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Re: New Obesity Index Proposed, But Further Work Needed

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This does seem more useful than BMI but wouldn't hip circumfrence miss the very

apple - build people, those who don't have much hip storage. The ethnic

populations it has been tested with tend to have more caboose action than whites

or Asians. (I am a pear and relate more to J Lo. than J An.)

" Muffin top " problems in low rise jeans led to tops with a gathered lower

waist-line to cover up the overflow. Fashion found a way to fix its own faux

pas.

R Vajda, R.D.

________________________________

To: RD-USA <rd-usa >

Sent: Fri, March 4, 2011 4:08:09 PM

Subject: New Obesity Index Proposed, But Further Work Needed

US researchers have developed a new index of adiposity that they say is a

more accurate measure of body fat than the traditionally used body-mass

index (BMI); the latter is calculated by dividing weight by height [1].

Using measurements of hip circumference and height, the new body adiposity

index (BAI) can be used to reflect percentage of body fat for adult men and

women of differing ethnicities, without numerical correction or assessment

of weight, say *Dr N Bergman* (University of Southern California,

Los Angeles) and colleagues in their paper published online March 3, 2011 in

*Obesity*.

However, they note that further work will be needed to extend and confirm

their findings--tested in Mexican Americans and African Americans--to whites

and other ethnic groups and to assess the role of the new index in children.

And " it remains to be seen if the BAI is a more useful predictor of health

outcome, in both males and females, than other indexes of body adiposity,

including the BMI itself. "

*Height and Hip Size Most Strongly Relate to Percentage Adiposity *

" We were interested in determining whether we could find an index of body

adiposity that at least in some ways may be better than the BMI, which has

been around since the 1840s " and is not a very accurate measure of adiposity

in individual patients, Bergman explained to* heartwire *. BMI is

particularly inaccurate in people with elevated lean body mass, such as

athletes, and in children, and it cannot be generalized among different

ethnic groups, he and his colleagues note.

Bergman et al are not the first to propose an alternative to BMI. Waist

circumference is widely thought to be a better indicator of cardiovascular

risk than BMI, although some studies have shown them to be equally

predictive. Other examples include the waist-to-hip ratio (WHR) and the

waist-to-hip-to-height index, which have both been forwarded as potentially

better measures of obesity than BMI. But critics have said that it is

difficult and time-consuming to get very accurate measurements of waist and

hip circumference and height and that BMI has remained popular because it is

simple and fast.

In their study, Bergman and colleagues used a large database, *BetaGene*,

which consisted of relatives of Mexican Americans with gestational diabetes,

to determine whether there might be a better index. They chose the Mexican

American population because of its prevalence in Los Angeles, observing,

" Most of the world population is nonwhite. "

" We looked at which variables most strongly related to percent adiposity,

and they were height and hip size. Because these variables were

uncorrelated, we proposed a new index, the BAI, based upon these measures

alone, " Bergman explains.

*BAI Will Be Easy to Calculate*

" We showed that the BAI, calculated as (hip circumference/height1.5)–18, was

a good predictor of percent fat and worked for men and women, " he

continues. The BAI also yielded the percentage of fat itself, rather than

just a correlate (or index) of it, which is what the BMI does, he notes. The

BAI was validated against the " gold standard " of dual-energy X-ray

absorption (DEXA).

" It will be very easy for a physician or a nurse practitioner to work out

this index for individual patients, using a calculator, a computer program,

or an iPhone app, " Bergman says.

The researchers then went on to corroborate their findings in another

population, the *Triglyceride and Cardiovascular Risk in African

Americans*(TARA) study, and found that the behavior of the BAI was

quite similar

between the blacks in that population and the Hispanics in BetaGene.

" Thus, we believe that we have presented evidence of accuracy at least in

two ethnic populations, and further work on the generalizability of BAI to

other groups is under way, " they state. It will also be important to see

whether the index can reliably forecast percentage of adiposity in children

and predict risk of cardiovascular disease, they note.

medscape.com

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <http://www.xtranormal.com/watch/11216383/>

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

Link to comment
Share on other sites

Guest guest

This does seem more useful than BMI but wouldn't hip circumfrence miss the very

apple - build people, those who don't have much hip storage. The ethnic

populations it has been tested with tend to have more caboose action than whites

or Asians. (I am a pear and relate more to J Lo. than J An.)

" Muffin top " problems in low rise jeans led to tops with a gathered lower

waist-line to cover up the overflow. Fashion found a way to fix its own faux

pas.

R Vajda, R.D.

________________________________

To: RD-USA <rd-usa >

Sent: Fri, March 4, 2011 4:08:09 PM

Subject: New Obesity Index Proposed, But Further Work Needed

US researchers have developed a new index of adiposity that they say is a

more accurate measure of body fat than the traditionally used body-mass

index (BMI); the latter is calculated by dividing weight by height [1].

Using measurements of hip circumference and height, the new body adiposity

index (BAI) can be used to reflect percentage of body fat for adult men and

women of differing ethnicities, without numerical correction or assessment

of weight, say *Dr N Bergman* (University of Southern California,

Los Angeles) and colleagues in their paper published online March 3, 2011 in

*Obesity*.

However, they note that further work will be needed to extend and confirm

their findings--tested in Mexican Americans and African Americans--to whites

and other ethnic groups and to assess the role of the new index in children.

And " it remains to be seen if the BAI is a more useful predictor of health

outcome, in both males and females, than other indexes of body adiposity,

including the BMI itself. "

*Height and Hip Size Most Strongly Relate to Percentage Adiposity *

" We were interested in determining whether we could find an index of body

adiposity that at least in some ways may be better than the BMI, which has

been around since the 1840s " and is not a very accurate measure of adiposity

in individual patients, Bergman explained to* heartwire *. BMI is

particularly inaccurate in people with elevated lean body mass, such as

athletes, and in children, and it cannot be generalized among different

ethnic groups, he and his colleagues note.

Bergman et al are not the first to propose an alternative to BMI. Waist

circumference is widely thought to be a better indicator of cardiovascular

risk than BMI, although some studies have shown them to be equally

predictive. Other examples include the waist-to-hip ratio (WHR) and the

waist-to-hip-to-height index, which have both been forwarded as potentially

better measures of obesity than BMI. But critics have said that it is

difficult and time-consuming to get very accurate measurements of waist and

hip circumference and height and that BMI has remained popular because it is

simple and fast.

In their study, Bergman and colleagues used a large database, *BetaGene*,

which consisted of relatives of Mexican Americans with gestational diabetes,

to determine whether there might be a better index. They chose the Mexican

American population because of its prevalence in Los Angeles, observing,

" Most of the world population is nonwhite. "

" We looked at which variables most strongly related to percent adiposity,

and they were height and hip size. Because these variables were

uncorrelated, we proposed a new index, the BAI, based upon these measures

alone, " Bergman explains.

*BAI Will Be Easy to Calculate*

" We showed that the BAI, calculated as (hip circumference/height1.5)–18, was

a good predictor of percent fat and worked for men and women, " he

continues. The BAI also yielded the percentage of fat itself, rather than

just a correlate (or index) of it, which is what the BMI does, he notes. The

BAI was validated against the " gold standard " of dual-energy X-ray

absorption (DEXA).

" It will be very easy for a physician or a nurse practitioner to work out

this index for individual patients, using a calculator, a computer program,

or an iPhone app, " Bergman says.

The researchers then went on to corroborate their findings in another

population, the *Triglyceride and Cardiovascular Risk in African

Americans*(TARA) study, and found that the behavior of the BAI was

quite similar

between the blacks in that population and the Hispanics in BetaGene.

" Thus, we believe that we have presented evidence of accuracy at least in

two ethnic populations, and further work on the generalizability of BAI to

other groups is under way, " they state. It will also be important to see

whether the index can reliably forecast percentage of adiposity in children

and predict risk of cardiovascular disease, they note.

medscape.com

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <http://www.xtranormal.com/watch/11216383/>

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

Link to comment
Share on other sites

Guest guest

Exactly what I was thinking re: waist circumference would seem to be a

better indicator....

On Fri, Mar 4, 2011 at 8:05 PM, Vajda wrote:

>

>

> This does seem more useful than BMI but wouldn't hip circumfrence miss the

> very

> apple - build people, those who don't have much hip storage. The ethnic

> populations it has been tested with tend to have more caboose action than

> whites

> or Asians. (I am a pear and relate more to J Lo. than J An.)

>

> " Muffin top " problems in low rise jeans led to tops with a gathered lower

> waist-line to cover up the overflow. Fashion found a way to fix its own

> faux

> pas.

>

> R Vajda, R.D.

>

>

> ________________________________

>

> To: RD-USA <rd-usa >

> Sent: Fri, March 4, 2011 4:08:09 PM

> Subject: New Obesity Index Proposed, But Further Work Needed

>

>

> US researchers have developed a new index of adiposity that they say is a

> more accurate measure of body fat than the traditionally used body-mass

> index (BMI); the latter is calculated by dividing weight by height [1].

>

> Using measurements of hip circumference and height, the new body adiposity

> index (BAI) can be used to reflect percentage of body fat for adult men and

> women of differing ethnicities, without numerical correction or assessment

> of weight, say *Dr N Bergman* (University of Southern California,

> Los Angeles) and colleagues in their paper published online March 3, 2011

> in

> *Obesity*.

>

> However, they note that further work will be needed to extend and confirm

> their findings--tested in Mexican Americans and African Americans--to

> whites

> and other ethnic groups and to assess the role of the new index in

> children.

> And " it remains to be seen if the BAI is a more useful predictor of health

> outcome, in both males and females, than other indexes of body adiposity,

> including the BMI itself. "

>

> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>

> " We were interested in determining whether we could find an index of body

> adiposity that at least in some ways may be better than the BMI, which has

> been around since the 1840s " and is not a very accurate measure of

> adiposity

> in individual patients, Bergman explained to* heartwire *. BMI is

> particularly inaccurate in people with elevated lean body mass, such as

> athletes, and in children, and it cannot be generalized among different

> ethnic groups, he and his colleagues note.

>

> Bergman et al are not the first to propose an alternative to BMI. Waist

> circumference is widely thought to be a better indicator of cardiovascular

> risk than BMI, although some studies have shown them to be equally

> predictive. Other examples include the waist-to-hip ratio (WHR) and the

> waist-to-hip-to-height index, which have both been forwarded as potentially

> better measures of obesity than BMI. But critics have said that it is

> difficult and time-consuming to get very accurate measurements of waist and

> hip circumference and height and that BMI has remained popular because it

> is

> simple and fast.

>

> In their study, Bergman and colleagues used a large database, *BetaGene*,

> which consisted of relatives of Mexican Americans with gestational

> diabetes,

> to determine whether there might be a better index. They chose the Mexican

> American population because of its prevalence in Los Angeles, observing,

> " Most of the world population is nonwhite. "

>

> " We looked at which variables most strongly related to percent adiposity,

> and they were height and hip size. Because these variables were

> uncorrelated, we proposed a new index, the BAI, based upon these measures

> alone, " Bergman explains.

>

> *BAI Will Be Easy to Calculate*

>

> " We showed that the BAI, calculated as (hip circumference/height1.5)–18,

> was

> a good predictor of percent fat and worked for men and women, " he

> continues. The BAI also yielded the percentage of fat itself, rather than

> just a correlate (or index) of it, which is what the BMI does, he notes.

> The

> BAI was validated against the " gold standard " of dual-energy X-ray

> absorption (DEXA).

>

> " It will be very easy for a physician or a nurse practitioner to work out

> this index for individual patients, using a calculator, a computer program,

> or an iPhone app, " Bergman says.

>

> The researchers then went on to corroborate their findings in another

> population, the *Triglyceride and Cardiovascular Risk in African

> Americans*(TARA) study, and found that the behavior of the BAI was

> quite similar

> between the blacks in that population and the Hispanics in BetaGene.

>

> " Thus, we believe that we have presented evidence of accuracy at least in

> two ethnic populations, and further work on the generalizability of BAI to

> other groups is under way, " they state. It will also be important to see

> whether the index can reliably forecast percentage of adiposity in children

> and predict risk of cardiovascular disease, they note.

>

> medscape.com

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

> Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <http://www.xtranormal.com/watch/11216383/>

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

Link to comment
Share on other sites

Guest guest

Exactly what I was thinking re: waist circumference would seem to be a

better indicator....

On Fri, Mar 4, 2011 at 8:05 PM, Vajda wrote:

>

>

> This does seem more useful than BMI but wouldn't hip circumfrence miss the

> very

> apple - build people, those who don't have much hip storage. The ethnic

> populations it has been tested with tend to have more caboose action than

> whites

> or Asians. (I am a pear and relate more to J Lo. than J An.)

>

> " Muffin top " problems in low rise jeans led to tops with a gathered lower

> waist-line to cover up the overflow. Fashion found a way to fix its own

> faux

> pas.

>

> R Vajda, R.D.

>

>

> ________________________________

>

> To: RD-USA <rd-usa >

> Sent: Fri, March 4, 2011 4:08:09 PM

> Subject: New Obesity Index Proposed, But Further Work Needed

>

>

> US researchers have developed a new index of adiposity that they say is a

> more accurate measure of body fat than the traditionally used body-mass

> index (BMI); the latter is calculated by dividing weight by height [1].

>

> Using measurements of hip circumference and height, the new body adiposity

> index (BAI) can be used to reflect percentage of body fat for adult men and

> women of differing ethnicities, without numerical correction or assessment

> of weight, say *Dr N Bergman* (University of Southern California,

> Los Angeles) and colleagues in their paper published online March 3, 2011

> in

> *Obesity*.

>

> However, they note that further work will be needed to extend and confirm

> their findings--tested in Mexican Americans and African Americans--to

> whites

> and other ethnic groups and to assess the role of the new index in

> children.

> And " it remains to be seen if the BAI is a more useful predictor of health

> outcome, in both males and females, than other indexes of body adiposity,

> including the BMI itself. "

>

> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>

> " We were interested in determining whether we could find an index of body

> adiposity that at least in some ways may be better than the BMI, which has

> been around since the 1840s " and is not a very accurate measure of

> adiposity

> in individual patients, Bergman explained to* heartwire *. BMI is

> particularly inaccurate in people with elevated lean body mass, such as

> athletes, and in children, and it cannot be generalized among different

> ethnic groups, he and his colleagues note.

>

> Bergman et al are not the first to propose an alternative to BMI. Waist

> circumference is widely thought to be a better indicator of cardiovascular

> risk than BMI, although some studies have shown them to be equally

> predictive. Other examples include the waist-to-hip ratio (WHR) and the

> waist-to-hip-to-height index, which have both been forwarded as potentially

> better measures of obesity than BMI. But critics have said that it is

> difficult and time-consuming to get very accurate measurements of waist and

> hip circumference and height and that BMI has remained popular because it

> is

> simple and fast.

>

> In their study, Bergman and colleagues used a large database, *BetaGene*,

> which consisted of relatives of Mexican Americans with gestational

> diabetes,

> to determine whether there might be a better index. They chose the Mexican

> American population because of its prevalence in Los Angeles, observing,

> " Most of the world population is nonwhite. "

>

> " We looked at which variables most strongly related to percent adiposity,

> and they were height and hip size. Because these variables were

> uncorrelated, we proposed a new index, the BAI, based upon these measures

> alone, " Bergman explains.

>

> *BAI Will Be Easy to Calculate*

>

> " We showed that the BAI, calculated as (hip circumference/height1.5)–18,

> was

> a good predictor of percent fat and worked for men and women, " he

> continues. The BAI also yielded the percentage of fat itself, rather than

> just a correlate (or index) of it, which is what the BMI does, he notes.

> The

> BAI was validated against the " gold standard " of dual-energy X-ray

> absorption (DEXA).

>

> " It will be very easy for a physician or a nurse practitioner to work out

> this index for individual patients, using a calculator, a computer program,

> or an iPhone app, " Bergman says.

>

> The researchers then went on to corroborate their findings in another

> population, the *Triglyceride and Cardiovascular Risk in African

> Americans*(TARA) study, and found that the behavior of the BAI was

> quite similar

> between the blacks in that population and the Hispanics in BetaGene.

>

> " Thus, we believe that we have presented evidence of accuracy at least in

> two ethnic populations, and further work on the generalizability of BAI to

> other groups is under way, " they state. It will also be important to see

> whether the index can reliably forecast percentage of adiposity in children

> and predict risk of cardiovascular disease, they note.

>

> medscape.com

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

> Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <http://www.xtranormal.com/watch/11216383/>

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

Link to comment
Share on other sites

Guest guest

I am glad to hear there is work towards new index.However, this one may work

only for ambulating clients/outpt settings. Hospitalized pt...how will I measure

them when they are bad bound. Someone might say " the RN would have to do that

on the initial screening " but I have hard time getting the Ht & Wt on admission,

hip circ...? I don't see it happen.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: jennyvajda@...

Date: Fri, 4 Mar 2011 17:05:49 -0800

Subject: Re: New Obesity Index Proposed, But Further Work Needed

This does seem more useful than BMI but wouldn't hip circumfrence miss the

very

apple - build people, those who don't have much hip storage. The ethnic

populations it has been tested with tend to have more caboose action than whites

or Asians. (I am a pear and relate more to J Lo. than J An.)

" Muffin top " problems in low rise jeans led to tops with a gathered lower

waist-line to cover up the overflow. Fashion found a way to fix its own faux

pas.

R Vajda, R.D.

________________________________

To: RD-USA <rd-usa >

Sent: Fri, March 4, 2011 4:08:09 PM

Subject: New Obesity Index Proposed, But Further Work Needed

US researchers have developed a new index of adiposity that they say is a

more accurate measure of body fat than the traditionally used body-mass

index (BMI); the latter is calculated by dividing weight by height [1].

Using measurements of hip circumference and height, the new body adiposity

index (BAI) can be used to reflect percentage of body fat for adult men and

women of differing ethnicities, without numerical correction or assessment

of weight, say *Dr N Bergman* (University of Southern California,

Los Angeles) and colleagues in their paper published online March 3, 2011 in

*Obesity*.

However, they note that further work will be needed to extend and confirm

their findings--tested in Mexican Americans and African Americans--to whites

and other ethnic groups and to assess the role of the new index in children.

