 156) had higher adipose-IR than females with similar BMI levels (n = 268) (P < 0.05). Adipose-IR progressively increased from overweight to class III obesity in both males and females (all P < 0.0001); however, only in the class III obesity group was the adipose-IR significantly higher in males than in females (P = 0.025). There were significant differences in testosterone between males and females (all P < 0.01); testosterone levels were negatively correlated with adipose-IR (r = -0.333, P < 0.001) in males but positively correlated with adipose-IR (r = 0.216, P < 0.001) in females. For the logistic regression analysis, testosterone was an independent protective factor against adipose-IR in males, with an odds ratio of 0.858 (B = -0.153 [95% CI, 0.743-0.991], P = 0.037).

CONCLUSIONS

Adipose-IR reflects the progressive deterioration in adipose tissue insulin sensitivity from overweight to obesity in both males and females. Males with class III obesity have more severe adipose-IR than similarly obese females. The sex difference is associated with testosterone, and low testosterone levels may contribute to more severe adipose-IR in obese males.

Visceral Adiposity in Relation to Body Adiposity and Nutritional Status in Elderly Patients with Stable Coronary Artery Disease

Introduction: The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities. There are numerous factors that make the body-mass index (BMI) a suboptimal measure of adiposity. The visceral adiposity index (VAI) may be considered a simple surrogate marker of visceral adipose tissue dysfunction. However, the evidence comparing general to visceral adiposity in CAD is scarce. Therefore, we have set out to investigate visceral adiposity in relation to general adiposity in patients with stable CAD. Material and methods: A total of 204 patients with stable CAD hospitalized in the Department of Medicine and the Department of Geriatrics entered the study. Based on the VAI-defined adipose tissue dysfunction (ATD) types, the study population (N = 204) was divided into four groups: (1) no ATD (N = 66), (2) mild ATD (N = 50), (3) moderate ATD (N = 48), and (4) severe ATD (N = 40). Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Results: Patients with moderate and severe ATD were the youngest (median 67 years), yet their metabolic age was the oldest (median 80 and 84 years, respectively). CONUT scores were similar across all four study groups. The VAI had only a modest positive correlation with BMI (r = 0.59 p < 0.01) and body adiposity index (BAI) (r = 0.40 p < 0.01). There was no correlation between VAI and CONUT scores. There was high variability in the distribution of BMI-defined weight categories across all four types of ATD. A total of 75% of patients with normal nutritional status had some form of ATD, and one-third of patients with moderate or severe malnutrition did not have any ATD (p = 0.008). In contrast, 55-60% of patients with mild, moderate, or severe ATD had normal nutritional status (p = 0.008). ROC analysis demonstrated that BMI and BAI have poor predictive value in determining no ATD. Both BMI (AUC 0.78 p < 0.0001) and BAI (AUC 0.66 p = 0.003) had strong predictive value for determining severe ATD (the difference between AUC 0.12 being p = 0.0002). However, BMI predicted mild ATD and severe ATD better than BAI. Conclusions: ATD and malnutrition were common in patients with CAD. Notably, this study has shown a high rate of misclassification of visceral ATD via BMI and BAI. In addition, we demonstrated that the majority of patients with normal nutritional status had some form of ATD and as much as one-third of patients with moderate or severe malnutrition did not have any ATD. These findings have important clinical ramifications for everyday practice regarding the line between health and disease in the context of malnutrition in terms of body composition and visceral ATD, which are significant for developing an accurate definition of the standards for the intensity of clinical interventions.

Body adiposity index to analyze the percentage of fat in young men aged between 7 and 17 years

BACKGROUND

The body adiposity index (BAI), uses anthropometry to estimate percent body fat (%F). However, previous studies have shown that the BAI has limited accuracy for children and adolescents.

OBJECTIVE

We propose to develop and validate an adjusted BAI for use in male children and adolescents from 7 to 17 years of age.

METHODS

The sample consisted of 141 physically active male children and adolescents (age: 12.5 ± 2.14). The %F was determined by X-ray dual energy absorptometry equipment (DXA) as the standard method and by BAI, using an equation that uses height and hip circumference. Arithmetic modeling was used to adjust the structure of the BAI mathematical model.

RESULTS

The BAI arithmetic adjustment was successful, resulting in the mathematical model named in the present study of adjusted body adiposity index (BAI_ADJ ). BAI and BAI_ADJ correlated with DXA (r ≤ .70, p < .001). Regression analyzes indicate that, BAI (CI 95% β: [1.35; 1.90], p < .0001) and BAI_ADJ (CI 95% β: [1.40; 1.90], p < .0001) have the potential to estimate %F. BAI pointed out a difference in relation to DXA (p = .04). While there was no difference between BAI_ADJ and DXA (p = .1). There was a proportion bias of 13.2% for BAI (p < .05), but not for BAI_ADJ (p > .05).

