title: Validation of anthropometric indices of adiposity against whole-body magnetic resonance imaging--a study within the German European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts.
abstract: BACKGROUND
  In epidemiological studies, measures of body fat generally are obtained through anthropometric indices such as the body mass index (BMI), waist (WC), and hip circumferences (HC). Such indices, however, can only provide estimates of a person's true body fat content, overall or by adipose compartment, and may have limited accuracy, especially for the visceral adipose compartment (VAT).
  
  
  OBJECTIVE
  To determine the extent to which different body adipose tissue compartments are adequately predicted by anthropometry, and to identify anthropometric measures alone, or in combination to predict overall adiposity and specific adipose tissue compartments, independently of age and body size (height).
  
  
  METHODS
  In a sub-study of 1,192 participants of the German EPIC (European Prospective Investigation into Cancer and Nutrition) cohorts, whole-body MRI was performed to determine adipose and muscle tissue compartments. Additional anthropometric measurements of BMI, WC and HC were taken.
  
  
  RESULTS
  After adjusting for age and height, BMI, WC and HC were better predictors of total body volume (TBV), total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) than for VAT, coronary adipose tissue (CAT) and skeletal muscle tissue (SMT). In both sexes, BMI was the best predictor for TBV (men: r = 0.72 [0.68-0.76], women: r = 0.80 [0.77-0.83]) and SMT (men: r = 0.52 [0.45-0.57], women: r = 0.48 [0.41-0.54]). WC was the best predictor variable for TAT (r = 0.48 [0.41-0.54]), VAT (r = 0.44 [0.37-0.50]) and CAT (r = 0.34 [0.26-0.41]) (men), and for VAT (r = 0.42 [0.35-0.49]) and CAT (r = 0.29 [0.22-0.37]) (women). BMI was the best predictor for TAT (r = 0.49 [0.43-0.55]) (women). HC was the best predictor for SAT (men (r = 0.39 [0.32-0.45]) and women (r = 0.52 [0.46-0.58])).
  
  
  CONCLUSIONS
  Especially the volumes of internal body fat compartments are poorly predicted by anthropometry. A possible implication may be that associations of chronic disease risks with the sizes of internal body fat as measured by BMI, WC and HC may be strongly underestimated.
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Neamat-Allah
authors.affiliation: Division of Medical and Biological Informatics, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Wald
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Anika
authors.initials: A
authors.lastname: Hüsing
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Department of Translational Pulmonology, Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wendt
authors.affiliation: Division of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Delorme
authors.affiliation: Division of Radiology, German Cancer Research Center, Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Julien
authors.initials: J
authors.lastname: Dinkel
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: Matthaeus
authors.initials: M
authors.lastname: Vigl
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: Manuela M
authors.initials: MM
authors.lastname: Bergmann
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Feller
authors.affiliation: Department of Diagnostic and Interventional Radiology, Clinic Ernst-von-Bergmann, Potsdam, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hierholzer
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D015331:Cohort Studies; D005060:Europe; D005260:Female; D005858:Germany; D006615:Hip; D006801:Humans; D050152:Intra-Abdominal Fat; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D050507:Subcutaneous Fat, Abdominal; D055105:Waist Circumference