And " it remains to be seen if the BAI is a more useful predictor of health

outcome, in both males and females, than other indexes of body adiposity,

including the BMI itself. "

*Height and Hip Size Most Strongly Relate to Percentage Adiposity *

" We were interested in determining whether we could find an index of body

adiposity that at least in some ways may be better than the BMI, which has

been around since the 1840s " and is not a very accurate measure of adiposity

in individual patients, Bergman explained to* heartwire *. BMI is

particularly inaccurate in people with elevated lean body mass, such as

athletes, and in children, and it cannot be generalized among different

ethnic groups, he and his colleagues note.

Bergman et al are not the first to propose an alternative to BMI. Waist

circumference is widely thought to be a better indicator of cardiovascular

risk than BMI, although some studies have shown them to be equally

predictive. Other examples include the waist-to-hip ratio (WHR) and the

waist-to-hip-to-height index, which have both been forwarded as potentially

better measures of obesity than BMI. But critics have said that it is

difficult and time-consuming to get very accurate measurements of waist and

hip circumference and height and that BMI has remained popular because it is

simple and fast.

In their study, Bergman and colleagues used a large database, *BetaGene*,

which consisted of relatives of Mexican Americans with gestational diabetes,

to determine whether there might be a better index. They chose the Mexican

American population because of its prevalence in Los Angeles, observing,

" Most of the world population is nonwhite. "

" We looked at which variables most strongly related to percent adiposity,

and they were height and hip size. Because these variables were

uncorrelated, we proposed a new index, the BAI, based upon these measures

alone, " Bergman explains.

*BAI Will Be Easy to Calculate*

" We showed that the BAI, calculated as (hip circumference/height1.5)–18, was

a good predictor of percent fat and worked for men and women, " he

continues. The BAI also yielded the percentage of fat itself, rather than

just a correlate (or index) of it, which is what the BMI does, he notes. The

BAI was validated against the " gold standard " of dual-energy X-ray

absorption (DEXA).

" It will be very easy for a physician or a nurse practitioner to work out

this index for individual patients, using a calculator, a computer program,

or an iPhone app, " Bergman says.

The researchers then went on to corroborate their findings in another

population, the *Triglyceride and Cardiovascular Risk in African

Americans*(TARA) study, and found that the behavior of the BAI was

quite similar

between the blacks in that population and the Hispanics in BetaGene.

" Thus, we believe that we have presented evidence of accuracy at least in

two ethnic populations, and further work on the generalizability of BAI to

other groups is under way, " they state. It will also be important to see

whether the index can reliably forecast percentage of adiposity in children

and predict risk of cardiovascular disease, they note.

medscape.com

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <http://www.xtranormal.com/watch/11216383/>

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

Link to comment
Share on other sites

Guest guest

I am glad to hear there is work towards new index.However, this one may work

only for ambulating clients/outpt settings. Hospitalized pt...how will I measure

them when they are bad bound. Someone might say " the RN would have to do that

on the initial screening " but I have hard time getting the Ht & Wt on admission,

hip circ...? I don't see it happen.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: jennyvajda@...

Date: Fri, 4 Mar 2011 17:05:49 -0800

Subject: Re: New Obesity Index Proposed, But Further Work Needed

This does seem more useful than BMI but wouldn't hip circumfrence miss the

very

apple - build people, those who don't have much hip storage. The ethnic

populations it has been tested with tend to have more caboose action than whites

or Asians. (I am a pear and relate more to J Lo. than J An.)

" Muffin top " problems in low rise jeans led to tops with a gathered lower

waist-line to cover up the overflow. Fashion found a way to fix its own faux

pas.

R Vajda, R.D.

________________________________

To: RD-USA <rd-usa >

Sent: Fri, March 4, 2011 4:08:09 PM

Subject: New Obesity Index Proposed, But Further Work Needed

US researchers have developed a new index of adiposity that they say is a

more accurate measure of body fat than the traditionally used body-mass

index (BMI); the latter is calculated by dividing weight by height [1].

Using measurements of hip circumference and height, the new body adiposity

index (BAI) can be used to reflect percentage of body fat for adult men and

women of differing ethnicities, without numerical correction or assessment

of weight, say *Dr N Bergman* (University of Southern California,

Los Angeles) and colleagues in their paper published online March 3, 2011 in

*Obesity*.

However, they note that further work will be needed to extend and confirm

their findings--tested in Mexican Americans and African Americans--to whites

and other ethnic groups and to assess the role of the new index in children.

And " it remains to be seen if the BAI is a more useful predictor of health

outcome, in both males and females, than other indexes of body adiposity,

including the BMI itself. "

*Height and Hip Size Most Strongly Relate to Percentage Adiposity *

" We were interested in determining whether we could find an index of body

adiposity that at least in some ways may be better than the BMI, which has

been around since the 1840s " and is not a very accurate measure of adiposity

in individual patients, Bergman explained to* heartwire *. BMI is

particularly inaccurate in people with elevated lean body mass, such as

athletes, and in children, and it cannot be generalized among different

ethnic groups, he and his colleagues note.

Bergman et al are not the first to propose an alternative to BMI. Waist

circumference is widely thought to be a better indicator of cardiovascular

risk than BMI, although some studies have shown them to be equally

predictive. Other examples include the waist-to-hip ratio (WHR) and the

waist-to-hip-to-height index, which have both been forwarded as potentially

better measures of obesity than BMI. But critics have said that it is

difficult and time-consuming to get very accurate measurements of waist and

hip circumference and height and that BMI has remained popular because it is

simple and fast.

In their study, Bergman and colleagues used a large database, *BetaGene*,

which consisted of relatives of Mexican Americans with gestational diabetes,

to determine whether there might be a better index. They chose the Mexican

American population because of its prevalence in Los Angeles, observing,

" Most of the world population is nonwhite. "

" We looked at which variables most strongly related to percent adiposity,

and they were height and hip size. Because these variables were

uncorrelated, we proposed a new index, the BAI, based upon these measures

alone, " Bergman explains.

*BAI Will Be Easy to Calculate*

" We showed that the BAI, calculated as (hip circumference/height1.5)–18, was

a good predictor of percent fat and worked for men and women, " he

continues. The BAI also yielded the percentage of fat itself, rather than

just a correlate (or index) of it, which is what the BMI does, he notes. The

BAI was validated against the " gold standard " of dual-energy X-ray

absorption (DEXA).

" It will be very easy for a physician or a nurse practitioner to work out

this index for individual patients, using a calculator, a computer program,

or an iPhone app, " Bergman says.

The researchers then went on to corroborate their findings in another

population, the *Triglyceride and Cardiovascular Risk in African

Americans*(TARA) study, and found that the behavior of the BAI was

quite similar

between the blacks in that population and the Hispanics in BetaGene.

" Thus, we believe that we have presented evidence of accuracy at least in

two ethnic populations, and further work on the generalizability of BAI to

other groups is under way, " they state. It will also be important to see

whether the index can reliably forecast percentage of adiposity in children

and predict risk of cardiovascular disease, they note.

medscape.com

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <http://www.xtranormal.com/watch/11216383/>

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

Link to comment
Share on other sites

Guest guest

But there will always be exceptions - amputees, bed-bound like you said,

etc.

>

> I am glad to hear there is work towards new index.However, this one may

> work only for ambulating clients/outpt settings. Hospitalized pt...how will

> I measure them when they are bad bound. Someone might say " the RN would

> have to do that on the initial screening " but I have hard time getting the

> Ht & Wt on admission, hip circ...? I don't see it happen.

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

>

>

>

> To: rd-usa

> From: jennyvajda@...

> Date: Fri, 4 Mar 2011 17:05:49 -0800

> Subject: Re: New Obesity Index Proposed, But Further Work Needed

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> This does seem more useful than BMI but wouldn't hip circumfrence miss

> the very

>

> apple - build people, those who don't have much hip storage. The ethnic

>

> populations it has been tested with tend to have more caboose action than

> whites

>

> or Asians. (I am a pear and relate more to J Lo. than J An.)

>

>

>

> " Muffin top " problems in low rise jeans led to tops with a gathered lower

>

> waist-line to cover up the overflow. Fashion found a way to fix its own

> faux

>

> pas.

>

>

>

> R Vajda, R.D.

>

>

>

>

>

> ________________________________

>

>

>

> To: RD-USA <rd-usa >

>

> Sent: Fri, March 4, 2011 4:08:09 PM

>

> Subject: New Obesity Index Proposed, But Further Work Needed

>

>

>

> US researchers have developed a new index of adiposity that they say is a

>

> more accurate measure of body fat than the traditionally used body-mass

>

> index (BMI); the latter is calculated by dividing weight by height [1].

>

>

>

> Using measurements of hip circumference and height, the new body adiposity

>

> index (BAI) can be used to reflect percentage of body fat for adult men and

>

> women of differing ethnicities, without numerical correction or assessment

>

> of weight, say *Dr N Bergman* (University of Southern California,

>

> Los Angeles) and colleagues in their paper published online March 3, 2011

> in

>

> *Obesity*.

>

>

>

> However, they note that further work will be needed to extend and confirm

>

> their findings--tested in Mexican Americans and African Americans--to

> whites

>

> and other ethnic groups and to assess the role of the new index in

> children.

>

> And " it remains to be seen if the BAI is a more useful predictor of health

>

> outcome, in both males and females, than other indexes of body adiposity,

>

> including the BMI itself. "

>

>

>

> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>

>

>

> " We were interested in determining whether we could find an index of body

>

> adiposity that at least in some ways may be better than the BMI, which has

>

> been around since the 1840s " and is not a very accurate measure of

> adiposity

>

> in individual patients, Bergman explained to* heartwire *. BMI is

>

> particularly inaccurate in people with elevated lean body mass, such as

>

> athletes, and in children, and it cannot be generalized among different

>

> ethnic groups, he and his colleagues note.

>

>

>

> Bergman et al are not the first to propose an alternative to BMI. Waist

>

> circumference is widely thought to be a better indicator of cardiovascular

>

> risk than BMI, although some studies have shown them to be equally

>

> predictive. Other examples include the waist-to-hip ratio (WHR) and the

>

> waist-to-hip-to-height index, which have both been forwarded as potentially

>

> better measures of obesity than BMI. But critics have said that it is

>

> difficult and time-consuming to get very accurate measurements of waist and

>

> hip circumference and height and that BMI has remained popular because it

> is

>

> simple and fast.

>

>

>

> In their study, Bergman and colleagues used a large database, *BetaGene*,

>

> which consisted of relatives of Mexican Americans with gestational

> diabetes,

>

> to determine whether there might be a better index. They chose the Mexican

>

> American population because of its prevalence in Los Angeles, observing,

>

> " Most of the world population is nonwhite. "

>

>

>

> " We looked at which variables most strongly related to percent adiposity,

>

> and they were height and hip size. Because these variables were

>

> uncorrelated, we proposed a new index, the BAI, based upon these measures

>

> alone, " Bergman explains.

>

>

>

> *BAI Will Be Easy to Calculate*

>

>

>

> " We showed that the BAI, calculated as (hip circumference/height1.5)–18,

> was

>

> a good predictor of percent fat and worked for men and women, " he

>

> continues. The BAI also yielded the percentage of fat itself, rather than

>

> just a correlate (or index) of it, which is what the BMI does, he notes.

> The

>

> BAI was validated against the " gold standard " of dual-energy X-ray

>

> absorption (DEXA).

>

>

>

> " It will be very easy for a physician or a nurse practitioner to work out

>

> this index for individual patients, using a calculator, a computer program,

>

> or an iPhone app, " Bergman says.

>

>

>

> The researchers then went on to corroborate their findings in another

>

> population, the *Triglyceride and Cardiovascular Risk in African

>

> Americans*(TARA) study, and found that the behavior of the BAI was

>

> quite similar

>

> between the blacks in that population and the Hispanics in BetaGene.

>

>

>

> " Thus, we believe that we have presented evidence of accuracy at least in

>

> two ethnic populations, and further work on the generalizability of BAI to

>

> other groups is under way, " they state. It will also be important to see

>

> whether the index can reliably forecast percentage of adiposity in children

>

> and predict risk of cardiovascular disease, they note.

>

>

>

> medscape.com

>

> --

>

> Ortiz, MS, RD

>

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

>

> Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

>

> student <http://www.xtranormal.com/watch/11216383/>

>

>

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

>

>

> *at the years people have behind them but also the

>

> *

>

>

>

> *quality of the years ahead of them.*

>

>

>

>

Link to comment
Share on other sites

Guest guest

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@...

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

>

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa

>> From: jennyvajda@...

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>>

>>

>> To: RD-USA <rd-usa >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)–18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@...

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

>

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa

>> From: jennyvajda@...

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>>

>>

>> To: RD-USA <rd-usa >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)–18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

amputees we have calculations to correct, but bed bound you cannot measure to

begin with.and was hoping for a better index, not one that excludes more ppl.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Sat, 5 Mar 2011 11:01:29 -0500

> Subject: Re: New Obesity Index Proposed, But Further Work Needed

>

> But there will always be exceptions - amputees, bed-bound like you said,

> etc.

>

>

>

> >

> > I am glad to hear there is work towards new index.However, this one may

> > work only for ambulating clients/outpt settings. Hospitalized pt...how will

> > I measure them when they are bad bound. Someone might say " the RN would

> > have to do that on the initial screening " but I have hard time getting the

> > Ht & Wt on admission, hip circ...? I don't see it happen.

> >

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> >

> >

> > To: rd-usa

> > From: jennyvajda@...

> > Date: Fri, 4 Mar 2011 17:05:49 -0800

> > Subject: Re: New Obesity Index Proposed, But Further Work Needed

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > This does seem more useful than BMI but wouldn't hip circumfrence miss

> > the very

> >

> > apple - build people, those who don't have much hip storage. The ethnic

> >

> > populations it has been tested with tend to have more caboose action than

> > whites

> >

> > or Asians. (I am a pear and relate more to J Lo. than J An.)

> >

> >

> >

> > " Muffin top " problems in low rise jeans led to tops with a gathered lower

> >

> > waist-line to cover up the overflow. Fashion found a way to fix its own

> > faux

> >

> > pas.

> >

> >

> >

> > R Vajda, R.D.

> >

> >

> >

> >

> >

> > ________________________________

> >

> >

> >

> > To: RD-USA <rd-usa >

> >

> > Sent: Fri, March 4, 2011 4:08:09 PM

> >

> > Subject: New Obesity Index Proposed, But Further Work Needed

> >

> >

> >

> > US researchers have developed a new index of adiposity that they say is a

> >

> > more accurate measure of body fat than the traditionally used body-mass

> >

> > index (BMI); the latter is calculated by dividing weight by height [1].

> >

> >

> >

> > Using measurements of hip circumference and height, the new body adiposity

> >

> > index (BAI) can be used to reflect percentage of body fat for adult men and

> >

> > women of differing ethnicities, without numerical correction or assessment

> >

> > of weight, say *Dr N Bergman* (University of Southern California,

> >

> > Los Angeles) and colleagues in their paper published online March 3, 2011

> > in

> >

> > *Obesity*.

> >

> >

> >

> > However, they note that further work will be needed to extend and confirm

> >

> > their findings--tested in Mexican Americans and African Americans--to

> > whites

> >

> > and other ethnic groups and to assess the role of the new index in

> > children.

> >

> > And " it remains to be seen if the BAI is a more useful predictor of health

> >

> > outcome, in both males and females, than other indexes of body adiposity,

> >

> > including the BMI itself. "

> >

> >

> >

> > *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> >

> >

> >

> > " We were interested in determining whether we could find an index of body

> >

> > adiposity that at least in some ways may be better than the BMI, which has

> >

> > been around since the 1840s " and is not a very accurate measure of

> > adiposity

> >

> > in individual patients, Bergman explained to* heartwire *. BMI is

> >

> > particularly inaccurate in people with elevated lean body mass, such as

> >

> > athletes, and in children, and it cannot be generalized among different

> >

> > ethnic groups, he and his colleagues note.

> >

> >

> >

> > Bergman et al are not the first to propose an alternative to BMI. Waist

> >

> > circumference is widely thought to be a better indicator of cardiovascular

> >

> > risk than BMI, although some studies have shown them to be equally

> >

> > predictive. Other examples include the waist-to-hip ratio (WHR) and the

> >

> > waist-to-hip-to-height index, which have both been forwarded as potentially

> >

> > better measures of obesity than BMI. But critics have said that it is

> >

> > difficult and time-consuming to get very accurate measurements of waist and

> >

> > hip circumference and height and that BMI has remained popular because it

> > is

> >

> > simple and fast.

> >

> >

> >

> > In their study, Bergman and colleagues used a large database, *BetaGene*,

> >

> > which consisted of relatives of Mexican Americans with gestational

> > diabetes,

> >

> > to determine whether there might be a better index. They chose the Mexican

> >

> > American population because of its prevalence in Los Angeles, observing,

> >

> > " Most of the world population is nonwhite. "

> >

> >

> >

> > " We looked at which variables most strongly related to percent adiposity,

> >

> > and they were height and hip size. Because these variables were

> >

> > uncorrelated, we proposed a new index, the BAI, based upon these measures

> >

> > alone, " Bergman explains.

> >

> >

> >

> > *BAI Will Be Easy to Calculate*

> >

> >

> >

> > " We showed that the BAI, calculated as (hip circumference/height1.5)–18,

> > was

> >

> > a good predictor of percent fat and worked for men and women, " he

> >

> > continues. The BAI also yielded the percentage of fat itself, rather than

> >

> > just a correlate (or index) of it, which is what the BMI does, he notes.

> > The

> >

> > BAI was validated against the " gold standard " of dual-energy X-ray

> >

> > absorption (DEXA).

> >

> >

> >

> > " It will be very easy for a physician or a nurse practitioner to work out

> >

> > this index for individual patients, using a calculator, a computer program,

> >

> > or an iPhone app, " Bergman says.

> >

> >

> >

> > The researchers then went on to corroborate their findings in another

> >

> > population, the *Triglyceride and Cardiovascular Risk in African

> >

> > Americans*(TARA) study, and found that the behavior of the BAI was

> >

> > quite similar

> >

> > between the blacks in that population and the Hispanics in BetaGene.

> >

> >

> >

> > " Thus, we believe that we have presented evidence of accuracy at least in

> >

> > two ethnic populations, and further work on the generalizability of BAI to

> >

> > other groups is under way, " they state. It will also be important to see

> >

> > whether the index can reliably forecast percentage of adiposity in children

> >

> > and predict risk of cardiovascular disease, they note.

