Obesity prevalence according to three anthropometric indexes in a representative sample of Valencian Community

Authors

  • Laura Torres-Collado Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain.
  • Manuela Garcia de la Hera Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.
  • Eva Maria Navarrete-Muñoz Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.
  • Sandra González-Palacios Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.
  • Alejandro Oncina-Cánovas Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain.
  • Jesús Vioque Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.

DOI:

https://doi.org/10.14306/renhyd.22.4.527

Keywords:

Obesity, Adult, Body Mass Index, Waist circumference.

Abstract

Introduction: Obesity is a public health problem that affects and has increased rapidly in the last decade in a large number of countries in the world. Moreover, it is an important cardiovascular risk factor and has been shown to be a possible risk factor in mortality, specially due to chronic disease. Objective: To determine the prevalence of obesity according to three anthropometric indexes: Body Mass Index (BMI), waist circumference (WC) and body fat percentage (% BF) measured by bioelectrical impedance and to estimate the validity and accuracy of BMI and WC indexes to define obesity using % BF as reference method.

Material and methods: We carried out a cross-sectional study that included 141 participants from the Nutrition Survey of Comunidad de Valencia conducted in 1994, who were evaluated again 10 years later. Anthropometric measurements were made with standardized protocols for weight and height obtaining BMI, CC and % GC. We classified the participants as obese (yes/no) using the following cut-off points of BMI ≥ 30 kg/m2, WC > 102 cm in men and > 88 cm in women, and % BF > 27 for men and 40 in women. Correlation coefficients between anthropometric indexes adjusting by age were obtained. Sensitivity, specificity and predictive values were estimated for BMI and WC using % BF as reference.

Results: The prevalence of obesity was 19.9%, 37.6 and 38.3% using BMI, WC and % BF respectively. The correlation coefficients ranged from 0.232 for WC-% BF and 0.829 for BMI-WC. Using the % BF as reference, the BMI showed greater specificity (92,6% in women and 93,9% in men) and WC greater sensitivity (83,3% in women and 53,7% in men) to detect obesity.

Conclusions: The prevalence of obesity differs according to the anthropometric index used. WC, given its easy measurement may be the most appropriate indicator to be used in population-based studies and preventive programs to detect obesity in adults.

Author Biographies

Laura Torres-Collado, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain.

Becaria FPU. Departamento de Salud Pública. UMH

Manuela Garcia de la Hera, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.

Profesora departamento de Salud Pública, Campus San Juan. Universidad Miguel Hernández. Ctra. Nacional 332 s/n 03550-Sant Joan d’Alacant España.

Eva Maria Navarrete-Muñoz, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.

Investigadora postdoc. CIBER en Epidemiología y Salud Pública (CIBERESP), España

Sandra González-Palacios, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.

Investigadora. CIBER en Epidemiología y Salud Pública (CIBERESP), España

Alejandro Oncina-Cánovas, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain.

Becario investigación.Departamento de Salud Pública. UMH.

Jesús Vioque, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. Alicante, Spain. Instituto de Salud e Investigación Biomédica (ISABIAL). Alicante, Spain. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. Madrid, Spain.

Catedrático de Salud Publica. Departamento de Salud Pública. UMH.

References

(1) NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016;387(10026):1377-96.

(2) NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42.

(3) World Health Organization. Obesity and overweight [Internet]. WHO. 2017 [citado 15 de noviembre de 2017]. Disponible en: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

(4) Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. PharmacoEconomics. 2015;33(7):673-89.

(5) Martínez-González MA, García-Arellano A, Toledo E, Bes-Rastrollo M, Bulló M, Corella D, et al. Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study. PLOS ONE. 2014;9(7):e103246.

(6) World Health Organization. 10 facts on obesity [Internet]. WHO. 2017 [citado 15 de noviembre de 2017]. Disponible en: http://www.who.int/features/factfiles/obesity/en/

(7) Zaslavsky O, Rillamas‐Sun E, LaCroix AZ, Woods NF, Tinker LF, Zisberg A, et al. Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women’s Health Initiative Study. J Am Geriatr Soc. 2016;64(2):277-84.

(8) Zhang Z, Deng J, He L, Ling W, Su Y, Chen Y. Comparison of Various Anthropometric and Body Fat Indices in Identifying Cardiometabolic Disturbances in Chinese Men and Women. PLOS ONE. 2013;8(8):e70893.

(9) Wollner M, Paulo Roberto B-B, Alysson Roncally SC, Jurandir N, Edil LS. Accuracy of the WHO’s body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil. J Public Health Res. 2017;6(2):904.

(10) Li Y, Wang H, Wang K, Wang W, Dong F, Qian Y, et al. Optimal body fat percentage cut-off values for identifying cardiovascular risk factors in Mongolian and Han adults: a population-based cross-sectional study in Inner Mongolia, China. BMJ Open. 2017;7(4):e014675.

