Agreement between body mass index, waist circumference and skin-fold thickness in the United Kingdom Army

General and abdominal obesity and dietary nutrient intake among university students in Bangladesh: A cross-sectional study targeting potential risk factors

BACKGROUND & AIMS

The overall national increase in the prevalence of overweight and obesity has emerged among university students in Bangladesh. Though, poor dietary habits and lifestyle is quite common among university students, their dietary nutrient intake level, obesity prevalence and potential risk factors has hitherto given little priority. This study aimed to understand the prevalence and factors associated with general and abdominal obesity and level of dietary nutrient intake among university students in Bangladesh.

METHODS

Data from 320 unselected tertiary level students (81.6% males, 18.4% females; average age 22.7±3.0, BMI 22.4±3.1 and waist-hip ratio (WHR) 0.88 ± 0.1) was collected randomly, in a single visit, from Islamic University, Kushtia, Bangladesh. Basic demographic and anthropometric information were collected. Twenty-four hour (24H) dietary recall and food frequency questionnaire (FFQ) was used to collect dietary nutrient level retrospectively. Descriptive statistics, chi-square test, t-test, ANOVA, and binomial logistic regression analysis were done.

RESULTS

Around 3% and 42% student were reported to be obese and overweight respectively. Whereas abdominal obesity was prevalent among ∼52% and more than 67% of student were reportedly obese/overweight by either BMI or WHR or WHtR category. Energy and carbohydrate (CHO) intake were reported to be significantly higher (P < 0.05) among overweight who born by C-section delivery and were fed formula milk than those were normal weight and born by vaginal-birth and were breastfed. The overweight individual with a history of preterm birth was reported to intake significantly higher (P < 0.05) carbohydrates compared to normal-weight individuals with a history of term birth. While total fat intake was significantly higher (P < 0.05) among overweight individuals with their mother had gestational diabetes than those with normal weight individuals with mother without gestational diabetes.

CONCLUSIONS

General and abdominal obesity is common among university students and possibly associated with mode of birth, gestational duration, gestational diabetes, and breastfeeding practice.

Relationship between Body Mass Index and Health and Occupational Performance among Law Enforcement Officers, Firefighters, and Military Personnel: A Systematic Review

The prevalence of overweight and obesity among tactical populations is estimated at 70%-75%, which may negatively impact health and performance. The relationship between BMI and health and performance is well established among the general population, however, literature on such relationships among tactical populations has yet to be reviewed and evaluated. The purpose of this study was to systematically review available literature on the relationship between BMI and health and occupational performance among law enforcement officer, firefighters, and military personnel. After reviewing the literature, 27 articles were included. Nine studies found BMI was positively associated with cardiovascular disease (CVD) risk factors. Studies involving BMI and cancer were lacking. One study found BMI was positively associated with type 2 diabetes (T2DM) risk. Five studies on occupational/physical performance and 12 studies on injury found a higher BMI was often indicative of decreased performance and increased risk of injury in general, but protective against stress fractures. Overall, higher BMI was often associated with negative health and performance outcomes among tactical populations, especially when beyond the overweight classification. Public health practitioners should focus efforts on improving nutrition and physical activity to promote a healthy BMI among these individuals.

Indicators of Obesity and Cardio-metabolic Risks: Important Consideration in Adults and Children

The prevalence of obesity has dramatically increased all over the world. Body mass index (BMI) has been used as the most common available measure to determining obesity status. While the site of excessive fat mass accumulation is a stronger determinant of cardio-metabolic complication, with respect to systemic and generalized obesity, which is only determined through BMI. So, it is concluded that using traditional anthropometric indices such as BMI for interpreting the obesity status and cardio-metabolic risk has considerable limitations. Thus, the main aims of the present study are to discuss possible drawbacks of anthropometric indices especially BMI, which in epidemiological studies are usually neglected, as well as lend important consideration to using other anthropometric indices such as measurement of obesity and related cardio-metabolic complications with a special emphasis on the use of waist circumference, waist-to-hip ratio and waist-to-height ratio.