> >

> >

> >

> > medscape.com

> >

> > --

> >

> > Ortiz, MS, RD

> >

> > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >

> > Check out my blog: mixture of deals and nutrition

> >

> > Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

> >

> > student <http://www.xtranormal.com/watch/11216383/>

> >

> >

> >

> > *Healthy Diet at any Age: We are NOT just looking

> >

> > *

> >

> >

> >

> > *at the years people have behind them but also the

> >

> > *

> >

> >

> >

> > *quality of the years ahead of them.*

> >

> >

> >

> >

Link to comment
Share on other sites

Guest guest

amputees we have calculations to correct, but bed bound you cannot measure to

begin with.and was hoping for a better index, not one that excludes more ppl.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Sat, 5 Mar 2011 11:01:29 -0500

> Subject: Re: New Obesity Index Proposed, But Further Work Needed

>

> But there will always be exceptions - amputees, bed-bound like you said,

> etc.

>

>

>

> >

> > I am glad to hear there is work towards new index.However, this one may

> > work only for ambulating clients/outpt settings. Hospitalized pt...how will

> > I measure them when they are bad bound. Someone might say " the RN would

> > have to do that on the initial screening " but I have hard time getting the

> > Ht & Wt on admission, hip circ...? I don't see it happen.

> >

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> >

> >

> > To: rd-usa

> > From: jennyvajda@...

> > Date: Fri, 4 Mar 2011 17:05:49 -0800

> > Subject: Re: New Obesity Index Proposed, But Further Work Needed

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > This does seem more useful than BMI but wouldn't hip circumfrence miss

> > the very

> >

> > apple - build people, those who don't have much hip storage. The ethnic

> >

> > populations it has been tested with tend to have more caboose action than

> > whites

> >

> > or Asians. (I am a pear and relate more to J Lo. than J An.)

> >

> >

> >

> > " Muffin top " problems in low rise jeans led to tops with a gathered lower

> >

> > waist-line to cover up the overflow. Fashion found a way to fix its own

> > faux

> >

> > pas.

> >

> >

> >

> > R Vajda, R.D.

> >

> >

> >

> >

> >

> > ________________________________

> >

> >

> >

> > To: RD-USA <rd-usa >

> >

> > Sent: Fri, March 4, 2011 4:08:09 PM

> >

> > Subject: New Obesity Index Proposed, But Further Work Needed

> >

> >

> >

> > US researchers have developed a new index of adiposity that they say is a

> >

> > more accurate measure of body fat than the traditionally used body-mass

> >

> > index (BMI); the latter is calculated by dividing weight by height [1].

> >

> >

> >

> > Using measurements of hip circumference and height, the new body adiposity

> >

> > index (BAI) can be used to reflect percentage of body fat for adult men and

> >

> > women of differing ethnicities, without numerical correction or assessment

> >

> > of weight, say *Dr N Bergman* (University of Southern California,

> >

> > Los Angeles) and colleagues in their paper published online March 3, 2011

> > in

> >

> > *Obesity*.

> >

> >

> >

> > However, they note that further work will be needed to extend and confirm

> >

> > their findings--tested in Mexican Americans and African Americans--to

> > whites

> >

> > and other ethnic groups and to assess the role of the new index in

> > children.

> >

> > And " it remains to be seen if the BAI is a more useful predictor of health

> >

> > outcome, in both males and females, than other indexes of body adiposity,

> >

> > including the BMI itself. "

> >

> >

> >

> > *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> >

> >

> >

> > " We were interested in determining whether we could find an index of body

> >

> > adiposity that at least in some ways may be better than the BMI, which has

> >

> > been around since the 1840s " and is not a very accurate measure of

> > adiposity

> >

> > in individual patients, Bergman explained to* heartwire *. BMI is

> >

> > particularly inaccurate in people with elevated lean body mass, such as

> >

> > athletes, and in children, and it cannot be generalized among different

> >

> > ethnic groups, he and his colleagues note.

> >

> >

> >

> > Bergman et al are not the first to propose an alternative to BMI. Waist

> >

> > circumference is widely thought to be a better indicator of cardiovascular

> >

> > risk than BMI, although some studies have shown them to be equally

> >

> > predictive. Other examples include the waist-to-hip ratio (WHR) and the

> >

> > waist-to-hip-to-height index, which have both been forwarded as potentially

> >

> > better measures of obesity than BMI. But critics have said that it is

> >

> > difficult and time-consuming to get very accurate measurements of waist and

> >

> > hip circumference and height and that BMI has remained popular because it

> > is

> >

> > simple and fast.

> >

> >

> >

> > In their study, Bergman and colleagues used a large database, *BetaGene*,

> >

> > which consisted of relatives of Mexican Americans with gestational

> > diabetes,

> >

> > to determine whether there might be a better index. They chose the Mexican

> >

> > American population because of its prevalence in Los Angeles, observing,

> >

> > " Most of the world population is nonwhite. "

> >

> >

> >

> > " We looked at which variables most strongly related to percent adiposity,

> >

> > and they were height and hip size. Because these variables were

> >

> > uncorrelated, we proposed a new index, the BAI, based upon these measures

> >

> > alone, " Bergman explains.

> >

> >

> >

> > *BAI Will Be Easy to Calculate*

> >

> >

> >

> > " We showed that the BAI, calculated as (hip circumference/height1.5)–18,

> > was

> >

> > a good predictor of percent fat and worked for men and women, " he

> >

> > continues. The BAI also yielded the percentage of fat itself, rather than

> >

> > just a correlate (or index) of it, which is what the BMI does, he notes.

> > The

> >

> > BAI was validated against the " gold standard " of dual-energy X-ray

> >

> > absorption (DEXA).

> >

> >

> >

> > " It will be very easy for a physician or a nurse practitioner to work out

> >

> > this index for individual patients, using a calculator, a computer program,

> >

> > or an iPhone app, " Bergman says.

> >

> >

> >

> > The researchers then went on to corroborate their findings in another

> >

> > population, the *Triglyceride and Cardiovascular Risk in African

> >

> > Americans*(TARA) study, and found that the behavior of the BAI was

> >

> > quite similar

> >

> > between the blacks in that population and the Hispanics in BetaGene.

> >

> >

> >

> > " Thus, we believe that we have presented evidence of accuracy at least in

> >

> > two ethnic populations, and further work on the generalizability of BAI to

> >

> > other groups is under way, " they state. It will also be important to see

> >

> > whether the index can reliably forecast percentage of adiposity in children

> >

> > and predict risk of cardiovascular disease, they note.

> >

> >

> >

> > medscape.com

> >

> > --

> >

> > Ortiz, MS, RD

> >

> > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >

> > Check out my blog: mixture of deals and nutrition

> >

> > Made my own " funny but real " movie: Me interviewing a " potential " Dietetic

> >

> > student <http://www.xtranormal.com/watch/11216383/>

> >

> >

> >

> > *Healthy Diet at any Age: We are NOT just looking

> >

> > *

> >

> >

> >

> > *at the years people have behind them but also the

> >

> > *

> >

> >

> >

> > *quality of the years ahead of them.*

> >

> >

> >

> >

Link to comment
Share on other sites

Guest guest

OK. Thanks for the clarification.

:)

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: pcharney@...

Date: Sat, 5 Mar 2011 08:06:12 -0800

Subject: Re: New Obesity Index Proposed, But Further Work Needed

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@...

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

>

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa

>> From: jennyvajda@...

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>>

>>

>> To: RD-USA <rd-usa >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)–18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

OK. Thanks for the clarification.

:)

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: pcharney@...

Date: Sat, 5 Mar 2011 08:06:12 -0800

Subject: Re: New Obesity Index Proposed, But Further Work Needed

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@...

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

>

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa

>> From: jennyvajda@...

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>>

>>

>> To: RD-USA <rd-usa >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)–18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

Pam, You may be correct, but just to play the devil's advocate, I'm now

forced to calculate BMI for 80 to 90 year olds, when we all agree (except

CMS evidently) that this is not a good indicator of weight status for the

elderly. Furthermore, I always seem to be in disagreement with the MDS 3.0

calculation and determination of weight status. So, how does our analysis as

nutrition experts come into play in this case? I see the new index as just

another way to automate and take away one of more area within our expertise.

I do agree we must use all available markers, but disagree with having to

accept the cookie-cutter standard if my opinion differs.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Pam Charney

Sent: Saturday, March 05, 2011 8:06 AM

To: rd-usa

Subject: Re: New Obesity Index Proposed, But Further Work Needed

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@... <mailto:pcharney%40mac.com>

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

> On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

<mailto:meravls%40msn.com> > wrote:

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

>>

>> To: RD-USA <rd-usa <mailto:rd-usa%40yahoogroups.com> >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)-18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

Maybe hip circumference (ideally two people and a flexible, but non-stretchy

tape measure with a little grip rather than slip to the fabric) would be more

accurate than waist circ. (or BMI) in the ill population as well as health. The

waist circumference could be monitored for edema changes and the hip might

represent catabolic weight loss change. For better results an intake mst for

baseline comparison to the individual's future mst change would be more useful

than comparison to an " average " person. The prevalence of edema and dehydration

in the elderly makes tracking weight frequently seem useless.

I am not an expert on measuring the elderly but I have measured thousands of

babies, children and women. And examined tape measures at every store in town

trying to find flat, non-stretchy, but more than 60 inches, to tape to the wall,

to comply with federal regulations. (never found, used more tape on the curved

metal hardware style.)

The mid-arm circumference band is used for head circumference as well, and it

has the nice slot to hold the end in place but the plastic is slippery on the

skin. Is the mid-arm circumference band used to track edema in the lower leg or

weight loss change in catabolic patients (elderly but also anorexics or

alcoholics)?

R Vajda, R.D.

________________________________

To: rd-usa

Sent: Sat, March 5, 2011 11:46:58 AM

Subject: RE: New Obesity Index Proposed, But Further Work Needed

Pam, You may be correct, but just to play the devil's advocate, I'm now

forced to calculate BMI for 80 to 90 year olds, when we all agree (except

CMS evidently) that this is not a good indicator of weight status for the

elderly. Furthermore, I always seem to be in disagreement with the MDS 3.0

calculation and determination of weight status. So, how does our analysis as

nutrition experts come into play in this case? I see the new index as just

another way to automate and take away one of more area within our expertise.

I do agree we must use all available markers, but disagree with having to

accept the cookie-cutter standard if my opinion differs.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Pam Charney

Sent: Saturday, March 05, 2011 8:06 AM

To: rd-usa

Subject: Re: New Obesity Index Proposed, But Further Work Needed

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@... <mailto:pcharney%40mac.com>

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

> On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

<mailto:meravls%40msn.com> > wrote:

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

>>

>> To: RD-USA <rd-usa <mailto:rd-usa%40yahoogroups.com> >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)-18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

Maybe hip circumference (ideally two people and a flexible, but non-stretchy

tape measure with a little grip rather than slip to the fabric) would be more

accurate than waist circ. (or BMI) in the ill population as well as health. The

waist circumference could be monitored for edema changes and the hip might

represent catabolic weight loss change. For better results an intake mst for

baseline comparison to the individual's future mst change would be more useful

than comparison to an " average " person. The prevalence of edema and dehydration

in the elderly makes tracking weight frequently seem useless.

I am not an expert on measuring the elderly but I have measured thousands of

babies, children and women. And examined tape measures at every store in town

trying to find flat, non-stretchy, but more than 60 inches, to tape to the wall,

to comply with federal regulations. (never found, used more tape on the curved

metal hardware style.)

The mid-arm circumference band is used for head circumference as well, and it

has the nice slot to hold the end in place but the plastic is slippery on the

skin. Is the mid-arm circumference band used to track edema in the lower leg or

weight loss change in catabolic patients (elderly but also anorexics or

alcoholics)?

R Vajda, R.D.

________________________________

To: rd-usa

Sent: Sat, March 5, 2011 11:46:58 AM

Subject: RE: New Obesity Index Proposed, But Further Work Needed

Pam, You may be correct, but just to play the devil's advocate, I'm now

forced to calculate BMI for 80 to 90 year olds, when we all agree (except

CMS evidently) that this is not a good indicator of weight status for the

elderly. Furthermore, I always seem to be in disagreement with the MDS 3.0

calculation and determination of weight status. So, how does our analysis as

nutrition experts come into play in this case? I see the new index as just

another way to automate and take away one of more area within our expertise.

I do agree we must use all available markers, but disagree with having to

accept the cookie-cutter standard if my opinion differs.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Pam Charney

Sent: Saturday, March 05, 2011 8:06 AM

To: rd-usa

Subject: Re: New Obesity Index Proposed, But Further Work Needed

Merav,

That's why we learn to interpret research. An index designed for use

in healthy adults applies only to that population. Healthy adults.

Pam Charney

pcharney@... <mailto:pcharney%40mac.com>

> But there will always be exceptions - amputees, bed-bound like you

> said,

> etc.

>

> On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

<mailto:meravls%40msn.com> > wrote:

>

>>

>> I am glad to hear there is work towards new index.However, this one

>> may

>> work only for ambulating clients/outpt settings. Hospitalized

>> pt...how will

>> I measure them when they are bad bound. Someone might say " the RN

>> would

>> have to do that on the initial screening " but I have hard time

>> getting the

>> Ht & Wt on admission, hip circ...? I don't see it happen.

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the

>> moments

>> that take your breath away. " - Carlin " People don't forget

>> the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>>

>>

>> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

>> Date: Fri, 4 Mar 2011 17:05:49 -0800

>> Subject: Re: New Obesity Index Proposed, But Further Work

>> Needed

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> This does seem more useful than BMI but wouldn't hip

>> circumfrence miss

>> the very

>>

>> apple - build people, those who don't have much hip storage. The

>> ethnic

>>

>> populations it has been tested with tend to have more caboose

>> action than

>> whites

>>

>> or Asians. (I am a pear and relate more to J Lo. than J An.)

>>

>>

>>

>> " Muffin top " problems in low rise jeans led to tops with a gathered

>> lower

>>

>> waist-line to cover up the overflow. Fashion found a way to fix its

>> own

>> faux

>>

>> pas.

>>

>>

>>

>> R Vajda, R.D.

>>

>>

>>

>>

>>

>> ________________________________

>>

>> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

>>

>> To: RD-USA <rd-usa <mailto:rd-usa%40yahoogroups.com> >

>>

>> Sent: Fri, March 4, 2011 4:08:09 PM

>>

>> Subject: New Obesity Index Proposed, But Further Work Needed

>>

>>

>>

>> US researchers have developed a new index of adiposity that they

>> say is a

>>

>> more accurate measure of body fat than the traditionally used body-

>> mass

>>

>> index (BMI); the latter is calculated by dividing weight by height

>> [1].

>>

>>

>>

>> Using measurements of hip circumference and height, the new body

>> adiposity

>>

>> index (BAI) can be used to reflect percentage of body fat for adult

>> men and

>>

>> women of differing ethnicities, without numerical correction or

>> assessment

>>

>> of weight, say *Dr N Bergman* (University of Southern

>> California,

>>

>> Los Angeles) and colleagues in their paper published online March

>> 3, 2011

>> in

>>

>> *Obesity*.

>>

>>

>>

>> However, they note that further work will be needed to extend and

>> confirm

>>

>> their findings--tested in Mexican Americans and African Americans--to

>> whites

>>

>> and other ethnic groups and to assess the role of the new index in

>> children.

>>

>> And " it remains to be seen if the BAI is a more useful predictor of

>> health

>>

>> outcome, in both males and females, than other indexes of body

>> adiposity,

>>

>> including the BMI itself. "

>>

>>

>>

>> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

>>

>>

>>

>> " We were interested in determining whether we could find an index

>> of body

>>

>> adiposity that at least in some ways may be better than the BMI,

>> which has

>>

>> been around since the 1840s " and is not a very accurate measure of

>> adiposity

>>

>> in individual patients, Bergman explained to* heartwire *. BMI is

>>

>> particularly inaccurate in people with elevated lean body mass,

>> such as

>>

>> athletes, and in children, and it cannot be generalized among

>> different

>>

>> ethnic groups, he and his colleagues note.

>>

>>

>>

>> Bergman et al are not the first to propose an alternative to BMI.

>> Waist

>>

>> circumference is widely thought to be a better indicator of

>> cardiovascular

>>

>> risk than BMI, although some studies have shown them to be equally

>>

>> predictive. Other examples include the waist-to-hip ratio (WHR) and

>> the

>>

>> waist-to-hip-to-height index, which have both been forwarded as

>> potentially

>>

>> better measures of obesity than BMI. But critics have said that it is

>>

>> difficult and time-consuming to get very accurate measurements of

>> waist and

>>

>> hip circumference and height and that BMI has remained popular

>> because it

>> is

>>

>> simple and fast.

>>

>>

>>

>> In their study, Bergman and colleagues used a large database,

>> *BetaGene*,

>>

>> which consisted of relatives of Mexican Americans with gestational

>> diabetes,

>>

>> to determine whether there might be a better index. They chose the

>> Mexican

>>

>> American population because of its prevalence in Los Angeles,

>> observing,

>>

>> " Most of the world population is nonwhite. "

>>

>>

>>

>> " We looked at which variables most strongly related to percent

>> adiposity,

>>

>> and they were height and hip size. Because these variables were

>>

>> uncorrelated, we proposed a new index, the BAI, based upon these

>> measures

>>

>> alone, " Bergman explains.

>>

>>

>>

>> *BAI Will Be Easy to Calculate*

>>

>>

>>

>> " We showed that the BAI, calculated as (hip circumference/

>> height1.5)-18,

>> was

>>

>> a good predictor of percent fat and worked for men and women, " he

>>

>> continues. The BAI also yielded the percentage of fat itself,

>> rather than

>>

>> just a correlate (or index) of it, which is what the BMI does, he

>> notes.

>> The

>>

>> BAI was validated against the " gold standard " of dual-energy X-ray

>>

>> absorption (DEXA).

>>

>>

>>

>> " It will be very easy for a physician or a nurse practitioner to

>> work out

>>

>> this index for individual patients, using a calculator, a computer

>> program,

>>

>> or an iPhone app, " Bergman says.

