Waist-to-height ratio as an anthropometric marker of overweight in elderly Brazilians

[Clinical phenotype of abdominal obesity and dynapenia: Brazilian Longitudinal Study of Aging (ELSI-Brazil)]

This study aims to examine the prevalence of abdominal obesity-dynapenia phenotype, identified by the presence of abdominal obesity and dynapenia, and understand its associated factors with a representative sample of the Brazilian population. Data were collected from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil) 2015-2016. Abdominal obesity was determined by a waist-to-height ratio ≥ 0.55cm, while dynapenia was identified by evidence of low handgrip strength assessed via dynamometry, according to cutoff points proposed for the Brazilian population. The dependent variable was the coexistence of both conditions (abdominal obesity and dynapenia), and its association with independent variables (sociodemographic characteristics, behavior and health conditions, chronic diseases, and place of residence by Brazilian region) was analyzed using Poisson regression to obtain crude and adjusted prevalence ratios by sex, age, and education level. The prevalence of isolated abdominal obesity was 57.8%, isolated dynapenia was 5.7%, and abdominal obesity-dynapenia was 12.3%. In the adjusted model, significant associations were found with smoking (0.7; 95%CI: 0.5-0.9), alcohol consumption (0.7; 95%CI: 0.5-0.9), physical activity (0.6; 95%CI: 0.5-0.8), poor self-rated health (1.7; 95%CI: 1.4-2.2), multimorbidity (1.3; 95%CI: 1.1-1.6), and regions of residence. These factors indicate key points for the development of prevention and treatment strategies for abdominal obesity associated with low muscle strength, and we suggest that methodologies discussed here for abdominal obesity diagnosis be used as a reliable and practical means to identify this condition in older adults.

A comparison of the different anthropometric indices for assessing malnutrition among older people in Turkey: a large population-based screening

OBJECTIVE

Due to an increase in aging worldwide, assessment of the nutritional status of older people becomes an important matter. Malnutrition in older people increases the risk of infections, disease period and hospitalization rates. This study aimed to compare the different anthropometric indices for detecting malnutrition among older people and comparing these indices among males and females to explain the possible differences.

METHODS

In this cross-sectional study, 2721 aged 65 years and older in Turkey were enrolled. Anthropometric measurements weight, height, hip circumference (HC), and waist circumference (WC), abdominal circumference (AC), mid-upper arm circumference (MUAC), triceps skinfold thickness (TST), calf circumference (CC)) were measured. Body mass index (BMI), abdominal volume index (AVI), body roundness index (BRI) and body adiposity index (BAI), and waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) indices were calculated using standardized formulas. The receiver operator characteristic curves (ROCs) were conducted in detecting the best anthropometric parameters. Adjusted odds ratios (OR) (stratified by sex) calculated for each anthropometric index.

RESULTS

Participants with both BMI < 18.5 (1.1%) and BMI > 25 (80%) defined as the malnourished group and BMI of 18.5-24.99 (18.9%) defined as the normal group. In both sexes, the area under the curve (AUC) was > 0.7 for all anthropometric indices except WHR in females (AUC 0.66). BRI, WHR, WHtR, and AVI indices strongly predict the risk of malnutrition among both sexes. In males, the ORs were for BRI (6.83, 95% CI 5.39-8.66), WHR (6.43, 95% CI 5.9-6.9), AVI (2.02, 95% CI 1.86-2.12). In females, the ORs were for BRI (3.72, 95% CI 3.09-4.48), WtHR (2.63, 95% CI 1.3-3.5), and WHR (2.45, 95% CI 1.9-3.06).

DISCUSSION

The presence of a large AUC in almost all anthropometric indices suggests that they can be used to assess the risk of malnutrition among older persons in both sexes.

Which anthropometric measures best identify excess weight in older adults?

