anthropometrics in obesity
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Anthropometrics in Obesity. Robert Kushner, MD Northwestern University Feinberg School of Medicine. Anthropometrics in Obesity. Height Weight Body Mass Index (BMI) [weight/height] 2 Kg/m 2 (lb/in) 2 x 703 Distribution of body fat Waist-hip ratio (WHR) Waist circumference - PowerPoint PPT PresentationTRANSCRIPT
Anthropometrics in Obesity
Robert Kushner, MD
Northwestern University
Feinberg School of Medicine
Anthropometrics in Obesity
Height
Weight
Body Mass Index (BMI) [weight/height]2
— Kg/m2
— (lb/in)2 x 703
Distribution of body fat— Waist-hip ratio (WHR)— Waist circumference
Body composition— Percent body fat
Anthropometrics in Obesity
Height
Weight
Body Mass Index (BMI) [weight/height]2
— Kg/m2
— (lb/in)2 x 703
Distribution of body fat— Waist-hip ratio (WHR)— Waist circumference
Body composition— Percent body fat
Body Mass Index Chart
Weight (lb)
23
22
21
19
18
17
16
15
15
25
24
22
21
20
19
18
17
16
27
26
24
23
21
20
19
18
17
29
27
26
24
23
22
20
19
18
31
29
28
26
24
23
22
21
20
33
31
29
27
26
24
23
22
21
35
33
31
29
27
26
24
23
22
37
35
33
31
29
27
26
24
23
39
37
34
32
30
29
27
26
24
41
38
36
34
32
30
29
27
26
43
40
38
36
34
32
30
28
27
45
42
40
37
35
33
31
30
28
47
44
41
39
37
35
33
31
29
49
46
43
40
38
36
34
32
30
51
48
45
42
40
37
35
33
32
53
49
46
44
41
39
37
35
33
55
51
48
45
43
40
38
36
34
57
53
50
47
44
42
39
37
35
59
55
52
49
46
43
41
39
37
63
59
55
52
48
46
43
41
40
66
62
58
55
52
49
46
44
41
70
66
62
58
55
52
49
46
44
74
70
65
61
58
55
52
49
46
78
73
69
65
61
57
54
51
49
120
130
140
150
160
170
180
190
200
210
220
320
340
360
240
250
260
230
270
280
290
380
300
400
6464
Hei
ght
(in)
6262
6060
7070
6868
6666
7272
7474
7676
Classification BMI (kg/m2) Risk
Underweight <18.5 Increased
Normal 18.5–24.9 Normal
Overweight 25.0–29.9 Increased
Obese I 30.0–34.9 High
II 35.0–39.9 Very high
III 40 Extremely high
Additional risks: • Large waist circumference (men >40 in; women >35 in)• 5 kg or more weight gain since age 18–20 y• Poor aerobic fitness• Specific races and ethnic groups
BMI-Associated Disease Risk
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. Obes Res 1998;6(suppl 2).
Multivariate relative risk of death from cardiovascular disease, cancer, and all other causes among men and Multivariate relative risk of death from cardiovascular disease, cancer, and all other causes among men and women who had never smoked and who had no history of disease at enrollment, according to body-mass index.women who had never smoked and who had no history of disease at enrollment, according to body-mass index.
The reference category was made up of subjects with a body-mass index of 23.5 to 24.9.The reference category was made up of subjects with a body-mass index of 23.5 to 24.9.
Multivariate relative risk of death from cardiovascular disease, cancer, and all other causes among men and Multivariate relative risk of death from cardiovascular disease, cancer, and all other causes among men and women who had never smoked and who had no history of disease at enrollment, according to body-mass index.women who had never smoked and who had no history of disease at enrollment, according to body-mass index.
The reference category was made up of subjects with a body-mass index of 23.5 to 24.9.The reference category was made up of subjects with a body-mass index of 23.5 to 24.9.
Relative Risk of Death From Cardiovascular Disease, Cancer, and All Other Causes
Calle EE, et al. Calle EE, et al. N Engl J Med.N Engl J Med. 1999;341:1097-1105. 1999;341:1097-1105.Calle EE, et al. Calle EE, et al. N Engl J Med.N Engl J Med. 1999;341:1097-1105. 1999;341:1097-1105.
3.23.02.82.62.42.22.01.81.61.41.21.00.80.6
Rel
ativ
e R
isk
of
Dea
th
Men
Cardiovascular diseaseCancerAll other causes
<18.
5 1
8.5-
20.4
20.5
-21.