>>

>>

>>

>> The researchers then went on to corroborate their findings in another

>>

>> population, the *Triglyceride and Cardiovascular Risk in African

>>

>> Americans*(TARA) study, and found that the behavior of the BAI was

>>

>> quite similar

>>

>> between the blacks in that population and the Hispanics in BetaGene.

>>

>>

>>

>> " Thus, we believe that we have presented evidence of accuracy at

>> least in

>>

>> two ethnic populations, and further work on the generalizability of

>> BAI to

>>

>> other groups is under way, " they state. It will also be important

>> to see

>>

>> whether the index can reliably forecast percentage of adiposity in

>> children

>>

>> and predict risk of cardiovascular disease, they note.

>>

>>

>>

>> medscape.com

>>

>> --

>>

>> Ortiz, MS, RD

>>

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>>

>> Made my own " funny but real " movie: Me interviewing a " potential "

>> Dietetic

>>

>> student <http://www.xtranormal.com/watch/11216383/>

>>

>>

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>>

>>

>> *at the years people have behind them but also the

>>

>> *

>>

>>

>>

>> *quality of the years ahead of them.*

>>

>>

>>

>>

Link to comment
Share on other sites

Guest guest

I was perhaps too brief. BMI works for the elderly; the problem is

when we attempt to apply a standard that was developed for a different

population. There is plenty of research in epidemiology demonstrating

a strong relationship between BMI and both short and long term

survival in the elderly (I cannot recall age ranges; the definition of

elderly seems to shift, especially as I get older). However, the cut

off for BMI in older populations is higher than the cut off for

younger age groups.

So, if we say that a BMI less than 18-19 in someone who is between 18

and 60 years of age requires further investigation (notice, I did not

say that a low BMI is automatically an indicator of anything), we have

to apply a higher standard to older adults. If I remember correctly,

recommendations I've seen are in the range of 22 - 24 for older folks.

I'm sure that varies if the person is community dwelling or in long

term care.

CMS won't change until someone (you?) comes forth to demonstrate that

there is sufficient evidence to do so. Just as we want to practice

based on the best available evidence, CMS is attempting to do the

same. We cannot expect them to do the work for us, so guidelines they

use won't change until there is sufficient impetus to make a change.

We throw the phrase " cookie-cutter " around all the time and I think

it's lost it's underlying meaning. What do you mean? Is it cookie

cutter to use BMI as a screening tool for the elderly? I would argue

that it's probably negligent to not evaluate weight status using some

sort of standard for comparison.

Regards,

pam

Pam Charney, PhD, RD

Affiliate Associate Professor

Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

pcharney@...

http://www.linkedin.com/in/pamcharney

> Pam, You may be correct, but just to play the devil's advocate, I'm

> now

> forced to calculate BMI for 80 to 90 year olds, when we all agree

> (except

> CMS evidently) that this is not a good indicator of weight status

> for the

> elderly. Furthermore, I always seem to be in disagreement with the

> MDS 3.0

> calculation and determination of weight status. So, how does our

> analysis as

> nutrition experts come into play in this case? I see the new index

> as just

> another way to automate and take away one of more area within our

> expertise.

> I do agree we must use all available markers, but disagree with

> having to

> accept the cookie-cutter standard if my opinion differs.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On

> Behalf Of

> Pam Charney

> Sent: Saturday, March 05, 2011 8:06 AM

> To: rd-usa

> Subject: Re: New Obesity Index Proposed, But Further Work

> Needed

>

> Merav,

>

> That's why we learn to interpret research. An index designed for use

> in healthy adults applies only to that population. Healthy adults.

>

> Pam Charney

> pcharney@... <mailto:pcharney%40mac.com>

>

>

>

> > But there will always be exceptions - amputees, bed-bound like you

> > said,

> > etc.

> >

> > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> <mailto:meravls%40msn.com> > wrote:

> >

> >>

> >> I am glad to hear there is work towards new index.However, this one

> >> may

> >> work only for ambulating clients/outpt settings. Hospitalized

> >> pt...how will

> >> I measure them when they are bad bound. Someone might say " the RN

> >> would

> >> have to do that on the initial screening " but I have hard time

> >> getting the

> >> Ht & Wt on admission, hip circ...? I don't see it happen.

> >>

> >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> >> http://www.linkedin.com/in/meravlevi

> >>

> >> " Life is not measured by the number of breath you take, but by the

> >> moments

> >> that take your breath away. " - Carlin " People don't forget

> >> the truth,

> >> they just become better in lying " (Revolutionary Road)

> >>

> >>

> >>

> >>

> >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

> >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> >> Subject: Re: New Obesity Index Proposed, But Further Work

> >> Needed

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >> This does seem more useful than BMI but wouldn't hip

> >> circumfrence miss

> >> the very

> >>

> >> apple - build people, those who don't have much hip storage. The

> >> ethnic

> >>

> >> populations it has been tested with tend to have more caboose

> >> action than

> >> whites

> >>

> >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> >>

> >>

> >>

> >> " Muffin top " problems in low rise jeans led to tops with a gathered

> >> lower

> >>

> >> waist-line to cover up the overflow. Fashion found a way to fix its

> >> own

> >> faux

> >>

> >> pas.

> >>

> >>

> >>

> >> R Vajda, R.D.

> >>

> >>

> >>

> >>

> >>

> >> ________________________________

> >>

> >> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

> >>

> >> To: RD-USA <rd-usa <mailto:rd-usa

> %40yahoogroups.com> >

> >>

> >> Sent: Fri, March 4, 2011 4:08:09 PM

> >>

> >> Subject: New Obesity Index Proposed, But Further Work

> Needed

> >>

> >>

> >>

> >> US researchers have developed a new index of adiposity that they

> >> say is a

> >>

> >> more accurate measure of body fat than the traditionally used body-

> >> mass

> >>

> >> index (BMI); the latter is calculated by dividing weight by height

> >> [1].

> >>

> >>

> >>

> >> Using measurements of hip circumference and height, the new body

> >> adiposity

> >>

> >> index (BAI) can be used to reflect percentage of body fat for adult

> >> men and

> >>

> >> women of differing ethnicities, without numerical correction or

> >> assessment

> >>

> >> of weight, say *Dr N Bergman* (University of Southern

> >> California,

> >>

> >> Los Angeles) and colleagues in their paper published online March

> >> 3, 2011

> >> in

> >>

> >> *Obesity*.

> >>

> >>

> >>

> >> However, they note that further work will be needed to extend and

> >> confirm

> >>

> >> their findings--tested in Mexican Americans and African

> Americans--to

> >> whites

> >>

> >> and other ethnic groups and to assess the role of the new index in

> >> children.

> >>

> >> And " it remains to be seen if the BAI is a more useful predictor of

> >> health

> >>

> >> outcome, in both males and females, than other indexes of body

> >> adiposity,

> >>

> >> including the BMI itself. "

> >>

> >>

> >>

> >> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> >>

> >>

> >>

> >> " We were interested in determining whether we could find an index

> >> of body

> >>

> >> adiposity that at least in some ways may be better than the BMI,

> >> which has

> >>

> >> been around since the 1840s " and is not a very accurate measure of

> >> adiposity

> >>

> >> in individual patients, Bergman explained to* heartwire *. BMI is

> >>

> >> particularly inaccurate in people with elevated lean body mass,

> >> such as

> >>

> >> athletes, and in children, and it cannot be generalized among

> >> different

> >>

> >> ethnic groups, he and his colleagues note.

> >>

> >>

> >>

> >> Bergman et al are not the first to propose an alternative to BMI.

> >> Waist

> >>

> >> circumference is widely thought to be a better indicator of

> >> cardiovascular

> >>

> >> risk than BMI, although some studies have shown them to be equally

> >>

> >> predictive. Other examples include the waist-to-hip ratio (WHR) and

> >> the

> >>

> >> waist-to-hip-to-height index, which have both been forwarded as

> >> potentially

> >>

> >> better measures of obesity than BMI. But critics have said that

> it is

> >>

> >> difficult and time-consuming to get very accurate measurements of

> >> waist and

> >>

> >> hip circumference and height and that BMI has remained popular

> >> because it

> >> is

> >>

> >> simple and fast.

> >>

> >>

> >>

> >> In their study, Bergman and colleagues used a large database,

> >> *BetaGene*,

> >>

> >> which consisted of relatives of Mexican Americans with gestational

> >> diabetes,

> >>

> >> to determine whether there might be a better index. They chose the

> >> Mexican

> >>

> >> American population because of its prevalence in Los Angeles,

> >> observing,

> >>

> >> " Most of the world population is nonwhite. "

> >>

> >>

> >>

> >> " We looked at which variables most strongly related to percent

> >> adiposity,

> >>

> >> and they were height and hip size. Because these variables were

> >>

> >> uncorrelated, we proposed a new index, the BAI, based upon these

> >> measures

> >>

> >> alone, " Bergman explains.

> >>

> >>

> >>

> >> *BAI Will Be Easy to Calculate*

> >>

> >>

> >>

> >> " We showed that the BAI, calculated as (hip circumference/

> >> height1.5)-18,

> >> was

> >>

> >> a good predictor of percent fat and worked for men and women, " he

> >>

> >> continues. The BAI also yielded the percentage of fat itself,

> >> rather than

> >>

> >> just a correlate (or index) of it, which is what the BMI does, he

> >> notes.

> >> The

> >>

> >> BAI was validated against the " gold standard " of dual-energy X-ray

> >>

> >> absorption (DEXA).

> >>

> >>

> >>

> >> " It will be very easy for a physician or a nurse practitioner to

> >> work out

> >>

> >> this index for individual patients, using a calculator, a computer

> >> program,

> >>

> >> or an iPhone app, " Bergman says.

> >>

> >>

> >>

> >> The researchers then went on to corroborate their findings in

> another

> >>

> >> population, the *Triglyceride and Cardiovascular Risk in African

> >>

> >> Americans*(TARA) study, and found that the behavior of the BAI was

> >>

> >> quite similar

> >>

> >> between the blacks in that population and the Hispanics in

> BetaGene.

> >>

> >>

> >>

> >> " Thus, we believe that we have presented evidence of accuracy at

> >> least in

> >>

> >> two ethnic populations, and further work on the generalizability of

> >> BAI to

> >>

> >> other groups is under way, " they state. It will also be important

> >> to see

> >>

> >> whether the index can reliably forecast percentage of adiposity in

> >> children

> >>

> >> and predict risk of cardiovascular disease, they note.

> >>

> >>

> >>

> >> medscape.com

> >>

> >> --

> >>

> >> Ortiz, MS, RD

> >>

> >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >>

> >> Check out my blog: mixture of deals and nutrition

> >>

> >> Made my own " funny but real " movie: Me interviewing a " potential "

> >> Dietetic

> >>

> >> student <http://www.xtranormal.com/watch/11216383/>

> >>

> >>

> >>

> >> *Healthy Diet at any Age: We are NOT just looking

> >>

> >> *

> >>

> >>

> >>

> >> *at the years people have behind them but also the

> >>

> >> *

> >>

> >>

> >>

> >> *quality of the years ahead of them.*

> >>

> >>

> >>

> >>

Link to comment
Share on other sites

Guest guest

I was perhaps too brief. BMI works for the elderly; the problem is

when we attempt to apply a standard that was developed for a different

population. There is plenty of research in epidemiology demonstrating

a strong relationship between BMI and both short and long term

survival in the elderly (I cannot recall age ranges; the definition of

elderly seems to shift, especially as I get older). However, the cut

off for BMI in older populations is higher than the cut off for

younger age groups.

So, if we say that a BMI less than 18-19 in someone who is between 18

and 60 years of age requires further investigation (notice, I did not

say that a low BMI is automatically an indicator of anything), we have

to apply a higher standard to older adults. If I remember correctly,

recommendations I've seen are in the range of 22 - 24 for older folks.

I'm sure that varies if the person is community dwelling or in long

term care.

CMS won't change until someone (you?) comes forth to demonstrate that

there is sufficient evidence to do so. Just as we want to practice

based on the best available evidence, CMS is attempting to do the

same. We cannot expect them to do the work for us, so guidelines they

use won't change until there is sufficient impetus to make a change.

We throw the phrase " cookie-cutter " around all the time and I think

it's lost it's underlying meaning. What do you mean? Is it cookie

cutter to use BMI as a screening tool for the elderly? I would argue

that it's probably negligent to not evaluate weight status using some

sort of standard for comparison.

Regards,

pam

Pam Charney, PhD, RD

Affiliate Associate Professor

Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

pcharney@...

http://www.linkedin.com/in/pamcharney

> Pam, You may be correct, but just to play the devil's advocate, I'm

> now

> forced to calculate BMI for 80 to 90 year olds, when we all agree

> (except

> CMS evidently) that this is not a good indicator of weight status

> for the

> elderly. Furthermore, I always seem to be in disagreement with the

> MDS 3.0

> calculation and determination of weight status. So, how does our

> analysis as

> nutrition experts come into play in this case? I see the new index

> as just

> another way to automate and take away one of more area within our

> expertise.

> I do agree we must use all available markers, but disagree with

> having to

> accept the cookie-cutter standard if my opinion differs.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On

> Behalf Of

> Pam Charney

> Sent: Saturday, March 05, 2011 8:06 AM

> To: rd-usa

> Subject: Re: New Obesity Index Proposed, But Further Work

> Needed

>

> Merav,

>

> That's why we learn to interpret research. An index designed for use

> in healthy adults applies only to that population. Healthy adults.

>

> Pam Charney

> pcharney@... <mailto:pcharney%40mac.com>

>

>

>

> > But there will always be exceptions - amputees, bed-bound like you

> > said,

> > etc.

> >

> > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> <mailto:meravls%40msn.com> > wrote:

> >

> >>

> >> I am glad to hear there is work towards new index.However, this one

> >> may

> >> work only for ambulating clients/outpt settings. Hospitalized

> >> pt...how will

> >> I measure them when they are bad bound. Someone might say " the RN

> >> would

> >> have to do that on the initial screening " but I have hard time

> >> getting the

> >> Ht & Wt on admission, hip circ...? I don't see it happen.

> >>

> >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> >> http://www.linkedin.com/in/meravlevi

> >>

> >> " Life is not measured by the number of breath you take, but by the

> >> moments

> >> that take your breath away. " - Carlin " People don't forget

> >> the truth,

> >> they just become better in lying " (Revolutionary Road)

> >>

> >>

> >>

> >>

> >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

> >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> >> Subject: Re: New Obesity Index Proposed, But Further Work

> >> Needed

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >> This does seem more useful than BMI but wouldn't hip

> >> circumfrence miss

> >> the very

> >>

> >> apple - build people, those who don't have much hip storage. The

> >> ethnic

> >>

> >> populations it has been tested with tend to have more caboose

> >> action than

> >> whites

> >>

> >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> >>

> >>

> >>

> >> " Muffin top " problems in low rise jeans led to tops with a gathered

> >> lower

> >>

> >> waist-line to cover up the overflow. Fashion found a way to fix its

> >> own

> >> faux

> >>

> >> pas.

> >>

> >>

> >>

> >> R Vajda, R.D.

> >>

> >>

> >>

> >>

> >>

> >> ________________________________

> >>

> >> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

> >>

> >> To: RD-USA <rd-usa <mailto:rd-usa

> %40yahoogroups.com> >

> >>

> >> Sent: Fri, March 4, 2011 4:08:09 PM

> >>

> >> Subject: New Obesity Index Proposed, But Further Work

> Needed

> >>

> >>

> >>

> >> US researchers have developed a new index of adiposity that they

> >> say is a

> >>

> >> more accurate measure of body fat than the traditionally used body-

> >> mass

> >>

> >> index (BMI); the latter is calculated by dividing weight by height

> >> [1].

> >>

> >>

> >>

> >> Using measurements of hip circumference and height, the new body

> >> adiposity

> >>

> >> index (BAI) can be used to reflect percentage of body fat for adult

> >> men and

> >>

> >> women of differing ethnicities, without numerical correction or

> >> assessment

> >>

> >> of weight, say *Dr N Bergman* (University of Southern

> >> California,

> >>

> >> Los Angeles) and colleagues in their paper published online March

> >> 3, 2011

> >> in

> >>

> >> *Obesity*.

> >>

> >>

> >>

> >> However, they note that further work will be needed to extend and

> >> confirm

> >>

> >> their findings--tested in Mexican Americans and African

> Americans--to

> >> whites

> >>

> >> and other ethnic groups and to assess the role of the new index in

> >> children.

> >>

> >> And " it remains to be seen if the BAI is a more useful predictor of

> >> health

> >>

> >> outcome, in both males and females, than other indexes of body

> >> adiposity,

> >>

> >> including the BMI itself. "

> >>

> >>

> >>

> >> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> >>

> >>

> >>

> >> " We were interested in determining whether we could find an index

> >> of body

> >>

> >> adiposity that at least in some ways may be better than the BMI,

> >> which has

> >>

> >> been around since the 1840s " and is not a very accurate measure of

> >> adiposity

> >>

> >> in individual patients, Bergman explained to* heartwire *. BMI is

> >>

> >> particularly inaccurate in people with elevated lean body mass,

> >> such as

> >>

> >> athletes, and in children, and it cannot be generalized among

> >> different

> >>

> >> ethnic groups, he and his colleagues note.

> >>

> >>

> >>

> >> Bergman et al are not the first to propose an alternative to BMI.

> >> Waist

> >>

> >> circumference is widely thought to be a better indicator of

> >> cardiovascular

> >>

> >> risk than BMI, although some studies have shown them to be equally

> >>

> >> predictive. Other examples include the waist-to-hip ratio (WHR) and

> >> the

> >>

> >> waist-to-hip-to-height index, which have both been forwarded as

> >> potentially

> >>

> >> better measures of obesity than BMI. But critics have said that

> it is

> >>

> >> difficult and time-consuming to get very accurate measurements of

> >> waist and

> >>

> >> hip circumference and height and that BMI has remained popular

> >> because it

> >> is

> >>

> >> simple and fast.

> >>

> >>

> >>

> >> In their study, Bergman and colleagues used a large database,

> >> *BetaGene*,

> >>

> >> which consisted of relatives of Mexican Americans with gestational

> >> diabetes,

> >>

> >> to determine whether there might be a better index. They chose the

> >> Mexican

> >>

> >> American population because of its prevalence in Los Angeles,

> >> observing,

> >>

> >> " Most of the world population is nonwhite. "

> >>

> >>

> >>

> >> " We looked at which variables most strongly related to percent

> >> adiposity,

> >>

> >> and they were height and hip size. Because these variables were

> >>

> >> uncorrelated, we proposed a new index, the BAI, based upon these

> >> measures

> >>

> >> alone, " Bergman explains.

