Basic Methods For Measurement Of Obesity:
The basic methods used to measure obesity are the following:
i- Body Mass Index (BMI).
ii- Skin Fold Thickness (SFT).
iii- Waist-Hip Ratio (Circumference).
I- Body Mass Index:
The Body Mass Index (BMI) is the most preferred measure of excess weight to estimat relative
risk in epidemiological studies . It is inexpensive and efficient to collect , requiring only the
acquisition of body weight and height .
Weight and height are regularly collected in a variety of nationally representative surveys such
as the National Nutrition and Examination Surveys (NHANES) and the National Health
Examination Surveys (NHES)
The BMI correlates with total body fat content , and morbidity and mortality , and can be applied
generally to adults. While percentage of BMI are preferred when evaluating excess weight in
children, collection of weight, height, age, and gender are only necessary.
BMI is calculated by measuring a person’s weight in kilograms and then dividing by the person’s
height in meters squared (kg/m2) . For example , an adult weighing 70kg with a height of 1.75
meters has a BMI of 70/ 1.752 = 22.9 .
The advantage of this index rather than the use of weight alone is that it is height-independent,
such that tall and short people of similar proportions have similar BMI. Ideal body weight may
also be defined as 100%, with overweight as 101% to 119% and obese as >120% of normal.
For children weight excess can also be classified according to the BMI using
standardized reference curves . A child whose BMI is above 99.6% is usually considered
overweight and requires remedial action . However. the child with BMI of 98-99.6% may also
have a weight problem, but in certain individuals, such as boys who are stocky and muscular,
the BMI may appear in the high range and yet not be indicative of excess fat. This makes the
BMI in children far less reliable as an indicator of excess fat than adults.
II- Skin Fold Thickness :
Body fat content may be measured using a number of techniques. The simplest method
involves measuring skin-thickness at four sites using a spring-loaded caliper and then applying
the values to publish equations:
1-Biceps: at the mid-point of the muscle with the arm hanging vertically .
2-Triceps: at a point equivalent from the acromion and the olecranon .
3-Sub-scapular: just below the tip of the inferior angle of the scapula.
4-Supra-iliac: over the iliac crest in the mid-axillary line .
To make the measurements the patients have to be undressed.
Table 2 presents measurements of skin thickness at the above four sites and of body density
by underwater weighing on 209 men and 272 women.
More exacting methods employ underwater weighing, isotopic measurement of whole body
potassium content – an index of lean (non-fat) mass, or impedance analysis. The latter
depends on the difference in electric resistance between lean tissues and fat. Normal body fat
content of an adult is 10-20% in men, and 20-30% in women. While abdominal fat can be
measured using the ratio of waist circumference to height.
III- Waist-Hip Ratio:
The waist-hip ratio is the waist circumference in centimeters divided by the hip
Circumference in centimeters.
The waist circumference is usually measured half-way between the superior iliac crest and the
rib cage in the mid-axillary line, whereas the hip circumference is measured one-third of the
distance between the superior iliac spine and the patella . If the waist-hip ratio in abdominal
obesity is >0.95 in males or >0.8 in females it forms a risk with patients associated with
diseases such as hypertension, hyperlipidaemia, insulin resistance, diabetes mellitus, and
cardiovascular diseases.
Lately, research has indicated that measurement of waist circumference alone might suffice to
define disease risk of intra-abdominal fat
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