Indices of whole-body and central adiposity for evaluating the metabolic load of obesity

ABSTRACT BACKGROUND: To assess the relative metabolic load or risk imposed by fatness, fat mass (FM) is commonly expressed as a proportion of weight (% fat), while central adiposity is

assessed using the ratio of triceps (TRI) to subscapular (SUBS) skinfolds. The statistical validity of these indices, defined as independence of the index from its denominator, has received

inadequate evaluation. OBJECTIVE: To critically examine commonly used obesity indices, and to propose more appropriate approaches. DESIGN: Cross-sectional studies. SUBJECTS: In total, 148

infants; 2195 adult men aged 18 y. METHODS: log–log regression analysis was used to explore the relationships between FM and weight (WT) or fat-free mass (FFM) (adults), and between TRI and

SUBS (infants and adults). RESULTS: The simple indices FM/WT, FM/FFM, TRI/SUBS and SUBS/TRI remained related to their denominators, showing their rankings of individuals to be biased by size

or fatness. The appropriate power (_p_) by which to raise the denominator was determined from regression analyses, and differed from unity in all cases. Both skinfold ratios showed a

nonlinear relationship with their denominators. CONCLUSION: Simple indices for evaluating whole-body or central adiposity are statistically flawed, and remain influenced by size or fatness

of the subject. The index FM/WT is conceptually flawed because FM appears in both numerator and denominator, and the index FM/FFM_p_ is preferable. Skinfold ratios are also problematic, and

to evaluate central adiposity SUBS alone, or SUBS/FFM_p_, may represent more appropriate approaches. These issues should be investigated in other studies in order to address possible

influences of age, ethnicity, gender and nutritional status. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS

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Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK J C K Wells * Post-graduate

Program in Epidemiology, Federal University of Pelotas, Brazil C G Victora Authors * J C K Wells View author publications You can also search for this author inPubMed Google Scholar * C G

Victora View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to J C K Wells. RIGHTS AND PERMISSIONS Reprints and

permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Wells, J., Victora, C. Indices of whole-body and central adiposity for evaluating the metabolic load of obesity. _Int J Obes_ 29, 483–489

(2005). https://doi.org/10.1038/sj.ijo.0802899 Download citation * Received: 04 April 2004 * Revised: 28 September 2004 * Accepted: 12 October 2004 * Published: 18 January 2005 * Issue Date:

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shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * body fatness * abdominal fat *

percent fat * body composition * skinfold