Obesity classification in military personnel: a comparison of body fat, waist circumference, and body mass index measurements.
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.
Heinrich
Katie M
KM
Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Road, Biomed D104B, Honolulu, HI 96822, USA.
Jitnarin
Nattinee
N
Suminski
Richard R
RR
Berkel
LaVerne
L
Hunter
Christine M
CM
Alvarez
Lisa
L
Brundige
Antionette R
AR
Peterson
Alan L
AL
Foreyt
John P
JP
Haddock
C Keith
CK
Poston
Walker S C
WS
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