Concordances and correlations between anthropometric indices of obesity: a systematic review

OBJECTIVES

The pandemic of overweight and obesity has become a major clinical and public health concern worldwide. Anthropometric indices are indirect and quantitative tools used to identify individuals at increased risk of body fat-related morbidity. The aim of this systematic review was to assess the concordances and correlations between anthropometric indices of obesity in adults and whether these indices can be used interchangeably.

STUDY DESIGN

Systematic review.

METHODS

A literature search was conducted in three databases of peer-reviewed publications (PubMed, Scopus, and Embase). Further, the first 10 pages of Google Scholar were also searched for relevant studies.

RESULTS

There were strong correlations between body mass index (BMI) and waist circumference (WC) and between BMI and waist-to-height ratio (WHtR), and a weak correlation between BMI and neck circumference (NC). There was a very strong correlation between WC and WHtR and a moderate correlation between WC and NC. There were moderate concordances between BMI and WC and between BMI and WHtR and good concordance between WC and WHtR.

CONCLUSION

BMI, WC, and WHtR indices can be moderately used interchangeably with caution. More studies in adult populations using statistical tests of concordance and adjusting for differences in ethnicity, age, gender, and weight quantiles are needed.

Significance and agreement between obesity anthropometric measurements and indices in adults: a population-based study from the United Arab Emirates

BACKGROUND

The rates of overweight and obese adults in the United Arab Emirates (UAE) have increased dramatically in recent decades. Several anthropometric measurements are used to assess body weight status. Some anthropometric measurements might not be convenient to use in certain communities and settings. The objective of this study was to assess the agreement of four anthropometric measurements and indices of weight status and to investigate their associations with cardiometabolic risks.

METHODS

The study design was a cross-section population-based study. Adults living in the Northern Emirates were surveyed. Fasting blood samples, blood pressure readings and anthropometric measurements were also collected.

RESULTS

A total of 3531 subjects were included in this study. The prevalence of obesity/overweight was 66.4% based on body mass index (BMI), 61.7% based on waist circumference (WC), 64.6% based on waist-hip ratio (WHR) and 71% based on neck circumference (NC). There were moderate agreements between BMI and WC and between WC and WHR, with kappa (k) ranging from 0.41 to 0.60. NC showed poor agreement with BMI, WC and WHR, with k ranging from 0 to 0.2. Overweight and obesity based on BMI, WC and WHR were significantly associated with cardiometabolic risks.

CONCLUSION

Overall, there was a moderate to a poor agreement between BMI, WC, WHR and NC. Particularly, NC showed poor agreement with BMI, WC and WHR. BMI and WC showed better performance for identifying cardiometabolic risks than WHR and NC.

Prevalence and correlates of normal body mass index central obesity among people with cardiovascular diseases in Australia

OBJECTIVE

Obesity is one of the most common risk factors for cardiometabolic diseases in Australia and worldwide. Recent studies show that people with normal body mass index (BMI) but with central obesity are at increased risk of morbidity and mortality from cardiometabolic diseases. This risk has not been explained well. The aim of this study was to examine the magnitude, correlates and effects of normal BMI central obesity in the Australian adult population.

STUDY DESIGN

Longitudinal study with data linkage.

METHODS

We used the Baker Biobank, which contains sociodemographic, behavioural, clinical and mortality data. Data were collected between 2000 and 2011 from 6530 adults who were between 18 and 69 years of age. Biobank data were linked to the National Death Index. A matrix of BMI and waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were used to create adiposity categories. For analysis, we used descriptive statistics, logistic regression and cox regression models.

RESULTS

The overall prevalence of normal BMI central obesity was 13.4% by WHtR and 14.4% by WHR. Gender, age, BMI and physical activity were associated with normal BMI central obesity. Higher odds of multimorbidity and increased hazards of all-cause and cardiovascular mortality were associated with WHR.

CONCLUSION

WHtR and WHR, when each used with BMI, provided similar estimates of prevalence of normal BMI central obesity. However, WHR is a better predictor of all-cause and cardiovascular mortality.