> >>

> >>

> >>

> >> *BAI Will Be Easy to Calculate*

> >>

> >>

> >>

> >> " We showed that the BAI, calculated as (hip circumference/

> >> height1.5)-18,

> >> was

> >>

> >> a good predictor of percent fat and worked for men and women, " he

> >>

> >> continues. The BAI also yielded the percentage of fat itself,

> >> rather than

> >>

> >> just a correlate (or index) of it, which is what the BMI does, he

> >> notes.

> >> The

> >>

> >> BAI was validated against the " gold standard " of dual-energy X-ray

> >>

> >> absorption (DEXA).

> >>

> >>

> >>

> >> " It will be very easy for a physician or a nurse practitioner to

> >> work out

> >>

> >> this index for individual patients, using a calculator, a computer

> >> program,

> >>

> >> or an iPhone app, " Bergman says.

> >>

> >>

> >>

> >> The researchers then went on to corroborate their findings in

> another

> >>

> >> population, the *Triglyceride and Cardiovascular Risk in African

> >>

> >> Americans*(TARA) study, and found that the behavior of the BAI was

> >>

> >> quite similar

> >>

> >> between the blacks in that population and the Hispanics in

> BetaGene.

> >>

> >>

> >>

> >> " Thus, we believe that we have presented evidence of accuracy at

> >> least in

> >>

> >> two ethnic populations, and further work on the generalizability of

> >> BAI to

> >>

> >> other groups is under way, " they state. It will also be important

> >> to see

> >>

> >> whether the index can reliably forecast percentage of adiposity in

> >> children

> >>

> >> and predict risk of cardiovascular disease, they note.

> >>

> >>

> >>

> >> medscape.com

> >>

> >> --

> >>

> >> Ortiz, MS, RD

> >>

> >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >>

> >> Check out my blog: mixture of deals and nutrition

> >>

> >> Made my own " funny but real " movie: Me interviewing a " potential "

> >> Dietetic

> >>

> >> student <http://www.xtranormal.com/watch/11216383/>

> >>

> >>

> >>

> >> *Healthy Diet at any Age: We are NOT just looking

> >>

> >> *

> >>

> >>

> >>

> >> *at the years people have behind them but also the

> >>

> >> *

> >>

> >>

> >>

> >> *quality of the years ahead of them.*

> >>

> >>

> >>

> >>

Link to comment
Share on other sites

Guest guest

Pam

What evidence do you see in the elderly and BMI? My concern is the

decreasing muscle mass I see in my nursing home clients and BMI wouldn't

account for this. Would pre-albumin and transferrin be the best indicators

(which most MDs do not order)?

Thanks

> I was perhaps too brief. BMI works for the elderly; the problem is

> when we attempt to apply a standard that was developed for a different

> population. There is plenty of research in epidemiology demonstrating

> a strong relationship between BMI and both short and long term

> survival in the elderly (I cannot recall age ranges; the definition of

> elderly seems to shift, especially as I get older). However, the cut

> off for BMI in older populations is higher than the cut off for

> younger age groups.

>

> So, if we say that a BMI less than 18-19 in someone who is between 18

> and 60 years of age requires further investigation (notice, I did not

> say that a low BMI is automatically an indicator of anything), we have

> to apply a higher standard to older adults. If I remember correctly,

> recommendations I've seen are in the range of 22 - 24 for older folks.

> I'm sure that varies if the person is community dwelling or in long

> term care.

>

> CMS won't change until someone (you?) comes forth to demonstrate that

> there is sufficient evidence to do so. Just as we want to practice

> based on the best available evidence, CMS is attempting to do the

> same. We cannot expect them to do the work for us, so guidelines they

> use won't change until there is sufficient impetus to make a change.

>

> We throw the phrase " cookie-cutter " around all the time and I think

> it's lost it's underlying meaning. What do you mean? Is it cookie

> cutter to use BMI as a screening tool for the elderly? I would argue

> that it's probably negligent to not evaluate weight status using some

> sort of standard for comparison.

>

> Regards,

> pam

>

> Pam Charney, PhD, RD

> Affiliate Associate Professor

> Pharmacy

>

> MS Student

> Clinical Informatics and Patient Centered Technology

> School of Nursing

>

> University of Washington

> Seattle, WA

> pcharney@...

> http://www.linkedin.com/in/pamcharney

>

>

>

>

>

> > Pam, You may be correct, but just to play the devil's advocate, I'm

> > now

> > forced to calculate BMI for 80 to 90 year olds, when we all agree

> > (except

> > CMS evidently) that this is not a good indicator of weight status

> > for the

> > elderly. Furthermore, I always seem to be in disagreement with the

> > MDS 3.0

> > calculation and determination of weight status. So, how does our

> > analysis as

> > nutrition experts come into play in this case? I see the new index

> > as just

> > another way to automate and take away one of more area within our

> > expertise.

> > I do agree we must use all available markers, but disagree with

> > having to

> > accept the cookie-cutter standard if my opinion differs.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On

> > Behalf Of

> > Pam Charney

> > Sent: Saturday, March 05, 2011 8:06 AM

> > To: rd-usa

> > Subject: Re: New Obesity Index Proposed, But Further Work

> > Needed

> >

> > Merav,

> >

> > That's why we learn to interpret research. An index designed for use

> > in healthy adults applies only to that population. Healthy adults.

> >

> > Pam Charney

> > pcharney@... <mailto:pcharney%40mac.com>

> >

> >

> >

> > > But there will always be exceptions - amputees, bed-bound like you

> > > said,

> > > etc.

> > >

> > > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> > <mailto:meravls%40msn.com> > wrote:

> > >

> > >>

> > >> I am glad to hear there is work towards new index.However, this one

> > >> may

> > >> work only for ambulating clients/outpt settings. Hospitalized

> > >> pt...how will

> > >> I measure them when they are bad bound. Someone might say " the RN

> > >> would

> > >> have to do that on the initial screening " but I have hard time

> > >> getting the

> > >> Ht & Wt on admission, hip circ...? I don't see it happen.

> > >>

> > >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > >> http://www.linkedin.com/in/meravlevi

> > >>

> > >> " Life is not measured by the number of breath you take, but by the

> > >> moments

> > >> that take your breath away. " - Carlin " People don't forget

> > >> the truth,

> > >> they just become better in lying " (Revolutionary Road)

> > >>

> > >>

> > >>

> > >>

> > >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> > >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

> > >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> > >> Subject: Re: New Obesity Index Proposed, But Further Work

> > >> Needed

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >> This does seem more useful than BMI but wouldn't hip

> > >> circumfrence miss

> > >> the very

> > >>

> > >> apple - build people, those who don't have much hip storage. The

> > >> ethnic

> > >>

> > >> populations it has been tested with tend to have more caboose

> > >> action than

> > >> whites

> > >>

> > >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> > >>

> > >>

> > >>

> > >> " Muffin top " problems in low rise jeans led to tops with a gathered

> > >> lower

> > >>

> > >> waist-line to cover up the overflow. Fashion found a way to fix its

> > >> own

> > >> faux

> > >>

> > >> pas.

> > >>

> > >>

> > >>

> > >> R Vajda, R.D.

> > >>

> > >>

> > >>

> > >>

> > >>

> > >> ________________________________

> > >>

> > >> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

> > >>

> > >> To: RD-USA <rd-usa <mailto:rd-usa

> > %40yahoogroups.com> >

> > >>

> > >> Sent: Fri, March 4, 2011 4:08:09 PM

> > >>

> > >> Subject: New Obesity Index Proposed, But Further Work

> > Needed

> > >>

> > >>

> > >>

> > >> US researchers have developed a new index of adiposity that they

> > >> say is a

> > >>

> > >> more accurate measure of body fat than the traditionally used body-

> > >> mass

> > >>

> > >> index (BMI); the latter is calculated by dividing weight by height

> > >> [1].

> > >>

> > >>

> > >>

> > >> Using measurements of hip circumference and height, the new body

> > >> adiposity

> > >>

> > >> index (BAI) can be used to reflect percentage of body fat for adult

> > >> men and

> > >>

> > >> women of differing ethnicities, without numerical correction or

> > >> assessment

> > >>

> > >> of weight, say *Dr N Bergman* (University of Southern

> > >> California,

> > >>

> > >> Los Angeles) and colleagues in their paper published online March

> > >> 3, 2011

> > >> in

> > >>

> > >> *Obesity*.

> > >>

> > >>

> > >>

> > >> However, they note that further work will be needed to extend and

> > >> confirm

> > >>

> > >> their findings--tested in Mexican Americans and African

> > Americans--to

> > >> whites

> > >>

> > >> and other ethnic groups and to assess the role of the new index in

> > >> children.

> > >>

> > >> And " it remains to be seen if the BAI is a more useful predictor of

> > >> health

> > >>

> > >> outcome, in both males and females, than other indexes of body

> > >> adiposity,

> > >>

> > >> including the BMI itself. "

> > >>

> > >>

> > >>

> > >> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> > >>

> > >>

> > >>

> > >> " We were interested in determining whether we could find an index

> > >> of body

> > >>

> > >> adiposity that at least in some ways may be better than the BMI,

> > >> which has

> > >>

> > >> been around since the 1840s " and is not a very accurate measure of

> > >> adiposity

> > >>

> > >> in individual patients, Bergman explained to* heartwire *. BMI is

> > >>

> > >> particularly inaccurate in people with elevated lean body mass,

> > >> such as

> > >>

> > >> athletes, and in children, and it cannot be generalized among

> > >> different

> > >>

> > >> ethnic groups, he and his colleagues note.

> > >>

> > >>

> > >>

> > >> Bergman et al are not the first to propose an alternative to BMI.

> > >> Waist

> > >>

> > >> circumference is widely thought to be a better indicator of

> > >> cardiovascular

> > >>

> > >> risk than BMI, although some studies have shown them to be equally

> > >>

> > >> predictive. Other examples include the waist-to-hip ratio (WHR) and

> > >> the

> > >>

> > >> waist-to-hip-to-height index, which have both been forwarded as

> > >> potentially

> > >>

> > >> better measures of obesity than BMI. But critics have said that

> > it is

> > >>

> > >> difficult and time-consuming to get very accurate measurements of

> > >> waist and

> > >>

> > >> hip circumference and height and that BMI has remained popular

> > >> because it

> > >> is

> > >>

> > >> simple and fast.

> > >>

> > >>

> > >>

> > >> In their study, Bergman and colleagues used a large database,

> > >> *BetaGene*,

> > >>

> > >> which consisted of relatives of Mexican Americans with gestational

> > >> diabetes,

> > >>

> > >> to determine whether there might be a better index. They chose the

> > >> Mexican

> > >>

> > >> American population because of its prevalence in Los Angeles,

> > >> observing,

> > >>

> > >> " Most of the world population is nonwhite. "

> > >>

> > >>

> > >>

> > >> " We looked at which variables most strongly related to percent

> > >> adiposity,

> > >>

> > >> and they were height and hip size. Because these variables were

> > >>

> > >> uncorrelated, we proposed a new index, the BAI, based upon these

> > >> measures

> > >>

> > >> alone, " Bergman explains.

> > >>

> > >>

> > >>

> > >> *BAI Will Be Easy to Calculate*

> > >>

> > >>

> > >>

> > >> " We showed that the BAI, calculated as (hip circumference/

> > >> height1.5)-18,

> > >> was

> > >>

> > >> a good predictor of percent fat and worked for men and women, " he

> > >>

> > >> continues. The BAI also yielded the percentage of fat itself,

> > >> rather than

> > >>

> > >> just a correlate (or index) of it, which is what the BMI does, he

> > >> notes.

> > >> The

> > >>

> > >> BAI was validated against the " gold standard " of dual-energy X-ray

> > >>

> > >> absorption (DEXA).

> > >>

> > >>

> > >>

> > >> " It will be very easy for a physician or a nurse practitioner to

> > >> work out

> > >>

> > >> this index for individual patients, using a calculator, a computer

> > >> program,

> > >>

> > >> or an iPhone app, " Bergman says.

> > >>

> > >>

> > >>

> > >> The researchers then went on to corroborate their findings in

> > another

> > >>

> > >> population, the *Triglyceride and Cardiovascular Risk in African

> > >>

> > >> Americans*(TARA) study, and found that the behavior of the BAI was

> > >>

> > >> quite similar

> > >>

> > >> between the blacks in that population and the Hispanics in

> > BetaGene.

> > >>

> > >>

> > >>

> > >> " Thus, we believe that we have presented evidence of accuracy at

> > >> least in

> > >>

> > >> two ethnic populations, and further work on the generalizability of

> > >> BAI to

> > >>

> > >> other groups is under way, " they state. It will also be important

> > >> to see

> > >>

> > >> whether the index can reliably forecast percentage of adiposity in

> > >> children

> > >>

> > >> and predict risk of cardiovascular disease, they note.

> > >>

> > >>

> > >>

> > >> medscape.com

> > >>

> > >> --

> > >>

> > >> Ortiz, MS, RD

> > >>

> > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > >>

> > >> Check out my blog: mixture of deals and nutrition

> > >>

> > >> Made my own " funny but real " movie: Me interviewing a " potential "

> > >> Dietetic

> > >>

> > >> student <http://www.xtranormal.com/watch/11216383/>

> > >>

> > >>

> > >>

> > >> *Healthy Diet at any Age: We are NOT just looking

> > >>

> > >> *

> > >>

> > >>

> > >>

> > >> *at the years people have behind them but also the

> > >>

> > >> *

> > >>

> > >>

> > >>

> > >> *quality of the years ahead of them.*

> > >>

> > >>

> > >>

> > >>

Link to comment
Share on other sites

Guest guest

Pam

What evidence do you see in the elderly and BMI? My concern is the

decreasing muscle mass I see in my nursing home clients and BMI wouldn't

account for this. Would pre-albumin and transferrin be the best indicators

(which most MDs do not order)?

Thanks

> I was perhaps too brief. BMI works for the elderly; the problem is

> when we attempt to apply a standard that was developed for a different

> population. There is plenty of research in epidemiology demonstrating

> a strong relationship between BMI and both short and long term

> survival in the elderly (I cannot recall age ranges; the definition of

> elderly seems to shift, especially as I get older). However, the cut

> off for BMI in older populations is higher than the cut off for

> younger age groups.

>

> So, if we say that a BMI less than 18-19 in someone who is between 18

> and 60 years of age requires further investigation (notice, I did not

> say that a low BMI is automatically an indicator of anything), we have

> to apply a higher standard to older adults. If I remember correctly,

> recommendations I've seen are in the range of 22 - 24 for older folks.

> I'm sure that varies if the person is community dwelling or in long

> term care.

>

> CMS won't change until someone (you?) comes forth to demonstrate that

> there is sufficient evidence to do so. Just as we want to practice

> based on the best available evidence, CMS is attempting to do the

> same. We cannot expect them to do the work for us, so guidelines they

> use won't change until there is sufficient impetus to make a change.

>

> We throw the phrase " cookie-cutter " around all the time and I think

> it's lost it's underlying meaning. What do you mean? Is it cookie

> cutter to use BMI as a screening tool for the elderly? I would argue

> that it's probably negligent to not evaluate weight status using some

> sort of standard for comparison.

>

> Regards,

> pam

>

> Pam Charney, PhD, RD

> Affiliate Associate Professor

> Pharmacy

>

> MS Student

> Clinical Informatics and Patient Centered Technology

> School of Nursing

>

> University of Washington

> Seattle, WA

> pcharney@...

> http://www.linkedin.com/in/pamcharney

>

>

>

>

>

> > Pam, You may be correct, but just to play the devil's advocate, I'm

> > now

> > forced to calculate BMI for 80 to 90 year olds, when we all agree

> > (except

> > CMS evidently) that this is not a good indicator of weight status

> > for the

> > elderly. Furthermore, I always seem to be in disagreement with the

> > MDS 3.0

> > calculation and determination of weight status. So, how does our

> > analysis as

> > nutrition experts come into play in this case? I see the new index

> > as just

> > another way to automate and take away one of more area within our

> > expertise.

> > I do agree we must use all available markers, but disagree with

> > having to

> > accept the cookie-cutter standard if my opinion differs.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On

> > Behalf Of

> > Pam Charney

> > Sent: Saturday, March 05, 2011 8:06 AM

> > To: rd-usa

> > Subject: Re: New Obesity Index Proposed, But Further Work

> > Needed

> >

> > Merav,

> >

> > That's why we learn to interpret research. An index designed for use

> > in healthy adults applies only to that population. Healthy adults.

> >

> > Pam Charney

> > pcharney@... <mailto:pcharney%40mac.com>

> >

> >

> >

> > > But there will always be exceptions - amputees, bed-bound like you

> > > said,

> > > etc.

> > >

> > > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> > <mailto:meravls%40msn.com> > wrote:

> > >

> > >>

> > >> I am glad to hear there is work towards new index.However, this one

> > >> may

> > >> work only for ambulating clients/outpt settings. Hospitalized

> > >> pt...how will

> > >> I measure them when they are bad bound. Someone might say " the RN

> > >> would

> > >> have to do that on the initial screening " but I have hard time

> > >> getting the

> > >> Ht & Wt on admission, hip circ...? I don't see it happen.

> > >>

> > >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > >> http://www.linkedin.com/in/meravlevi

> > >>

> > >> " Life is not measured by the number of breath you take, but by the

> > >> moments

> > >> that take your breath away. " - Carlin " People don't forget

> > >> the truth,

> > >> they just become better in lying " (Revolutionary Road)

> > >>

> > >>

> > >>

> > >>

> > >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> > >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net>

> > >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> > >> Subject: Re: New Obesity Index Proposed, But Further Work

> > >> Needed

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >> This does seem more useful than BMI but wouldn't hip

> > >> circumfrence miss

> > >> the very

> > >>

> > >> apple - build people, those who don't have much hip storage. The

> > >> ethnic

> > >>

> > >> populations it has been tested with tend to have more caboose

> > >> action than

> > >> whites

> > >>

> > >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> > >>

> > >>

> > >>

> > >> " Muffin top " problems in low rise jeans led to tops with a gathered

> > >> lower

> > >>

> > >> waist-line to cover up the overflow. Fashion found a way to fix its

> > >> own

> > >> faux

> > >>

> > >> pas.