9
22
.0-2
3.4
23.5
-24.
9
25
.0-2
6.4
26.5
-27.
9
28
.0-2
9.9
30.0
-31.
9
32
.0-3
4.9
>35.0
Body-Mass Index
Women
Rel
ativ
e R
isk
of
Dea
thBody-Mass Index
<18.
5 1
8.5-
20.4
20.5
-21.
9
22
.0-2
3.4
23.5
-24.
9
25
.0-2
6.4
26.5
-27.
9
28
.0-2
9.9
30.0
-31.
9
32
.0-3
4.9
>40.0
35.0
-39.
9
2.42.22.01.81.61.41.21.00.80.6
Relationship Between BMI and Risk of Type 2 Diabetes Mellitus
Chan J et al. Diabetes Care 1994;17:961. Colditz G et al. Ann Intern Med 1995;122:481.
Age
-Adj
uste
d R
elat
ive
Ris
k
Body Mass Index (kg/m2)
<23 24–24.9 25–26.9 27–28.9 33–34.9
0
25
50
75
100
1.02.9 4.3 5.0
8.1 15.8
27.6
40.3
54.0
93.2
<22 23–23.9 29–30.9 31–32.9 35+
1.0 1.52.2
4.46.7
11.6
21.3
42.1
1.0
Men
Women
Action BMI Ranges forAsian Populations are Lower
WHO expert consultation. Lancet 2004;363:157
High to very high risk
Adapted from: Gallagher et al. Am J Clin Nutr 2000;72:694.
Body Mass Index (kg/m2)
0
10
20
30
40
50
60
70
0 10 20 30 40 50 60
Bod
y F
at (
%)
Women
Men
Relationship Between BMI and Percent Body Fat in Men and Women
•Age
•Gender
•Race
Android Gynoid
Visceral Fat:The Critical Adipose Depot
BackBack
Immediately below the lowest rib
At the narrowest waist1
Midpoint between the lowest rib and the iliac crest2
Immediately above the iliac crest3,4
Waist CircumferenceMeasurement Sites
1. Anthropometric Standardization Reference Manual
2. World Health Organization (WHO)
3. National Institutes of Health (NIH)
4. National Health and Nutrition Examination Survey (NHANES)
How to Measure Waist Circumference
● Place a measuring tape, held parallel to the floor, around the patient’s abdomen at a designated level.
● The tape should fit snugly around the waist without compressing the skin
● Take the measurement at the end of a normal expiration
A waist circumference (at iliac crest) of ≥40 inches in men or ≥35 inches in women is diagnostic of abdominal obesity and suggests the presence of other cardiometabolic risk factors.
Adapted from Grundy SM, et al. Circulation. 2005;112:2735-2752.
Classification of overweight and obesity by BMI, waist circumference and associated disease risks
UnderweightUnderweight
NormalNormal
OverweightOverweight
ObesityObesity
Extreme obesityExtreme obesity
BMIBMI(kg/m(kg/m22))
<18.5<18.5
18.5 - 24.918.5 - 24.9
25.0 - 29.925.0 - 29.9
30.0 - 34.930.0 - 34.9
35.0 - 39.935.0 - 39.9
>40>40
ObesityObesityClassClass
II
IIII
IIIIII
Men (Men (<<102 cm) 102 cm) <<40 in 40 in Women (Women (<<88 cm) 88 cm) <<35 35
inin
----
----
IncreasedIncreased
HighHigh
Very HighVery High
Extremely HighExtremely High
Men (>102 cm) >40 in Men (>102 cm) >40 in Women (>88 cm) >35 Women (>88 cm) >35
inin
----
----
HighHigh
Very HighVery High
Very HighVery High
Extremely HighExtremely High
Disease Risk Relative to Normal Disease Risk Relative to Normal Weight and Waist CircumferenceWeight and Waist Circumference
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. Obes Res 1998;6(suppl 2).
Metabolic Syndrome: Refined Criteria (IDF)
Population Group Waist Circumference (inches)
Men Women
USA (NCEP ATP III) >40 >35
European >37 >30.5
South Asian/ >35.5 >30.5
Chinese
Japanese >33.5 >35.5
Body Composition (body fat)
Skinfold Anthropometry
Bioelectrical impedance analysis (BIA)
Dual-energy x-ray absorptiometry (DEXA)
Computed tomography (CT scan)— Abdominal visceral fat
Assessing Canine Obesity
Optimal Overweight ObeseBCS=5 BCS= 6-7 BCS = 8-9