Re: New Obesity Index Proposed, But Further Work Needed

[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.*

> > > > >>

> > > > >>

> > > > >>

> > > > >>