Regular strength training and baseline fitness in overweight infantry members of Slovenian Armed Forces

INTRODUCTION

The prevalence of overweight subjects in military cohorts increases despite the obligatory army physical fitness test (APFT) requirements and the negative consequences of possible test failure due to the increased body mass index (BMI). Studies that have examined the association of BMI with baseline fitness in the military are showing conflicting evidence. The primary aim of the study is to examine BMI effects on baseline fitness that was measured by APFT and additional functional performance tests (FT) (vertical countermovement jump with and without load, loaded prone plank, single-leg hamstring bridge test and pull-ups). Our secondary goal is to explore if regular strength training modifies the BMI effect on baseline fitness.

METHODS

A cross-sectional study on a sample of 118 male infantry soldiers that have performed APFT and FT was carried out. Body mass and body height measurements were used to calculate BMI, and to categorise participants into BMI ranks. Two independent categorical variables (BMI rank and strength training) were used to evaluate their influence on dependent variables of physical performance acquired from APFT and FT.

RESULTS

A significantly large size effect of BMI rank (F=1.69, p=0.037; effect size (ES)=0.15) and regular strength training (F=2.66, p=0.006; ES=0.21) on physical performance was found. It was shown that strength training had a medium ES on push-up and pull-up performance, as well as on the overall APFT score and loaded plank.

CONCLUSIONS

The importance of regular strength training and normal BMI for better overall baseline fitness in infantry members was highlighted. Most importantly, it was shown that performance is not affected in overweight soldiers who are performing regular strength training in addition to their daily physical training.

TRIAL REGISTRATION NUMBER

NCT03415464.

Comparison of Cardiovascular Health Between US Army and Civilians

Background

Cardiovascular conditions are common in US Army and civilian populations. The recently developed concept of ideal cardiovascular health provides a new approach to evaluating population cardiovascular status.

Methods and Results

We defined a cohort of 263 430 active duty Army personnel, aged 17 to 64 years, who completed a 2012 physical examination and a corresponding subset of the noninstitutionalized, civilian US population, who participated in the National Health and Nutrition Examination Survey (NHANES) 2011 to 2012 cycle. We compared 4 cardiovascular health metrics (current smoking, body mass index, blood pressure, and diabetic status) between Army and civilian groups overall, and separately by sex, race/ethnicity, and age. The Army population was younger, was less often women or Hispanic, and had less post–high school education than the NHANES population. Smoking rates were ≈20% in the Army and NHANES groups, but <15% among Army women and Hispanics. Overall, one third of the Army and NHANES groups and NHANES women, but nearly half of Army women, demonstrated ideal body mass index. Ideal blood pressure was strikingly less prevalent in the Army than NHANES participants (30% versus 55%). Diabetes mellitus was rare in both groups.

Conclusions

Ideal cardiovascular health was less prevalent in the Army than NHANES group, despite exclusion of the least healthy recruits. Prevalence of ideal body mass index and blood pressure was low in both the Army and NHANES groups, even at early adult ages. This finding reveals the need for policy changes to promote, preserve, and improve ideal cardiovascular health in both the Army and the US population as a whole.

Relevance of evaluating the rate of torque development in ballistic contractions of submaximal amplitude

OBJECTIVE

The neuromuscular quickness capacity can be assessed by calculating the rate of torque development (RTD) during ballistic contractions of maximal (RTD_maximal) or submaximal (RTD_submaximal) amplitudes. In a series of ballistic contractions of submaximal amplitudes, the RTD scaling factor (RTD-SF) represents the slope of the linear regression between achieved peak torques and the corresponding RTD. First we investigated whether the RTD-SF contributes to the prediction, together with maximal voluntary torques (MVT), of the RTD_maximal. Then, we evaluated the agreement between the z-scores of RTD_maximal and RTD_submaximal.

APPROACH

The MVT was obtained for the quadriceps and hamstrings muscles of 22 elite young soccer players. RTD-SF was quantified in a series of ballistic contractions of submaximal and maximal amplitudes. RTD_submaximal was estimated from the regression relationship between the peak torques and the corresponding RTD.

MAIN RESULTS

MVT, RTD-SF and y -intercept in total accounted for 76.9 and 61.2% of the variance in RTD_maximal in quadriceps and hamstrings, respectively. Specifically, RTD-SF accounted for 13.7% and 18.7% of the variance in RTD_maximal, respectively. Generally, the agreement between the z-scores of RTD_maximal and RTD_submaximal was poor both in quadriceps and hamstrings.