OBJECTIVES: To estimate the prevalence of and factors associated with excess weight in older adults according to body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WtHR), as well as to measure the differences between the prevalences estimated by WC and WtHR in relation to BMI. METHODS: This cross-sectional study was conducted in 2016 – 2017 with 549 older adults (72–102 years) from Campinas and Ermelino Matarazzo, two cities in the state of São Paulo, Brazil. Excess weight was defined according to cut-off points established for older adults. Multiple Poisson regression analysis was performed. RESULTS: The overweight/obesity prevalences were 47.36% (BMI), 61.38% (WC) and 65.57% (WtHR), being higher in women and in those with hypertension, diabetes, polypharmacy, and normal calf circumference. They were also higher in the youngest age strata (BMI and WC), in those with arthritis/rheumatism (BMI), and in those with slow gait (WtHR). The estimated overweight/obesity prevalences according to WC and WtHR were 29.00% and 38.00% higher, respectively, than BMI. In the multiple model, there was a higher prevalence of adiposity among diabetics and those with normal calf circumference. CONCLUSIONS: Measures of abdominal adiposity provided a better diagnosis of excess weight. We recommended that health professionals consider using WtHR in anthropometric assessment of older adults, especially regarding adiposity.

The influence of ultra-processed food consumption in anthropometric and atherogenic indices of adolescents

ABSTRACT Objective To investigate the influence of ultra-processed food consumption on anthropometric and atherogenic indices. Methods A cross-sectional study was conducted with 327 adolescents aged 14 to 19 years. Sociodemographic, anthropometric, biochemical, and food consumption data were evaluated. The ratios of atherogenic indices were calculated using the Castelli I (Total Cholesterol/High Density Lipoprotein Cholesterol), Castelli II (Low Density Lipoprotein Cholesterol/High Density Lipoprotein Cholesterol), and estimated Low Density Lipoprotein Cholesterol particle size (Atherogenic Index of Plasma=Triglycerides/High-Density Lipoprotein Cholesterol) indices. Logistic regression was used for the unadjusted and adjusted analysis between ultra-processed foods consumption, anthropometric, and atherogenic indices. The level of significance was 5%. Results Most participants were female (59.3%). Girls had a higher consumption of ultra-processed foods (26.6% vs. 20.5%). Of the total number of adolescents, 16.5% were overweight and 65.7% were from public schools. Adolescents with altered values for the Castelli I and II Index, and for the Atherogenic Index of Plasma had significantly higher weights, Waist Circumference, Waist Circumference/ Height and Body Mass Index/ Age values. The adjusted analysis identified a significant association (Odds ratio=2.29; 95% Confidence interval: 1.23-4.28) between the high consumption of ultra-processed foods and the Castelli II index. Conclusion The associations between atherogenic indices and anthropometric indices and the consumption of ultra-processed foods highlight the negative influence of these foods on adolescents’ cardiovascular health.

Waist-to-height ratio is a better discriminator of cardiovascular disease than other anthropometric indicators in Kurdish adults

It has been suggested that abdominal obesity might be a better cardiovascular diseases (CVDs) discriminator than overall obesity. The most appropriate obesity measures for estimating CVD events in Kurdish populations have not been well-recognized. The objective of the present study was, therefore, to determine the cutoff points of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist to height ratio (WHtR) as the diagnostic cut-offs to discriminate the prevalent cardiovascular diseases. The data collected from Ravansar Non-Communicable Disease (RaNCD) cohort, the first Kurdish population-based study, was analyzed. The information related to BMI, WC, WHR and WHtR of 10,065 adult participants in the age range of 35–65 was analyzed in this study. Receiver operating characteristic (ROC) analyses were conducted to evaluate the optimum cut-off values and to predict the incidence of cardiac events. The results showed that WHtR had the largest areas under the ROC curve for cardiac events in both male and female participants, and this was followed by WHR, WC, and BMI. The optimal cut-off values for determining the cardiac events in the Kurdish population were BMI = 27.02 kg/m² for men and BMI = 27.60 kg/m² for women, WC = 96.05 cm in men and 99.5 cm for women, WHRs = 0.96 in both sexes, and WHtR = 0.56 for men and 0.65 for women. The current study, therefore, showed that WHtR might serve as a better index of prevalent cardiac event than BMI, WHR and WC.

The ability of waist-to-height ratio to identify health risk

OBJECTIVE

To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference.

METHODS

A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories.

RESULTS

The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16–1.63) and 1.35 (95%CI 1.12–1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference.

CONCLUSIONS

The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.