> > >>

> > >>

> > >>

> > >> R Vajda, R.D.

> > >>

> > >>

> > >>

> > >>

> > >>

> > >> ________________________________

> > >>

> > >> From: Ortiz <nrord1@... <mailto:nrord1%40gmail.com> >

> > >>

> > >> To: RD-USA <rd-usa <mailto:rd-usa

> > %40yahoogroups.com> >

> > >>

> > >> Sent: Fri, March 4, 2011 4:08:09 PM

> > >>

> > >> Subject: New Obesity Index Proposed, But Further Work

> > Needed

> > >>

> > >>

> > >>

> > >> US researchers have developed a new index of adiposity that they

> > >> say is a

> > >>

> > >> more accurate measure of body fat than the traditionally used body-

> > >> mass

> > >>

> > >> index (BMI); the latter is calculated by dividing weight by height

> > >> [1].

> > >>

> > >>

> > >>

> > >> Using measurements of hip circumference and height, the new body

> > >> adiposity

> > >>

> > >> index (BAI) can be used to reflect percentage of body fat for adult

> > >> men and

> > >>

> > >> women of differing ethnicities, without numerical correction or

> > >> assessment

> > >>

> > >> of weight, say *Dr N Bergman* (University of Southern

> > >> California,

> > >>

> > >> Los Angeles) and colleagues in their paper published online March

> > >> 3, 2011

> > >> in

> > >>

> > >> *Obesity*.

> > >>

> > >>

> > >>

> > >> However, they note that further work will be needed to extend and

> > >> confirm

> > >>

> > >> their findings--tested in Mexican Americans and African

> > Americans--to

> > >> whites

> > >>

> > >> and other ethnic groups and to assess the role of the new index in

> > >> children.

> > >>

> > >> And " it remains to be seen if the BAI is a more useful predictor of

> > >> health

> > >>

> > >> outcome, in both males and females, than other indexes of body

> > >> adiposity,

> > >>

> > >> including the BMI itself. "

> > >>

> > >>

> > >>

> > >> *Height and Hip Size Most Strongly Relate to Percentage Adiposity *

> > >>

> > >>

> > >>

> > >> " We were interested in determining whether we could find an index

> > >> of body

> > >>

> > >> adiposity that at least in some ways may be better than the BMI,

> > >> which has

> > >>

> > >> been around since the 1840s " and is not a very accurate measure of

> > >> adiposity

> > >>

> > >> in individual patients, Bergman explained to* heartwire *. BMI is

> > >>

> > >> particularly inaccurate in people with elevated lean body mass,

> > >> such as

> > >>

> > >> athletes, and in children, and it cannot be generalized among

> > >> different

> > >>

> > >> ethnic groups, he and his colleagues note.

> > >>

> > >>

> > >>

> > >> Bergman et al are not the first to propose an alternative to BMI.

> > >> Waist

> > >>

> > >> circumference is widely thought to be a better indicator of

> > >> cardiovascular

> > >>

> > >> risk than BMI, although some studies have shown them to be equally

> > >>

> > >> predictive. Other examples include the waist-to-hip ratio (WHR) and

> > >> the

> > >>

> > >> waist-to-hip-to-height index, which have both been forwarded as

> > >> potentially

> > >>

> > >> better measures of obesity than BMI. But critics have said that

> > it is

> > >>

> > >> difficult and time-consuming to get very accurate measurements of

> > >> waist and

> > >>

> > >> hip circumference and height and that BMI has remained popular

> > >> because it

> > >> is

> > >>

> > >> simple and fast.

> > >>

> > >>

> > >>

> > >> In their study, Bergman and colleagues used a large database,

> > >> *BetaGene*,

> > >>

> > >> which consisted of relatives of Mexican Americans with gestational

> > >> diabetes,

> > >>

> > >> to determine whether there might be a better index. They chose the

> > >> Mexican

> > >>

> > >> American population because of its prevalence in Los Angeles,

> > >> observing,

> > >>

> > >> " Most of the world population is nonwhite. "

> > >>

> > >>

> > >>

> > >> " We looked at which variables most strongly related to percent

> > >> adiposity,

> > >>

> > >> and they were height and hip size. Because these variables were

> > >>

> > >> uncorrelated, we proposed a new index, the BAI, based upon these

> > >> measures

> > >>

> > >> alone, " Bergman explains.

> > >>

> > >>

> > >>

> > >> *BAI Will Be Easy to Calculate*

> > >>

> > >>

> > >>

> > >> " We showed that the BAI, calculated as (hip circumference/

> > >> height1.5)-18,

> > >> was

> > >>

> > >> a good predictor of percent fat and worked for men and women, " he

> > >>

> > >> continues. The BAI also yielded the percentage of fat itself,

> > >> rather than

> > >>

> > >> just a correlate (or index) of it, which is what the BMI does, he

> > >> notes.

> > >> The

> > >>

> > >> BAI was validated against the " gold standard " of dual-energy X-ray

> > >>

> > >> absorption (DEXA).

> > >>

> > >>

> > >>

> > >> " It will be very easy for a physician or a nurse practitioner to

> > >> work out

> > >>

> > >> this index for individual patients, using a calculator, a computer

> > >> program,

> > >>

> > >> or an iPhone app, " Bergman says.

> > >>

> > >>

> > >>

> > >> The researchers then went on to corroborate their findings in

> > another

> > >>

> > >> population, the *Triglyceride and Cardiovascular Risk in African

> > >>

> > >> Americans*(TARA) study, and found that the behavior of the BAI was

> > >>

> > >> quite similar

> > >>

> > >> between the blacks in that population and the Hispanics in

> > BetaGene.

> > >>

> > >>

> > >>

> > >> " Thus, we believe that we have presented evidence of accuracy at

> > >> least in

> > >>

> > >> two ethnic populations, and further work on the generalizability of

> > >> BAI to

> > >>

> > >> other groups is under way, " they state. It will also be important

> > >> to see

> > >>

> > >> whether the index can reliably forecast percentage of adiposity in

> > >> children

> > >>

> > >> and predict risk of cardiovascular disease, they note.

> > >>

> > >>

> > >>

> > >> medscape.com

> > >>

> > >> --

> > >>

> > >> Ortiz, MS, RD

> > >>

> > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > >>

> > >> Check out my blog: mixture of deals and nutrition

> > >>

> > >> Made my own " funny but real " movie: Me interviewing a " potential "

> > >> Dietetic

> > >>

> > >> student <http://www.xtranormal.com/watch/11216383/>

> > >>

> > >>

> > >>

> > >> *Healthy Diet at any Age: We are NOT just looking

> > >>

> > >> *

> > >>

> > >>

> > >>

> > >> *at the years people have behind them but also the

> > >>

> > >> *

> > >>

> > >>

> > >>

> > >> *quality of the years ahead of them.*

> > >>

> > >>

> > >>

> > >>

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Share on other sites

Guest guest

We need to let go of the paradigm (what we think about something

before we think about it) that albumin, transferrin and prealbumin

have anything to do with nutrition.

You can search PubMed using the key words " elderly " , " weight loss " ,

" outcomes " " body mass index " or any combination thereof to find some

of the research. If you know how to limit searches, you can add the

limits " epidemiology " and adults > 65 years.

Pam Charney

pcharney@...

> Pam

> What evidence do you see in the elderly and BMI? My concern is the

> decreasing muscle mass I see in my nursing home clients and BMI

> wouldn't

> account for this. Would pre-albumin and transferrin be the best

> indicators

> (which most MDs do not order)?

> Thanks

>

>

>

> > I was perhaps too brief. BMI works for the elderly; the problem is

> > when we attempt to apply a standard that was developed for a

> different

> > population. There is plenty of research in epidemiology

> demonstrating

> > a strong relationship between BMI and both short and long term

> > survival in the elderly (I cannot recall age ranges; the

> definition of

> > elderly seems to shift, especially as I get older). However, the cut

> > off for BMI in older populations is higher than the cut off for

> > younger age groups.

> >

> > So, if we say that a BMI less than 18-19 in someone who is between

> 18

> > and 60 years of age requires further investigation (notice, I did

> not

> > say that a low BMI is automatically an indicator of anything), we

> have

> > to apply a higher standard to older adults. If I remember correctly,

> > recommendations I've seen are in the range of 22 - 24 for older

> folks.

> > I'm sure that varies if the person is community dwelling or in long

> > term care.

> >

> > CMS won't change until someone (you?) comes forth to demonstrate

> that

> > there is sufficient evidence to do so. Just as we want to practice

> > based on the best available evidence, CMS is attempting to do the

> > same. We cannot expect them to do the work for us, so guidelines

> they

> > use won't change until there is sufficient impetus to make a change.

> >

> > We throw the phrase " cookie-cutter " around all the time and I think

> > it's lost it's underlying meaning. What do you mean? Is it cookie

> > cutter to use BMI as a screening tool for the elderly? I would argue

> > that it's probably negligent to not evaluate weight status using

> some

> > sort of standard for comparison.

> >

> > Regards,

> > pam

> >

> > Pam Charney, PhD, RD

> > Affiliate Associate Professor

> > Pharmacy

> >

> > MS Student

> > Clinical Informatics and Patient Centered Technology

> > School of Nursing

> >

> > University of Washington

> > Seattle, WA

> > pcharney@...

> > http://www.linkedin.com/in/pamcharney

> >

> >

> >

> >

> >

> > > Pam, You may be correct, but just to play the devil's advocate,

> I'm

> > > now

> > > forced to calculate BMI for 80 to 90 year olds, when we all agree

> > > (except

> > > CMS evidently) that this is not a good indicator of weight status

> > > for the

> > > elderly. Furthermore, I always seem to be in disagreement with the

> > > MDS 3.0

> > > calculation and determination of weight status. So, how does our

> > > analysis as

> > > nutrition experts come into play in this case? I see the new index

> > > as just

> > > another way to automate and take away one of more area within our

> > > expertise.

> > > I do agree we must use all available markers, but disagree with

> > > having to

> > > accept the cookie-cutter standard if my opinion differs.

> > >

> > > Digna

> > >

> > > From: rd-usa [mailto:rd-usa ] On

> > > Behalf Of

> > > Pam Charney

> > > Sent: Saturday, March 05, 2011 8:06 AM

> > > To: rd-usa

> > > Subject: Re: New Obesity Index Proposed, But Further Work

> > > Needed

> > >

> > > Merav,

> > >

> > > That's why we learn to interpret research. An index designed for

> use

> > > in healthy adults applies only to that population. Healthy adults.

> > >

> > > Pam Charney

> > > pcharney@... <mailto:pcharney%40mac.com>

> > >

> > >

> > >

> > > > But there will always be exceptions - amputees, bed-bound like

> you

> > > > said,

> > > > etc.

> > > >

> > > > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> > > <mailto:meravls%40msn.com> > wrote:

> > > >

> > > >>

> > > >> I am glad to hear there is work towards new index.However,

> this one

> > > >> may

> > > >> work only for ambulating clients/outpt settings. Hospitalized

> > > >> pt...how will

> > > >> I measure them when they are bad bound. Someone might say "

> the RN

> > > >> would

> > > >> have to do that on the initial screening " but I have hard time

> > > >> getting the

> > > >> Ht & Wt on admission, hip circ...? I don't see it happen.

> > > >>

> > > >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > > >> http://www.linkedin.com/in/meravlevi

> > > >>

> > > >> " Life is not measured by the number of breath you take, but

> by the

> > > >> moments

> > > >> that take your breath away. " - Carlin " People don't

> forget

> > > >> the truth,

> > > >> they just become better in lying " (Revolutionary Road)

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> > > >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net

> >

> > > >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> > > >> Subject: Re: New Obesity Index Proposed, But Further

> Work

> > > >> Needed

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> This does seem more useful than BMI but wouldn't hip

> > > >> circumfrence miss

> > > >> the very

> > > >>

> > > >> apple - build people, those who don't have much hip storage.

> The

> > > >> ethnic

> > > >>

> > > >> populations it has been tested with tend to have more caboose

> > > >> action than

> > > >> whites

> > > >>

> > > >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> > > >>

> > > >>

> > > >>

> > > >> " Muffin top " problems in low rise jeans led to tops with a

> gathered

> > > >> lower

> > > >>

> > > >> waist-line to cover up the overflow. Fashion found a way to

> fix its

> > > >> own

> > > >> faux

> > > >>

> > > >> pas.

> > > >>

> > > >>

> > > >>

> > > >> R Vajda, R.D.

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> ________________________________

> > > >>

> > > >> From: Ortiz <nrord1@...

> <mailto:nrord1%40gmail.com> >

> > > >>

> > > >> To: RD-USA <rd-usa <mailto:rd-usa

> > > %40yahoogroups.com> >

> > > >>

> > > >> Sent: Fri, March 4, 2011 4:08:09 PM

> > > >>

> > > >> Subject: New Obesity Index Proposed, But Further Work

> > > Needed

> > > >>

> > > >>

> > > >>

> > > >> US researchers have developed a new index of adiposity that

> they

> > > >> say is a

> > > >>

> > > >> more accurate measure of body fat than the traditionally used

> body-

> > > >> mass

> > > >>

> > > >> index (BMI); the latter is calculated by dividing weight by

> height

> > > >> [1].

> > > >>

> > > >>

> > > >>

> > > >> Using measurements of hip circumference and height, the new

> body

> > > >> adiposity

> > > >>

> > > >> index (BAI) can be used to reflect percentage of body fat for

> adult

> > > >> men and

> > > >>

> > > >> women of differing ethnicities, without numerical correction or

> > > >> assessment

> > > >>

> > > >> of weight, say *Dr N Bergman* (University of Southern

> > > >> California,

> > > >>

> > > >> Los Angeles) and colleagues in their paper published online

> March

> > > >> 3, 2011

> > > >> in

> > > >>

> > > >> *Obesity*.

> > > >>

> > > >>

> > > >>

> > > >> However, they note that further work will be needed to extend

> and

> > > >> confirm

> > > >>

> > > >> their findings--tested in Mexican Americans and African

> > > Americans--to

> > > >> whites

> > > >>

> > > >> and other ethnic groups and to assess the role of the new

> index in

> > > >> children.

> > > >>

> > > >> And " it remains to be seen if the BAI is a more useful

> predictor of

> > > >> health

> > > >>

> > > >> outcome, in both males and females, than other indexes of body

> > > >> adiposity,

> > > >>

> > > >> including the BMI itself. "

> > > >>

> > > >>

> > > >>

> > > >> *Height and Hip Size Most Strongly Relate to Percentage

> Adiposity *

> > > >>

> > > >>

> > > >>

> > > >> " We were interested in determining whether we could find an

> index

> > > >> of body

> > > >>

> > > >> adiposity that at least in some ways may be better than the

> BMI,

> > > >> which has

> > > >>

> > > >> been around since the 1840s " and is not a very accurate

> measure of

> > > >> adiposity

> > > >>

> > > >> in individual patients, Bergman explained to* heartwire *.

> BMI is

> > > >>

> > > >> particularly inaccurate in people with elevated lean body mass,

> > > >> such as

> > > >>

> > > >> athletes, and in children, and it cannot be generalized among

> > > >> different

> > > >>

> > > >> ethnic groups, he and his colleagues note.

> > > >>

> > > >>

> > > >>

> > > >> Bergman et al are not the first to propose an alternative to

> BMI.

> > > >> Waist

> > > >>

> > > >> circumference is widely thought to be a better indicator of

> > > >> cardiovascular

> > > >>

> > > >> risk than BMI, although some studies have shown them to be

> equally

> > > >>

> > > >> predictive. Other examples include the waist-to-hip ratio

> (WHR) and

> > > >> the

> > > >>

> > > >> waist-to-hip-to-height index, which have both been forwarded as

> > > >> potentially

> > > >>

> > > >> better measures of obesity than BMI. But critics have said that

> > > it is

> > > >>

> > > >> difficult and time-consuming to get very accurate

> measurements of

> > > >> waist and

> > > >>

> > > >> hip circumference and height and that BMI has remained popular

> > > >> because it

> > > >> is

> > > >>

> > > >> simple and fast.

> > > >>

> > > >>

> > > >>

> > > >> In their study, Bergman and colleagues used a large database,

> > > >> *BetaGene*,

> > > >>

> > > >> which consisted of relatives of Mexican Americans with

> gestational

> > > >> diabetes,

> > > >>

> > > >> to determine whether there might be a better index. They

> chose the

> > > >> Mexican

> > > >>

> > > >> American population because of its prevalence in Los Angeles,

> > > >> observing,

> > > >>

> > > >> " Most of the world population is nonwhite. "

> > > >>

> > > >>

> > > >>

> > > >> " We looked at which variables most strongly related to percent

> > > >> adiposity,

> > > >>

> > > >> and they were height and hip size. Because these variables were

> > > >>

> > > >> uncorrelated, we proposed a new index, the BAI, based upon

> these

> > > >> measures

> > > >>

> > > >> alone, " Bergman explains.

> > > >>

> > > >>

> > > >>

> > > >> *BAI Will Be Easy to Calculate*

> > > >>

> > > >>

> > > >>

> > > >> " We showed that the BAI, calculated as (hip circumference/

> > > >> height1.5)-18,

> > > >> was

> > > >>

> > > >> a good predictor of percent fat and worked for men and

> women, " he

> > > >>

> > > >> continues. The BAI also yielded the percentage of fat itself,

> > > >> rather than

> > > >>

> > > >> just a correlate (or index) of it, which is what the BMI

> does, he

> > > >> notes.

> > > >> The

> > > >>

> > > >> BAI was validated against the " gold standard " of dual-energy

> X-ray

> > > >>

> > > >> absorption (DEXA).

> > > >>

> > > >>

> > > >>

> > > >> " It will be very easy for a physician or a nurse practitioner

> to

> > > >> work out

> > > >>

> > > >> this index for individual patients, using a calculator, a

> computer

> > > >> program,

> > > >>

> > > >> or an iPhone app, " Bergman says.

> > > >>

> > > >>

> > > >>

> > > >> The researchers then went on to corroborate their findings in

> > > another

> > > >>

> > > >> population, the *Triglyceride and Cardiovascular Risk in

> African

> > > >>

> > > >> Americans*(TARA) study, and found that the behavior of the

> BAI was

> > > >>

> > > >> quite similar

> > > >>

> > > >> between the blacks in that population and the Hispanics in

> > > BetaGene.