SIGNIFICANCE

These results suggest that RTD-SF may have a functional relevance in the relationship between MVT and RTD_maximal and influence the amount of torque that can be achieved in a quick muscle contraction. Moreover, evaluating the RTD_submaximal does not provide results that are interchangeable with RTD_maximal. Thus, evaluating the RTD across the whole range of torque could provide additional meaningful information about neuromuscular quickness.

Relationship between obesity and health problems in help-seeking military veterans

Background

UK Armed Forces (UK AF) veterans may be particularly vulnerable to obesity and its comorbid physical and mental health problems.

Aim

To examine the relationship between body mass index (BMI), physical health problems, mental health disorders and sociodemographic characteristics in UK AF veterans engaged in psychological treatment.

Methods

Information regarding veteran BMI, demographic characteristics, physical health conditions and mental health problems was collected and analysed using univariate and multivariate regression analyses. Rates of veteran obesity were also compared with the UK general population.

Results

Of the 384 help-seeking veterans, 37.5% (n=151) were overweight (BMI 26–30) and 35.5% (n=143) were obese. Obesity in help-seeking male veterans was two to four times higher than that of the general population of UK. Higher scores on measures of anger and common mental health problems were significantly associated with greater BMI. Problems with physical systemic functioning and mobility were also significantly associated with greater BMI.

Conclusions

The results indicate that treatment-seeking UK AF veterans exhibit higher levels of obesity compared with the general population, and clinically significant physical and mental comorbidities. The findings highlight a need for mental health services to offer treatments that effectively integrate physical and mental healthcare in the treatment of people with mental health problems.

The association between obesity related health risk and fitness test results in the British Army personnel

OBJECTIVE

In the British Army, fitness is assessed by a load carriage test (Annual Fitness Test, AFT) and by a three event Personal Fitness Assessment (PFA). Body composition based on body mass index (BMI) and abdominal circumference (AC) is also part of a mandatory annual assessment. This study examined the influence of BMI and AC on fitness test results within a comprehensive sample of British Army personnel.

DESIGN

Secondary analyse were carried out on data obtained from the 2011 Defence Analytical Services and Advice (DASA) database for 50,635 soldiers (47,173 men and 3,462 women).

METHODS

Comparisons using loglinear analysis were made between groups of individuals classified by body mass index as obese (≥30kg/m2) and not obese (<30kg/m2), and further classified using combined BMI and AC for obesity-related health risks to compare "no risk" with "increased risk."

RESULTS

Not obese or "no risk" soldiers had a significant relationship with success in the AFT (p<0.01) and PFA (p<0.01). Of those soldiers who attempted the AFT, 99% of men and 92% of women passed; for the PFA, 92% of men and 91% of women passed. Obese or "at risk" soldiers were more likely to fail and far less likely to take both tests (p<0.05). Compared to older obese soldiers, young obese soldiers were more likely to attempt the tests.

CONCLUSIONS

We conclude that BMI and AC are useful indicators of fitness test outcome in the British Army.

Occupational differences for nutrient intake and physical-activity levels in young and middle-aged men

BACKGROUND

Physical demands may vary between white collar and blue collar occupations when evaluating specific physiological differences such as one's weight, body mass index and body fat percentage.

OBJECTIVE

To explore nutritional, anthropometric, and physical-activity differences between young and middle-aged WC and BC workers.

METHODS

Ninety-one male participants aged 19-64 that were either WC and/or BC workers completed a 3-day food recall, modified Baecke Questionnaire, and had their height, weight, body mass index and body fat percentage measured. Participants were classified as: young-white-collar, young-blue-collar, middle-white-collar or middle-blue-collar workers.

RESULTS

No nutritional differences within ages or between occupations were reported. Body mass index and body fat percentage were lower for young vs. middle-aged workers. Lastly, physical-activity at work was higher for young and middle-aged Blue collar workers, while White collar workers participated in more physical activity outside of work.

CONCLUSIONS

The present findings suggest that the observed increases in body fat percentage and body mass index with age, are independent of occupation.

Agreement Analysis among Measures of Thinness and Obesity Assessment in Iranian School Children and Adolescents

Purpose

This study investigated the agreement of four anthropometric-based measurements including weight-for-height (WH), body mass index-for-age (BMI), mid-upper arm circumference-for-age (MUAC) and triceps skinfold thickness-for-age (TST) to identify underweight and overweight children and adolescents.