CONCLUSION

The adjusted model of the body adiposity index proves to be an effective tool for the analysis of the fat percentage in young males. In addition, it demonstrated significant degrees of agreement and validity in relation to DXA.

Is body mass index (BMI) or body adiposity index (BAI) a better indicator to estimate body fat and selected cardiometabolic risk factors in adults with intellectual disabilities?

Background

The BMI index cannot always be used in people with intellectual disabilities due to neuromuscular coordination disorders and psychological barriers that may hinder conventional body weight measurement. The study aimed to assess the usefulness of BMI and BAI in estimating obesity and body fat in people with intellectual disabilities.

Methods

The first stage of the research involved 161 people with profound intellectual disabilities. Somatic parameters (BM, BH, WC, HC) were measured and BMI, BAI, WHR were calculated. Fifty seven persons with above-normal BMI and BAI were included in the second stage of the study and biochemical parameters were determined (TC, LDL-cholesterol, HDL-cholesterol, TG, GL).

Results

According to both BMI and BAI classifications, most people were overweight or obese. A high correlation of %BF with BMI and BAI indices was observed (r = 0.78). The sensitivity of both indices was 95.65%. In groups with above-normal BMI and BAI, an upward trend was found for mean values of TC, LDL, TG, and GL, with a simultaneous downward trend for HDL. Statistically significant intergroup differences were recorded for TG and GL (p < 0.05) for both indices (BMI and BAI).

Conclusions

Our research demonstrated that BAI is complementary to BMI and can be recommended for the estimation of body fat and cardiometabolic risks in people with intellectual disabilities. Due to the ease of measurement, BAI has high utility value.

Evaluation of the body adiposity index against dual-energy X-ray absorptiometry for assessing body composition in children and adolescents

BACKGROUND

It is important to clarify the association of lean and fat mass between children and adolescents considering the rising prevalence of overweight and obesity in this age group. The aim of this study was to verify the association between the body adiposity index (BAI) and dual-energy X-ray absorptiometry (DXA) methods for analyzing body composition, as well as analyzing the validity of BAI to verify the percentage of fat in children and adolescents.

METHODS

The sample was composed of 106 children and adolescents, 44 females (age: 11.5 ± 1.8 years) and 62 evils (13.6 ± 2.6 years). The body fat (%F) was measured using DXA and the doubly indirect BAI body fat estimation technique.

RESULTS

The BAI and DXA estimates of %F were strongly correlated (boys: r = .71, P < .0001; girls: r = .72, P < .0001). The linear regression analyses showed that BAI is significant to estimate the %F in total sample (P < .0001). For boys, the %F analyzes performed by BAI and DXA did not show any differences when compared (P = .2). In addition, BAI pointed out a significant proportion bias for both sexes (P < .0001), which suggests its inefficiency in the analysis of %F.

CONCLUSIONS

BAI and DXA correlate; however, there is low reliability and a high proportion bias for the analysis of %F by BAI.

Relative accuracy of body adiposity index and relative fat mass in participants with and without down syndrome

BACKGROUND/OBJECTIVES

The body adiposity index (BAI) and relative fat mass (RFM) are anthropometric measures developed to estimate body composition (%Fat). There is limited research validating these methods of body composition assessment in adults with Down syndrome (DS). The aim of this study was to examine the accuracy of the BAI and RFM in a sample of adults with- and without DS. We hypothesize that the RFM would provide greater accuracy than the BAI when estimating %Fat.

SUBJECTS/METHODS

BAI and RFM were assessed in a sample of adults (n = 235, 50.2% female, 20.0% DS, 23.1 ± 6.7 years). %Fat assessed using dual-energy X-ray absorptiometry served as the criterion method of body composition. Between-group differences were assessed using a two-way (SEX × DS) analysis of variance.

RESULTS

BAI overestimated %Fat in men without DS, but underestimated %Fat in women without DS (4.1 ± 4.5%Fat vs. -3.5 ± 4.6%Fat, respectively, p < 0.001). BAI overestimated %Fat in men and women with DS (4.7 ± 7.8%Fat vs. 0.8 ± 7.5%Fat, respectively, p = 0.090). RFM slightly overestimated %Fat in male and female participants without DS, and did not vary by sex (0.9 ± 4.0%Fat vs. 0.2 ± 4.2%Fat, respectively, p = 0.248). RFM underestimated %Fat in men and women with DS, with no differences observed between sexes (-2.1 ± 5.3%Fat vs. -2.2 ± 6.9%Fat, respectively, p = 0.953).

CONCLUSIONS

The BAI and RFM can be used to estimate body composition in individuals with- and without DS, however, the RFM yields greater accuracy and is recommended when more advanced methods of body composition assessment are unavailable or create unwanted participant burden.