> > > >>

> > > >>

> > > >>

> > > >> " Thus, we believe that we have presented evidence of accuracy

> at

> > > >> least in

> > > >>

> > > >> two ethnic populations, and further work on the

> generalizability of

> > > >> BAI to

> > > >>

> > > >> other groups is under way, " they state. It will also be

> important

> > > >> to see

> > > >>

> > > >> whether the index can reliably forecast percentage of

> adiposity in

> > > >> children

> > > >>

> > > >> and predict risk of cardiovascular disease, they note.

> > > >>

> > > >>

> > > >>

> > > >> medscape.com

> > > >>

> > > >> --

> > > >>

> > > >> Ortiz, MS, RD

> > > >>

> > > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > >>

> > > >> Check out my blog: mixture of deals and nutrition

> > > >>

> > > >> Made my own " funny but real " movie: Me interviewing a

> " potential "

> > > >> Dietetic

> > > >>

> > > >> student <http://www.xtranormal.com/watch/11216383/>

> > > >>

> > > >>

> > > >>

> > > >> *Healthy Diet at any Age: We are NOT just looking

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *at the years people have behind them but also the

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *quality of the years ahead of them.*

> > > >>

> > > >>

> > > >>

> > > >>

Link to comment
Share on other sites

Guest guest

We need to let go of the paradigm (what we think about something

before we think about it) that albumin, transferrin and prealbumin

have anything to do with nutrition.

You can search PubMed using the key words " elderly " , " weight loss " ,

" outcomes " " body mass index " or any combination thereof to find some

of the research. If you know how to limit searches, you can add the

limits " epidemiology " and adults > 65 years.

Pam Charney

pcharney@...

> Pam

> What evidence do you see in the elderly and BMI? My concern is the

> decreasing muscle mass I see in my nursing home clients and BMI

> wouldn't

> account for this. Would pre-albumin and transferrin be the best

> indicators

> (which most MDs do not order)?

> Thanks

>

>

>

> > I was perhaps too brief. BMI works for the elderly; the problem is

> > when we attempt to apply a standard that was developed for a

> different

> > population. There is plenty of research in epidemiology

> demonstrating

> > a strong relationship between BMI and both short and long term

> > survival in the elderly (I cannot recall age ranges; the

> definition of

> > elderly seems to shift, especially as I get older). However, the cut

> > off for BMI in older populations is higher than the cut off for

> > younger age groups.

> >

> > So, if we say that a BMI less than 18-19 in someone who is between

> 18

> > and 60 years of age requires further investigation (notice, I did

> not

> > say that a low BMI is automatically an indicator of anything), we

> have

> > to apply a higher standard to older adults. If I remember correctly,

> > recommendations I've seen are in the range of 22 - 24 for older

> folks.

> > I'm sure that varies if the person is community dwelling or in long

> > term care.

> >

> > CMS won't change until someone (you?) comes forth to demonstrate

> that

> > there is sufficient evidence to do so. Just as we want to practice

> > based on the best available evidence, CMS is attempting to do the

> > same. We cannot expect them to do the work for us, so guidelines

> they

> > use won't change until there is sufficient impetus to make a change.

> >

> > We throw the phrase " cookie-cutter " around all the time and I think

> > it's lost it's underlying meaning. What do you mean? Is it cookie

> > cutter to use BMI as a screening tool for the elderly? I would argue

> > that it's probably negligent to not evaluate weight status using

> some

> > sort of standard for comparison.

> >

> > Regards,

> > pam

> >

> > Pam Charney, PhD, RD

> > Affiliate Associate Professor

> > Pharmacy

> >

> > MS Student

> > Clinical Informatics and Patient Centered Technology

> > School of Nursing

> >

> > University of Washington

> > Seattle, WA

> > pcharney@...

> > http://www.linkedin.com/in/pamcharney

> >

> >

> >

> >

> >

> > > Pam, You may be correct, but just to play the devil's advocate,

> I'm

> > > now

> > > forced to calculate BMI for 80 to 90 year olds, when we all agree

> > > (except

> > > CMS evidently) that this is not a good indicator of weight status

> > > for the

> > > elderly. Furthermore, I always seem to be in disagreement with the

> > > MDS 3.0

> > > calculation and determination of weight status. So, how does our

> > > analysis as

> > > nutrition experts come into play in this case? I see the new index

> > > as just

> > > another way to automate and take away one of more area within our

> > > expertise.

> > > I do agree we must use all available markers, but disagree with

> > > having to

> > > accept the cookie-cutter standard if my opinion differs.

> > >

> > > Digna

> > >

> > > From: rd-usa [mailto:rd-usa ] On

> > > Behalf Of

> > > Pam Charney

> > > Sent: Saturday, March 05, 2011 8:06 AM

> > > To: rd-usa

> > > Subject: Re: New Obesity Index Proposed, But Further Work

> > > Needed

> > >

> > > Merav,

> > >

> > > That's why we learn to interpret research. An index designed for

> use

> > > in healthy adults applies only to that population. Healthy adults.

> > >

> > > Pam Charney

> > > pcharney@... <mailto:pcharney%40mac.com>

> > >

> > >

> > >

> > > > But there will always be exceptions - amputees, bed-bound like

> you

> > > > said,

> > > > etc.

> > > >

> > > > On Sat, Mar 5, 2011 at 10:58 AM, Merav Levi <meravls@...

> > > <mailto:meravls%40msn.com> > wrote:

> > > >

> > > >>

> > > >> I am glad to hear there is work towards new index.However,

> this one

> > > >> may

> > > >> work only for ambulating clients/outpt settings. Hospitalized

> > > >> pt...how will

> > > >> I measure them when they are bad bound. Someone might say "

> the RN

> > > >> would

> > > >> have to do that on the initial screening " but I have hard time

> > > >> getting the

> > > >> Ht & Wt on admission, hip circ...? I don't see it happen.

> > > >>

> > > >> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > > >> http://www.linkedin.com/in/meravlevi

> > > >>

> > > >> " Life is not measured by the number of breath you take, but

> by the

> > > >> moments

> > > >> that take your breath away. " - Carlin " People don't

> forget

> > > >> the truth,

> > > >> they just become better in lying " (Revolutionary Road)

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> > > >> From: jennyvajda@... <mailto:jennyvajda%40sbcglobal.net

> >

> > > >> Date: Fri, 4 Mar 2011 17:05:49 -0800

> > > >> Subject: Re: New Obesity Index Proposed, But Further

> Work

> > > >> Needed

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> This does seem more useful than BMI but wouldn't hip

> > > >> circumfrence miss

> > > >> the very

> > > >>

> > > >> apple - build people, those who don't have much hip storage.

> The

> > > >> ethnic

> > > >>

> > > >> populations it has been tested with tend to have more caboose

> > > >> action than

> > > >> whites

> > > >>

> > > >> or Asians. (I am a pear and relate more to J Lo. than J An.)

> > > >>

> > > >>

> > > >>

> > > >> " Muffin top " problems in low rise jeans led to tops with a

> gathered

> > > >> lower

> > > >>

> > > >> waist-line to cover up the overflow. Fashion found a way to

> fix its

> > > >> own

> > > >> faux

> > > >>

> > > >> pas.

> > > >>

> > > >>

> > > >>

> > > >> R Vajda, R.D.

> > > >>

> > > >>

> > > >>

> > > >>

> > > >>

> > > >> ________________________________

> > > >>

> > > >> From: Ortiz <nrord1@...

> <mailto:nrord1%40gmail.com> >

> > > >>

> > > >> To: RD-USA <rd-usa <mailto:rd-usa

> > > %40yahoogroups.com> >

> > > >>

> > > >> Sent: Fri, March 4, 2011 4:08:09 PM

> > > >>

> > > >> Subject: New Obesity Index Proposed, But Further Work

> > > Needed

> > > >>

> > > >>

> > > >>

> > > >> US researchers have developed a new index of adiposity that

> they

> > > >> say is a

> > > >>

> > > >> more accurate measure of body fat than the traditionally used

> body-

> > > >> mass

> > > >>

> > > >> index (BMI); the latter is calculated by dividing weight by

> height

> > > >> [1].

> > > >>

> > > >>

> > > >>

> > > >> Using measurements of hip circumference and height, the new

> body

> > > >> adiposity

> > > >>

> > > >> index (BAI) can be used to reflect percentage of body fat for

> adult

> > > >> men and

> > > >>

> > > >> women of differing ethnicities, without numerical correction or

> > > >> assessment

> > > >>

> > > >> of weight, say *Dr N Bergman* (University of Southern

> > > >> California,

> > > >>

> > > >> Los Angeles) and colleagues in their paper published online

> March

> > > >> 3, 2011

> > > >> in

> > > >>

> > > >> *Obesity*.

> > > >>

> > > >>

> > > >>

> > > >> However, they note that further work will be needed to extend

> and

> > > >> confirm

> > > >>

> > > >> their findings--tested in Mexican Americans and African

> > > Americans--to

> > > >> whites

> > > >>

> > > >> and other ethnic groups and to assess the role of the new

> index in

> > > >> children.

> > > >>

> > > >> And " it remains to be seen if the BAI is a more useful

> predictor of

> > > >> health

> > > >>

> > > >> outcome, in both males and females, than other indexes of body

> > > >> adiposity,

> > > >>

> > > >> including the BMI itself. "

> > > >>

> > > >>

> > > >>

> > > >> *Height and Hip Size Most Strongly Relate to Percentage

> Adiposity *

> > > >>

> > > >>

> > > >>

> > > >> " We were interested in determining whether we could find an

> index

> > > >> of body

> > > >>

> > > >> adiposity that at least in some ways may be better than the

> BMI,

> > > >> which has

> > > >>

> > > >> been around since the 1840s " and is not a very accurate

> measure of

> > > >> adiposity

> > > >>

> > > >> in individual patients, Bergman explained to* heartwire *.

> BMI is

> > > >>

> > > >> particularly inaccurate in people with elevated lean body mass,

> > > >> such as

> > > >>

> > > >> athletes, and in children, and it cannot be generalized among

> > > >> different

> > > >>

> > > >> ethnic groups, he and his colleagues note.

> > > >>

> > > >>

> > > >>

> > > >> Bergman et al are not the first to propose an alternative to

> BMI.

> > > >> Waist

> > > >>

> > > >> circumference is widely thought to be a better indicator of

> > > >> cardiovascular

> > > >>

> > > >> risk than BMI, although some studies have shown them to be

> equally

> > > >>

> > > >> predictive. Other examples include the waist-to-hip ratio

> (WHR) and

> > > >> the

> > > >>

> > > >> waist-to-hip-to-height index, which have both been forwarded as

> > > >> potentially

> > > >>

> > > >> better measures of obesity than BMI. But critics have said that

> > > it is

> > > >>

> > > >> difficult and time-consuming to get very accurate

> measurements of

> > > >> waist and

> > > >>

> > > >> hip circumference and height and that BMI has remained popular

> > > >> because it

> > > >> is

> > > >>

> > > >> simple and fast.

> > > >>

> > > >>

> > > >>

> > > >> In their study, Bergman and colleagues used a large database,

> > > >> *BetaGene*,

> > > >>

> > > >> which consisted of relatives of Mexican Americans with

> gestational

> > > >> diabetes,

> > > >>

> > > >> to determine whether there might be a better index. They

> chose the

> > > >> Mexican

> > > >>

> > > >> American population because of its prevalence in Los Angeles,

> > > >> observing,

> > > >>

> > > >> " Most of the world population is nonwhite. "

> > > >>

> > > >>

> > > >>

> > > >> " We looked at which variables most strongly related to percent

> > > >> adiposity,

> > > >>

> > > >> and they were height and hip size. Because these variables were

> > > >>

> > > >> uncorrelated, we proposed a new index, the BAI, based upon

> these

> > > >> measures

> > > >>

> > > >> alone, " Bergman explains.

> > > >>

> > > >>

> > > >>

> > > >> *BAI Will Be Easy to Calculate*

> > > >>

> > > >>

> > > >>

> > > >> " We showed that the BAI, calculated as (hip circumference/

> > > >> height1.5)-18,

> > > >> was

> > > >>

> > > >> a good predictor of percent fat and worked for men and

> women, " he

> > > >>

> > > >> continues. The BAI also yielded the percentage of fat itself,

> > > >> rather than

> > > >>

> > > >> just a correlate (or index) of it, which is what the BMI

> does, he

> > > >> notes.

> > > >> The

> > > >>

> > > >> BAI was validated against the " gold standard " of dual-energy

> X-ray

> > > >>

> > > >> absorption (DEXA).

> > > >>

> > > >>

> > > >>

> > > >> " It will be very easy for a physician or a nurse practitioner

> to

> > > >> work out

> > > >>

> > > >> this index for individual patients, using a calculator, a

> computer

> > > >> program,

> > > >>

> > > >> or an iPhone app, " Bergman says.

> > > >>

> > > >>

> > > >>

> > > >> The researchers then went on to corroborate their findings in

> > > another

> > > >>

> > > >> population, the *Triglyceride and Cardiovascular Risk in

> African

> > > >>

> > > >> Americans*(TARA) study, and found that the behavior of the

> BAI was

> > > >>

> > > >> quite similar

> > > >>

> > > >> between the blacks in that population and the Hispanics in

> > > BetaGene.

> > > >>

> > > >>

> > > >>

> > > >> " Thus, we believe that we have presented evidence of accuracy

> at

> > > >> least in

> > > >>

> > > >> two ethnic populations, and further work on the

> generalizability of

> > > >> BAI to

> > > >>

> > > >> other groups is under way, " they state. It will also be

> important

> > > >> to see

> > > >>

> > > >> whether the index can reliably forecast percentage of

> adiposity in

> > > >> children

> > > >>

> > > >> and predict risk of cardiovascular disease, they note.

> > > >>

> > > >>

> > > >>

> > > >> medscape.com

> > > >>

> > > >> --

> > > >>

> > > >> Ortiz, MS, RD

> > > >>

> > > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > >>

> > > >> Check out my blog: mixture of deals and nutrition

> > > >>

> > > >> Made my own " funny but real " movie: Me interviewing a

> " potential "

> > > >> Dietetic

> > > >>

> > > >> student <http://www.xtranormal.com/watch/11216383/>

> > > >>

> > > >>

> > > >>

> > > >> *Healthy Diet at any Age: We are NOT just looking

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *at the years people have behind them but also the

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *quality of the years ahead of them.*

> > > >>

> > > >>

> > > >>

> > > >>

Link to comment
Share on other sites

Guest guest

So, Pam, is there any lab value that is indicative of malnutrition?

Ro

New Obesity Index Proposed, But Further Work

> > > Needed

> > > >>

> > > >>

> > > >>

> > > >> US researchers have developed a new index of adiposity that

> they

> > > >> say is a

> > > >>

> > > >> more accurate measure of body fat than the traditionally used

> body-

> > > >> mass

> > > >>

> > > >> index (BMI); the latter is calculated by dividing weight by

> height

> > > >> [1].

> > > >>

> > > >>

> > > >>

> > > >> Using measurements of hip circumference and height, the new

> body

> > > >> adiposity

> > > >>

> > > >> index (BAI) can be used to reflect percentage of body fat for

> adult

> > > >> men and

> > > >>

> > > >> women of differing ethnicities, without numerical correction or

> > > >> assessment

> > > >>

> > > >> of weight, say *Dr N Bergman* (University of Southern

> > > >> California,

> > > >>

> > > >> Los Angeles) and colleagues in their paper published online

> March

> > > >> 3, 2011

> > > >> in

> > > >>

> > > >> *Obesity*.

> > > >>

> > > >>

> > > >>

> > > >> However, they note that further work will be needed to extend

> and

> > > >> confirm

> > > >>

> > > >> their findings--tested in Mexican Americans and African

> > > Americans--to

> > > >> whites

> > > >>

> > > >> and other ethnic groups and to assess the role of the new

> index in

> > > >> children.

> > > >>

> > > >> And " it remains to be seen if the BAI is a more useful

> predictor of

> > > >> health

> > > >>

> > > >> outcome, in both males and females, than other indexes of body

> > > >> adiposity,

> > > >>

> > > >> including the BMI itself. "

> > > >>

> > > >>

> > > >>

> > > >> *Height and Hip Size Most Strongly Relate to Percentage

> Adiposity *

> > > >>

> > > >>

> > > >>

> > > >> " We were interested in determining whether we could find an

> index

> > > >> of body

> > > >>

> > > >> adiposity that at least in some ways may be better than the

> BMI,

> > > >> which has

> > > >>

> > > >> been around since the 1840s " and is not a very accurate

> measure of

> > > >> adiposity

> > > >>

> > > >> in individual patients, Bergman explained to* heartwire *.

> BMI is

> > > >>

> > > >> particularly inaccurate in people with elevated lean body mass,

> > > >> such as

> > > >>

> > > >> athletes, and in children, and it cannot be generalized among

> > > >> different

> > > >>

> > > >> ethnic groups, he and his colleagues note.

> > > >>

> > > >>

> > > >>

> > > >> Bergman et al are not the first to propose an alternative to

> BMI.

> > > >> Waist

> > > >>

> > > >> circumference is widely thought to be a better indicator of

> > > >> cardiovascular

> > > >>

> > > >> risk than BMI, although some studies have shown them to be

> equally

> > > >>

> > > >> predictive. Other examples include the waist-to-hip ratio

> (WHR) and

> > > >> the

> > > >>

> > > >> waist-to-hip-to-height index, which have both been forwarded as

> > > >> potentially

> > > >>

> > > >> better measures of obesity than BMI. But critics have said that

> > > it is

> > > >>

> > > >> difficult and time-consuming to get very accurate

> measurements of

> > > >> waist and

> > > >>

> > > >> hip circumference and height and that BMI has remained popular

> > > >> because it

> > > >> is

> > > >>

> > > >> simple and fast.