Methods

Two data sets were used in this research. The first one was a multistage random sample of 2397 healthy school children in pre-pubertal stage in Shiraz. The second data set consisted of 487 healthy students in pubertal stage and 558 students in post-pubertal stage. The parametric LMS method was used to construct reference centiles curves for each measure. The Kappa statistic was applied to examine the pairwise agreement of the four indices for detecting thinness and obesity.

Results

Generally, the pairwise agreement of adiposity measures was higher for identifying obesity than thinness. There was an excellent agreement between WH and BMI for detecting both thin and obese children in almost all subgroups (P<0.001). MUAC had an excellent agreement with BMI in pre-pubertal individuals (P<0.001). However, TST had a weak agreement with the other three indices for detecting thinness and weak to good agreement for classification of obesity.

Conclusion

The performance of the four anthropometric-based measurements varied by sex and maturity level. MUAC as a simple and low-cost screening tool can also be used as an alternative to BMI for obesity assessment among pre-pubertal groups.

Accuracy of body mass index-defined overweight in fire fighters

BACKGROUND

Overweight, obesity and weight gain are significant problems in the U.S. fire service. While classification of obesity using body mass index (BMI) has demonstrated accuracy and low rates of false positives when compared with body fat percentage (BF%)-based standards, no studies have examined the accuracy of BMI-based overweight and normal weight status with other comparable body composition indices.

AIMS

To compare overweight and normal weight BMI categories with BF% standards from the American Council on Exercise and analogous waist circumference (WC) categories and to examine rates and types of misclassification in fire fighters.

METHODS

Data were collected from 11 randomly selected career fire departments in the International Association of Fire Chief's Missouri Valley Region. Demographics, occupational history, and body composition indices (weight, BF% and WC) were obtained from male career fire fighters who were categorized as normal weight or overweight based on BMI.

RESULTS

There were 293 participants of whom 92 had normal BMI. There were low rates of false positives (12%) and moderate rates of false negatives (22%) when comparing BMI categories to the compar able BF% categories. However, using WC as the standard resulted in very high rates of false positives (63%) and very low rates of false negatives (5%).

CONCLUSIONS

BMI-based overweight status was associated with significant errors in classification depending on the standard to which it was compared.

Trends in body mass index and associations with physical activity among career soldiers in South Korea

OBJECTIVE

This study was designed to describe the trends in body mass index (BMI) during 6 years (2002 - 2008) and to identify associations between these trends and the amount of physical activity of South Korean career soldiers.

METHOD

This study targeted the 40 993 (38 857 men and 2136 women) of the 58 657 career soldiers who had undergone four (2002, 2004, 2006, and 2008) biennial medical examinations conducted by the National Health Insurance Corporation; 17 664 soldiers with missing data on height, weight, and physical activity were excluded. A linear mixed-regression model was used to categorize changes in BMI due to age versus those due to amount of physical activity.

RESULTS

Career soldiers experienced significant increases in BMI compared with baseline data gathered in 2002. The increases in each age group were as follows: men aged 20-29: 1.16, men aged 30-39: 0.61, men aged 40-49: 0.05, women aged 20-29: 0.35, women aged 30-39: 0.30, women aged 40-49: 0.26, and women aged 50-59: 0.21. However, men aged 50 or older showed significant decreases (as high as 0.5) in BMI compared with baseline data obtained in 2002. They also experienced significant decreases in BMI compared with those who reported no physical activity. The differences between baseline and final BMIs were: 0.02 for men exercising 1-2 times per week, -0.07 for men exercising 3-4 times per week, -0.19 for men exercising 5-6 times per week, -0.21 for men exercising seven times per week, -0.05 for women exercising 1-2 times per week, -0.19 for women exercising 3-4 times per week, -0.30 for women exercising 5-6 times per week, and -0.30 for women exercising seven times per week.

CONCLUSIONS

Obesity in South Korean career soldiers increased markedly between 2002 and 2008, and our data showed that the amount of physical activity was inversely related to increases in BMI. Policies to prevent obesity are needed to reduce this trend.