Accuracy of Current Body Mass Index Obesity Classification for White, Black, and Hispanic Reproductive-Age Women

Mahbubur Rahman, Abbey Berenson

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Objective: To compare the National Institutes of Health's (NIH) body mass index (BMI)-based classification to identify obesity in comparison with the World Health Organization (WHO), which uses percent body fat, among white, black, and Hispanic reproductive-aged women. Methods: Body weight, height, BMI, and percent body fat (dual-energy X-ray absorptiometry generated) were determined for 555 healthy adult women aged 20-33 years (mean±standard deviation 26.5±4.0 years). Diagnostic accuracy of the NIH-based obesity definition (BMI of 30 kg/m or higher) was determined using the WHO criterion standard (percent body fat greater than 35%). Results: Obesity as defined by the NIH (BMI 30 kg/m2 or higher) and by WHO (percent body fat greater than 35%) classified 205 (36.9%) and 350 (63.1%) of the women as obese, respectively. The NIH-defined obesity cutoff values had 47.8%, 75.0%, and 53.9% sensitivity in white, black and Hispanic, women, respectively. White and Hispanic women had 2.9% greater percent body fat than black women for a given BMI. Receiver operating characteristics curves analyses showed that the respective sensitivities improved to 85.6%, 81.3%, and 83.2%, and that 311 women (56.0%) were classified as obese as a whole when race or ethnic-specific BMI cutoff values driven by our data (BMI at or above 25.5, 28.7, and 26.2 kg/m 2 for white, black, and Hispanic women, respectively) were used to detect percent body fat-defined obesity. Conclusion: Current BMI cutoff values recommended by the NIH failed to identify nearly half of reproductive-aged women who met the criteria for obesity by percent body fat. Using race or ethnic-specific BMI cutoff values would more accurately identify obesity in this population than the existing classification system.

Original languageEnglish (US)
Pages (from-to)982-988
Number of pages7
JournalObstetrics and Gynecology
Volume115
Issue number5
DOIs
StatePublished - May 2010

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Hispanic Americans
Body Mass Index
Obesity
Adipose Tissue
National Institutes of Health (U.S.)
hydroquinone
Body Height
Photon Absorptiometry
ROC Curve
Body Weight
Population

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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Accuracy of Current Body Mass Index Obesity Classification for White, Black, and Hispanic Reproductive-Age Women. / Rahman, Mahbubur; Berenson, Abbey.

In: Obstetrics and Gynecology, Vol. 115, No. 5, 05.2010, p. 982-988.

Research output: Contribution to journalArticle

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abstract = "Objective: To compare the National Institutes of Health's (NIH) body mass index (BMI)-based classification to identify obesity in comparison with the World Health Organization (WHO), which uses percent body fat, among white, black, and Hispanic reproductive-aged women. Methods: Body weight, height, BMI, and percent body fat (dual-energy X-ray absorptiometry generated) were determined for 555 healthy adult women aged 20-33 years (mean±standard deviation 26.5±4.0 years). Diagnostic accuracy of the NIH-based obesity definition (BMI of 30 kg/m or higher) was determined using the WHO criterion standard (percent body fat greater than 35{\%}). Results: Obesity as defined by the NIH (BMI 30 kg/m2 or higher) and by WHO (percent body fat greater than 35{\%}) classified 205 (36.9{\%}) and 350 (63.1{\%}) of the women as obese, respectively. The NIH-defined obesity cutoff values had 47.8{\%}, 75.0{\%}, and 53.9{\%} sensitivity in white, black and Hispanic, women, respectively. White and Hispanic women had 2.9{\%} greater percent body fat than black women for a given BMI. Receiver operating characteristics curves analyses showed that the respective sensitivities improved to 85.6{\%}, 81.3{\%}, and 83.2{\%}, and that 311 women (56.0{\%}) were classified as obese as a whole when race or ethnic-specific BMI cutoff values driven by our data (BMI at or above 25.5, 28.7, and 26.2 kg/m 2 for white, black, and Hispanic women, respectively) were used to detect percent body fat-defined obesity. Conclusion: Current BMI cutoff values recommended by the NIH failed to identify nearly half of reproductive-aged women who met the criteria for obesity by percent body fat. Using race or ethnic-specific BMI cutoff values would more accurately identify obesity in this population than the existing classification system.",
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