> > > >>

> > > >>

> > > >>

> > > >> In their study, Bergman and colleagues used a large database,

> > > >> *BetaGene*,

> > > >>

> > > >> which consisted of relatives of Mexican Americans with

> gestational

> > > >> diabetes,

> > > >>

> > > >> to determine whether there might be a better index. They

> chose the

> > > >> Mexican

> > > >>

> > > >> American population because of its prevalence in Los Angeles,

> > > >> observing,

> > > >>

> > > >> " Most of the world population is nonwhite. "

> > > >>

> > > >>

> > > >>

> > > >> " We looked at which variables most strongly related to percent

> > > >> adiposity,

> > > >>

> > > >> and they were height and hip size. Because these variables were

> > > >>

> > > >> uncorrelated, we proposed a new index, the BAI, based upon

> these

> > > >> measures

> > > >>

> > > >> alone, " Bergman explains.

> > > >>

> > > >>

> > > >>

> > > >> *BAI Will Be Easy to Calculate*

> > > >>

> > > >>

> > > >>

> > > >> " We showed that the BAI, calculated as (hip circumference/

> > > >> height1.5)-18,

> > > >> was

> > > >>

> > > >> a good predictor of percent fat and worked for men and

> women, " he

> > > >>

> > > >> continues. The BAI also yielded the percentage of fat itself,

> > > >> rather than

> > > >>

> > > >> just a correlate (or index) of it, which is what the BMI

> does, he

> > > >> notes.

> > > >> The

> > > >>

> > > >> BAI was validated against the " gold standard " of dual-energy

> X-ray

> > > >>

> > > >> absorption (DEXA).

> > > >>

> > > >>

> > > >>

> > > >> " It will be very easy for a physician or a nurse practitioner

> to

> > > >> work out

> > > >>

> > > >> this index for individual patients, using a calculator, a

> computer

> > > >> program,

> > > >>

> > > >> or an iPhone app, " Bergman says.

> > > >>

> > > >>

> > > >>

> > > >> The researchers then went on to corroborate their findings in

> > > another

> > > >>

> > > >> population, the *Triglyceride and Cardiovascular Risk in

> African

> > > >>

> > > >> Americans*(TARA) study, and found that the behavior of the

> BAI was

> > > >>

> > > >> quite similar

> > > >>

> > > >> between the blacks in that population and the Hispanics in

> > > BetaGene.

> > > >>

> > > >>

> > > >>

> > > >> " Thus, we believe that we have presented evidence of accuracy

> at

> > > >> least in

> > > >>

> > > >> two ethnic populations, and further work on the

> generalizability of

> > > >> BAI to

> > > >>

> > > >> other groups is under way, " they state. It will also be

> important

> > > >> to see

> > > >>

> > > >> whether the index can reliably forecast percentage of

> adiposity in

> > > >> children

> > > >>

> > > >> and predict risk of cardiovascular disease, they note.

> > > >>

> > > >>

> > > >>

> > > >> medscape.com

> > > >>

> > > >> --

> > > >>

> > > >> Ortiz, MS, RD

> > > >>

> > > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > >>

> > > >> Check out my blog: mixture of deals and nutrition

> > > >>

> > > >> Made my own " funny but real " movie: Me interviewing a

> " potential "

> > > >> Dietetic

> > > >>

> > > >> student <http://www.xtranormal.com/watch/11216383/>

> > > >>

> > > >>

> > > >>

> > > >> *Healthy Diet at any Age: We are NOT just looking

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *at the years people have behind them but also the

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *quality of the years ahead of them.*

> > > >>

> > > >>

> > > >>

> > > >>

Link to comment
Share on other sites

Guest guest

you have to look at the whole picture. there is no one lab value that will be

nutrition only related.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: lindarord@...

Date: Sun, 6 Mar 2011 13:42:36 -0500

Subject: Re: New Obesity Index Proposed, But Further Work Needed

So, Pam, is there any lab value that is indicative of malnutrition?

Ro

New Obesity Index Proposed, But Further Work

> > > Needed

> > > >>

> > > >>

> > > >>

> > > >> US researchers have developed a new index of adiposity that

> they

> > > >> say is a

> > > >>

> > > >> more accurate measure of body fat than the traditionally used

> body-

> > > >> mass

> > > >>

> > > >> index (BMI); the latter is calculated by dividing weight by

> height

> > > >> [1].

> > > >>

> > > >>

> > > >>

> > > >> Using measurements of hip circumference and height, the new

> body

> > > >> adiposity

> > > >>

> > > >> index (BAI) can be used to reflect percentage of body fat for

> adult

> > > >> men and

> > > >>

> > > >> women of differing ethnicities, without numerical correction or

> > > >> assessment

> > > >>

> > > >> of weight, say *Dr N Bergman* (University of Southern

> > > >> California,

> > > >>

> > > >> Los Angeles) and colleagues in their paper published online

> March

> > > >> 3, 2011

> > > >> in

> > > >>

> > > >> *Obesity*.

> > > >>

> > > >>

> > > >>

> > > >> However, they note that further work will be needed to extend

> and

> > > >> confirm

> > > >>

> > > >> their findings--tested in Mexican Americans and African

> > > Americans--to

> > > >> whites

> > > >>

> > > >> and other ethnic groups and to assess the role of the new

> index in

> > > >> children.

> > > >>

> > > >> And " it remains to be seen if the BAI is a more useful

> predictor of

> > > >> health

> > > >>

> > > >> outcome, in both males and females, than other indexes of body

> > > >> adiposity,

> > > >>

> > > >> including the BMI itself. "

> > > >>

> > > >>

> > > >>

> > > >> *Height and Hip Size Most Strongly Relate to Percentage

> Adiposity *

> > > >>

> > > >>

> > > >>

> > > >> " We were interested in determining whether we could find an

> index

> > > >> of body

> > > >>

> > > >> adiposity that at least in some ways may be better than the

> BMI,

> > > >> which has

> > > >>

> > > >> been around since the 1840s " and is not a very accurate

> measure of

> > > >> adiposity

> > > >>

> > > >> in individual patients, Bergman explained to* heartwire *.

> BMI is

> > > >>

> > > >> particularly inaccurate in people with elevated lean body mass,

> > > >> such as

> > > >>

> > > >> athletes, and in children, and it cannot be generalized among

> > > >> different

> > > >>

> > > >> ethnic groups, he and his colleagues note.

> > > >>

> > > >>

> > > >>

> > > >> Bergman et al are not the first to propose an alternative to

> BMI.

> > > >> Waist

> > > >>

> > > >> circumference is widely thought to be a better indicator of

> > > >> cardiovascular

> > > >>

> > > >> risk than BMI, although some studies have shown them to be

> equally

> > > >>

> > > >> predictive. Other examples include the waist-to-hip ratio

> (WHR) and

> > > >> the

> > > >>

> > > >> waist-to-hip-to-height index, which have both been forwarded as

> > > >> potentially

> > > >>

> > > >> better measures of obesity than BMI. But critics have said that

> > > it is

> > > >>

> > > >> difficult and time-consuming to get very accurate

> measurements of

> > > >> waist and

> > > >>

> > > >> hip circumference and height and that BMI has remained popular

> > > >> because it

> > > >> is

> > > >>

> > > >> simple and fast.

> > > >>

> > > >>

> > > >>

> > > >> In their study, Bergman and colleagues used a large database,

> > > >> *BetaGene*,

> > > >>

> > > >> which consisted of relatives of Mexican Americans with

> gestational

> > > >> diabetes,

> > > >>

> > > >> to determine whether there might be a better index. They

> chose the

> > > >> Mexican

> > > >>

> > > >> American population because of its prevalence in Los Angeles,

> > > >> observing,

> > > >>

> > > >> " Most of the world population is nonwhite. "

> > > >>

> > > >>

> > > >>

> > > >> " We looked at which variables most strongly related to percent

> > > >> adiposity,

> > > >>

> > > >> and they were height and hip size. Because these variables were

> > > >>

> > > >> uncorrelated, we proposed a new index, the BAI, based upon

> these

> > > >> measures

> > > >>

> > > >> alone, " Bergman explains.

> > > >>

> > > >>

> > > >>

> > > >> *BAI Will Be Easy to Calculate*

> > > >>

> > > >>

> > > >>

> > > >> " We showed that the BAI, calculated as (hip circumference/

> > > >> height1.5)-18,

> > > >> was

> > > >>

> > > >> a good predictor of percent fat and worked for men and

> women, " he

> > > >>

> > > >> continues. The BAI also yielded the percentage of fat itself,

> > > >> rather than

> > > >>

> > > >> just a correlate (or index) of it, which is what the BMI

> does, he

> > > >> notes.

> > > >> The

> > > >>

> > > >> BAI was validated against the " gold standard " of dual-energy

> X-ray

> > > >>

> > > >> absorption (DEXA).

> > > >>

> > > >>

> > > >>

> > > >> " It will be very easy for a physician or a nurse practitioner

> to

> > > >> work out

> > > >>

> > > >> this index for individual patients, using a calculator, a

> computer

> > > >> program,

> > > >>

> > > >> or an iPhone app, " Bergman says.

> > > >>

> > > >>

> > > >>

> > > >> The researchers then went on to corroborate their findings in

> > > another

> > > >>

> > > >> population, the *Triglyceride and Cardiovascular Risk in

> African

> > > >>

> > > >> Americans*(TARA) study, and found that the behavior of the

> BAI was

> > > >>

> > > >> quite similar

> > > >>

> > > >> between the blacks in that population and the Hispanics in

> > > BetaGene.

> > > >>

> > > >>

> > > >>

> > > >> " Thus, we believe that we have presented evidence of accuracy

> at

> > > >> least in

> > > >>

> > > >> two ethnic populations, and further work on the

> generalizability of

> > > >> BAI to

> > > >>

> > > >> other groups is under way, " they state. It will also be

> important

> > > >> to see

> > > >>

> > > >> whether the index can reliably forecast percentage of

> adiposity in

> > > >> children

> > > >>

> > > >> and predict risk of cardiovascular disease, they note.

> > > >>

> > > >>

> > > >>

> > > >> medscape.com

> > > >>

> > > >> --

> > > >>

> > > >> Ortiz, MS, RD

> > > >>

> > > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > >>

> > > >> Check out my blog: mixture of deals and nutrition

> > > >>

> > > >> Made my own " funny but real " movie: Me interviewing a

> " potential "

> > > >> Dietetic

> > > >>

> > > >> student <http://www.xtranormal.com/watch/11216383/>

> > > >>

> > > >>

> > > >>

> > > >> *Healthy Diet at any Age: We are NOT just looking

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *at the years people have behind them but also the

> > > >>

> > > >> *

> > > >>

> > > >>

> > > >>

> > > >> *quality of the years ahead of them.*

> > > >>

> > > >>

> > > >>

> > > >>

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Guest guest

No.

In fact, we could probably count on the fingers of one finger the

number of conditions for which there is one diagnostic test with

sufficient reliability and validity to diagnose much of anything.....

Pam Charney

pcharney@...

> So, Pam, is there any lab value that is indicative of malnutrition?

> Ro

>

> New Obesity Index Proposed, But Further

> Work

> > > > Needed

> > > > >>

> > > > >>

> > > > >>

> > > > >> US researchers have developed a new index of adiposity that

> > they

> > > > >> say is a

> > > > >>

> > > > >> more accurate measure of body fat than the traditionally used

> > body-

> > > > >> mass

> > > > >>

> > > > >> index (BMI); the latter is calculated by dividing weight by

> > height

> > > > >> [1].

> > > > >>

> > > > >>

> > > > >>

> > > > >> Using measurements of hip circumference and height, the new

> > body

> > > > >> adiposity

> > > > >>

> > > > >> index (BAI) can be used to reflect percentage of body fat for

> > adult

> > > > >> men and

> > > > >>

> > > > >> women of differing ethnicities, without numerical

> correction or

> > > > >> assessment

> > > > >>

> > > > >> of weight, say *Dr N Bergman* (University of Southern

> > > > >> California,

> > > > >>

> > > > >> Los Angeles) and colleagues in their paper published online

> > March

> > > > >> 3, 2011

> > > > >> in

> > > > >>

> > > > >> *Obesity*.

> > > > >>

> > > > >>

> > > > >>

> > > > >> However, they note that further work will be needed to extend

> > and

> > > > >> confirm

> > > > >>

> > > > >> their findings--tested in Mexican Americans and African

> > > > Americans--to

> > > > >> whites

> > > > >>

> > > > >> and other ethnic groups and to assess the role of the new

> > index in

> > > > >> children.

> > > > >>

> > > > >> And " it remains to be seen if the BAI is a more useful

> > predictor of

> > > > >> health

> > > > >>

> > > > >> outcome, in both males and females, than other indexes of

> body

> > > > >> adiposity,

> > > > >>

> > > > >> including the BMI itself. "

> > > > >>

> > > > >>

> > > > >>

> > > > >> *Height and Hip Size Most Strongly Relate to Percentage

> > Adiposity *

> > > > >>

> > > > >>

> > > > >>

> > > > >> " We were interested in determining whether we could find an

> > index

> > > > >> of body

> > > > >>

> > > > >> adiposity that at least in some ways may be better than the

> > BMI,

> > > > >> which has

> > > > >>

> > > > >> been around since the 1840s " and is not a very accurate

> > measure of

> > > > >> adiposity

> > > > >>

> > > > >> in individual patients, Bergman explained to* heartwire *.

> > BMI is

> > > > >>

> > > > >> particularly inaccurate in people with elevated lean body

> mass,

> > > > >> such as

> > > > >>

> > > > >> athletes, and in children, and it cannot be generalized among

> > > > >> different

> > > > >>

> > > > >> ethnic groups, he and his colleagues note.

> > > > >>

> > > > >>

> > > > >>

> > > > >> Bergman et al are not the first to propose an alternative to

> > BMI.

> > > > >> Waist

> > > > >>

> > > > >> circumference is widely thought to be a better indicator of

> > > > >> cardiovascular

> > > > >>

> > > > >> risk than BMI, although some studies have shown them to be

> > equally

> > > > >>

> > > > >> predictive. Other examples include the waist-to-hip ratio

> > (WHR) and

> > > > >> the

> > > > >>

> > > > >> waist-to-hip-to-height index, which have both been

> forwarded as

> > > > >> potentially

> > > > >>

> > > > >> better measures of obesity than BMI. But critics have said

> that

> > > > it is

> > > > >>

> > > > >> difficult and time-consuming to get very accurate

> > measurements of

> > > > >> waist and

> > > > >>

> > > > >> hip circumference and height and that BMI has remained

> popular

> > > > >> because it

> > > > >> is

> > > > >>

> > > > >> simple and fast.

> > > > >>

> > > > >>

> > > > >>

> > > > >> In their study, Bergman and colleagues used a large database,

> > > > >> *BetaGene*,

> > > > >>

> > > > >> which consisted of relatives of Mexican Americans with

> > gestational

> > > > >> diabetes,

> > > > >>

> > > > >> to determine whether there might be a better index. They

> > chose the

> > > > >> Mexican

> > > > >>

> > > > >> American population because of its prevalence in Los Angeles,

> > > > >> observing,

> > > > >>

> > > > >> " Most of the world population is nonwhite. "

> > > > >>

> > > > >>

> > > > >>

> > > > >> " We looked at which variables most strongly related to

> percent

> > > > >> adiposity,

> > > > >>

> > > > >> and they were height and hip size. Because these variables

> were

> > > > >>

> > > > >> uncorrelated, we proposed a new index, the BAI, based upon

> > these

> > > > >> measures

> > > > >>

> > > > >> alone, " Bergman explains.

> > > > >>

> > > > >>

> > > > >>

> > > > >> *BAI Will Be Easy to Calculate*

> > > > >>

> > > > >>

> > > > >>

> > > > >> " We showed that the BAI, calculated as (hip circumference/

> > > > >> height1.5)-18,

> > > > >> was

> > > > >>

> > > > >> a good predictor of percent fat and worked for men and

> > women, " he

> > > > >>

> > > > >> continues. The BAI also yielded the percentage of fat itself,

> > > > >> rather than

> > > > >>

> > > > >> just a correlate (or index) of it, which is what the BMI

> > does, he

> > > > >> notes.

> > > > >> The

> > > > >>

> > > > >> BAI was validated against the " gold standard " of dual-energy

> > X-ray

> > > > >>

> > > > >> absorption (DEXA).

> > > > >>

> > > > >>

> > > > >>

> > > > >> " It will be very easy for a physician or a nurse practitioner

> > to

> > > > >> work out

> > > > >>

> > > > >> this index for individual patients, using a calculator, a

> > computer

> > > > >> program,

> > > > >>

> > > > >> or an iPhone app, " Bergman says.

> > > > >>

> > > > >>

> > > > >>

> > > > >> The researchers then went on to corroborate their findings in

> > > > another

> > > > >>

> > > > >> population, the *Triglyceride and Cardiovascular Risk in

> > African

> > > > >>

> > > > >> Americans*(TARA) study, and found that the behavior of the

> > BAI was

> > > > >>

> > > > >> quite similar

> > > > >>

> > > > >> between the blacks in that population and the Hispanics in

> > > > BetaGene.

> > > > >>

> > > > >>

> > > > >>

> > > > >> " Thus, we believe that we have presented evidence of accuracy

> > at

> > > > >> least in

> > > > >>

> > > > >> two ethnic populations, and further work on the

> > generalizability of

> > > > >> BAI to

> > > > >>

> > > > >> other groups is under way, " they state. It will also be

> > important

> > > > >> to see

> > > > >>

> > > > >> whether the index can reliably forecast percentage of

> > adiposity in

> > > > >> children

> > > > >>

> > > > >> and predict risk of cardiovascular disease, they note.

> > > > >>

> > > > >>

> > > > >>

> > > > >> medscape.com

> > > > >>

> > > > >> --

> > > > >>

> > > > >> Ortiz, MS, RD

> > > > >>

> > > > >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > > >>

> > > > >> Check out my blog: mixture of deals and nutrition

> > > > >>

> > > > >> Made my own " funny but real " movie: Me interviewing a

> > " potential "

> > > > >> Dietetic

> > > > >>

> > > > >> student <http://www.xtranormal.com/watch/11216383/>

> > > > >>

> > > > >>

> > > > >>

> > > > >> *Healthy Diet at any Age: We are NOT just looking

> > > > >>

> > > > >> *

> > > > >>

> > > > >>

> > > > >>

> > > > >> *at the years people have behind them but also the

> > > > >>

> > > > >> *

> > > > >>

> > > > >>

> > > > >>

> > > > >> *quality of the years ahead of them.*

> > > > >>

> > > > >>

> > > > >>

> > > > >>

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