Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel
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(2020) 39:24
ORIGINAL ARTICLE
Open Access
Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel Qingqing Zhu1, Binbin Huang1, Qiaoli Li1, Liqian Huang2, Wenbo Shu1, Lin Xu2, Qiongying Deng2, Ziliang Ye3, Chunyan Li3 and Peng Liu2*
Abstract Background: The rising prevalence of obesity in military personnel has raised great concerns. Previous studies suggest that body mass index (BMI)- and waist-to-hip ratio (WHR)-based obesity classifications in US military personnel and firefighters have high false negative and subsequently cause obesity misclassification. Objective: To determine whether BMI and WHR could reflect the fat mass of Chinese military personnel. Methods: Three hundred fifty-three male Chinese military personnel and 380 age-matched male adults were recruited. Obesity classification was defined by BMI, WHR, and body fat percentage (BFP). Results: Chinese military personnel had extremely low obesity rate determined by either BFP (0.3%) or BMI (0.6%). By combining overweight and obese individuals, BMI- and WHR-determined prevalence of overweight/obesity was 22.4% and 17.0% compared to BFP-based standard (4.0%) (P < 0.05). In reference to BFP, BMI and WHR have high false-positive rate compared to the control group. Further analysis showed that Chinese military personnel consisted of high percentage of BFPlowBMIhigh and/or BFPlowWHRhigh subpopulations. Eighty-one percent of BMIhigh and 78.3% of WHRhigh of them were BFP low. Conclusions: Chinese military personnel has extremely low obesity rate. BMI and WHR have high false-positive rates in reference to BFP, which cannot accurately reflect the mass of adipose tissue and leads to obesity misclassification. Keywords: Chinese military personnel, Obesity misclassification, Body composition, BMI, BFP, WHR
Background The rising prevalence of obesity remains a growing public concern, and it is considered the fifth most important risk factor contributing to global death [1] Obesity and overweight lead to multiple health dysfunctions including cardiovascular diseases, cancers, and metabolic syndromes as well as increased risk of mortality [2, 3]. Unfortunately, military personnel worldwide are not * Correspondence: [email protected] 2 Department of Anatomy, Guangxi Medical University, Nanning 530021, Guangxi, China Full list of author information is available at the end of the article
immune to this obesity epidemic. A study analyzing the trend in overweight and obesity from 1989 to 2012 among the US army revealed that the prevalence of obesity increased from 5.6% in 1989 to 8.0% in 2012 and peaked at 12.3% in 2009 [4]. The body mass index (BMI)-defined obesity prevalence in the British army was 12% in 2014, while a higher percentage of males were obese [5]. The consequence of overweight and obesity are costly to the military in terms of medical and related financial burdens. Excess weight has been associated with numerous health issues for the military personnel such as hypertension, diabetes, sleep apnea
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