title: Obesity classification in military personnel: a comparison of body fat, waist circumference, and body mass index measurements.
abstract: OBJECTIVE
  The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC).
  
  
  METHODS
  A total of 451 overweight/obese active duty military personnel completed all three assessments.
  
  
  RESULTS
  Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women.
  
  
  CONCLUSIONS
  Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.
authors.affiliation: Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Road, Biomed D104B, Honolulu, HI 96822, USA.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Heinrich
authors.forename: Nattinee
authors.initials: N
authors.lastname: Jitnarin
authors.forename: Richard R
authors.initials: RR
authors.lastname: Suminski
authors.forename: LaVerne
authors.initials: L
authors.lastname: Berkel
authors.forename: Christine M
authors.initials: CM
authors.lastname: Hunter
authors.forename: Lisa
authors.initials: L
authors.lastname: Alvarez
authors.forename: Antionette R
authors.initials: AR
authors.lastname: Brundige
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
authors.forename: John P
authors.initials: JP
authors.lastname: Foreyt
authors.forename: C Keith
authors.initials: CK
authors.lastname: Haddock
authors.forename: Walker S C
authors.initials: WS
authors.lastname: Poston
mesh_terms: D000273:Adipose Tissue; D050154:Adiposity; D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D009765:Obesity / Q000145:classification* / Q000453:epidemiology / Q000503:physiopathology; D012016:Reference Values; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D049629:Waist-Hip Ratio