title: Accuracy of body mass index-defined overweight in fire fighters.
abstract: BACKGROUND
  Overweight, obesity and weight gain are significant problems in the U.S. fire service. While classification of obesity using body mass index (BMI) has demonstrated accuracy and low rates of false positives when compared with body fat percentage (BF%)-based standards, no studies have examined the accuracy of BMI-based overweight and normal weight status with other comparable body composition indices.
  
  
  OBJECTIVE
  To compare overweight and normal weight BMI categories with BF% standards from the American Council on Exercise and analogous waist circumference (WC) categories and to examine rates and types of misclassification in fire fighters.
  
  
  METHODS
  Data were collected from 11 randomly selected career fire departments in the International Association of Fire Chief's Missouri Valley Region. Demographics, occupational history, and body composition indices (weight, BF% and WC) were obtained from male career fire fighters who were categorized as normal weight or overweight based on BMI.
  
  
  RESULTS
  There were 293 participants of whom 92 had normal BMI. There were low rates of false positives (12%) and moderate rates of false negatives (22%) when comparing BMI categories to the compar able BF% categories. However, using WC as the standard resulted in very high rates of false positives (63%) and very low rates of false negatives (5%).
  
  
  CONCLUSIONS
  BMI-based overweight status was associated with significant errors in classification depending on the standard to which it was compared.
authors.affiliation: Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS 66224, USA. jitnarin@ndri.org
authors.forename: N
authors.initials: N
authors.lastname: Jitnarin
authors.forename: W S C
authors.initials: WS
authors.lastname: Poston
authors.forename: C K
authors.initials: CK
authors.lastname: Haddock
authors.forename: S
authors.initials: S
authors.lastname: Jahnke
authors.forename: B C
authors.initials: BC
authors.lastname: Tuley
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003951:Diagnostic Errors; D061388:Firefighters; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000175:diagnosis*; D012015:Reference Standards; D014481:United States; D055105:Waist Circumference; D055815:Young Adult