(11) Quiles J, Vioque J. Prevalencia de la obesidad en la Comunidad Valenciana. Med Clin. 1998;110(8):319.

(12) Vioque J, Weinbrenner T, Castelló A, Asensio L, Hera MG de la. Intake of Fruits and Vegetables in Relation to 10-year Weight Gain Among Spanish Adults. Obesity. 2008;16(3):664-70.

(13) Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72(3):694-701.

(14) World Health Organization. Waist circumference and waist-hip ratio : report of a WHO expert consultation, Geneva, 8-11 December 2008 [Internet]. Geneva: Geneva : World Health Organization; 2011. Disponible en: http://apps.who.int/iris/handle/10665/44583

(15) Verma M, Rajput M, Sahoo SS, Kaur N, Rohilla R. Correlation between the percentage of body fat and surrogate indices of obesity among adult population in rural block of Haryana. J Family Med Prim Care. 2016;5(1):154-9.

(16) Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China. PLoS ONE. 2017;12(9):e0183934.

(17) Lopez-Garcia E, van Dam RM, Li TY, Rodriguez-Artalejo F, Hu FB. The Relationship of Coffee Consumption with Total and Disease-Specific Mortality: a Cohort Study. Ann Intern Med. 2008;148(12):904-14.

(18) Hübers M, Pourhassan M, Braun W, Geisler C, Müller MJ. Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance: differences between children, adolescents and adults. Obes Sci Pract. 2017;3(3):272-81.

(19) Cheong KC, Ghazali SM, Hock LK, Subenthiran S, Huey TC, Kuay LK, et al. The discriminative ability of waist circumference, body mass index and waist-to-hip ratio in identifying metabolic syndrome: Variations by age, sex and race. Diabetes Metab Syndr. 2015;9(2):74-8.

(20) Flegal KM, Shepherd JA, Looker AC, Graubard BI, Borrud LG, Ogden CL, et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. Am J Clin Nutr. 2009;89(2):500-8.

(21) Carmienke S, Freitag MH, Pischon T, Schlattmann P, Fankhaenel T, Goebel H, et al. General and abdominal obesity parameters and their combination in relation to mortality: a systematic review and meta-regression analysis. Eur J Clin Nutr. 2013;67(6):573-85.

(22) Song X, Jousilahti P, Stehouwer CDA, Söderberg S, Onat A, Laatikainen T, et al. Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans. Nutr Metab Cardiovasc Dis. 2015;25(3):295-304.

(23) Haghighatdoost F, Amini M, Feizi A, Iraj B. Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study. World J Diabetes. 2017;8(7):365-73.

(24) Oreopoulos A, Fonarow GC, Ezekowitz JA, McAlister FA, Sharma AM, Kalantar-Zadeh K, et al. Do anthropometric indices accurately reflect directly measured body composition in men and women with chronic heart failure? Congest Heart Fail. 2011;17(2):90-2.

(25) Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79(3):379-84.

(26) Jacobsen BK, Aars NA. Changes in waist circumference and the prevalence of abdominal obesity during 1994-2008 - cross-sectional and longitudinal results from two surveys: the Tromsø Study. BMC Obes. 2016;3:41.

(27) Walls HL, Stevenson CE, Mannan HR, Abdullah A, Reid CM, McNeil JJ, et al. Comparing trends in BMI and waist circumference. Obesity (Silver Spring). 2011;19(1):216-9.

(28) López-Sobaler AM, Aparicio A, Aranceta-Bartrina J, Gil Á, González-Gross M, Serra-Majem L, et al. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study. Biomed Res Int. 2016;2016:8341487.

(29) Vioque J, Weinbrenner T, Asensio L, Castelló A, Young IS, Fletcher A. Plasma concentrations of carotenoids and vitamin C are better correlated with dietary intake in normal weight than overweight and obese elderly subjects. Br J Nutr. 2007;97(5):977-86.

(30) Widen EM, Strain G, King WC, Yu W, Lin S, Goodpaster B, et al. Validity of bioelectrical impedance analysis for measuring changes in body water and percent fat after bariatric surgery. Obes Surg. 2014;24(6):847-54.

(31) Ramírez‐Vélez R, Tordecilla‐Sanders A, Correa‐Bautista JE, González‐Ruíz K, González‐Jiménez E, Triana‐Reina HR, et al. Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults. Am J Hum Biol. 2018;30(1):e23071.

Published

2018-12-31

How to Cite

Torres-Collado, L., Garcia de la Hera, M., Navarrete-Muñoz, E. M., González-Palacios, S., Oncina-Cánovas, A., & Vioque, J. (2018). Obesity prevalence according to three anthropometric indexes in a representative sample of Valencian Community. Spanish Journal of Human Nutrition and Dietetics, 22(4), 272–278. https://doi.org/10.14306/renhyd.22.4.527

Most read articles by the same author(s)

<< < 1 2