Nutr Hosp. 2015;32(1):101-109 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318 Original / Obesidad Body adiposity index and associated factors in adults: method and logistics of a population-based study Wellington Segheto1, Danielle Cristina Guimarães da Silva1, France Araújo Coelho1, Vanessa Guimaraes Reis1, Sílvia Helena Oliveira Morais1, João Carlos Bouzas Marins2, Andréia Queiroz Ribeiro3 and Giana Zarbato Longo3 1Federal University of Viçosa, Minas Gerais. 2Department of Physical Education and Sports. Federal University of Viçosa, Minas Gerais. 3Nutrition and Health Department. Federal University of Viçosa, Minas Gerais, Brazil. Abstract ÍNDICE DE ADIPOSIDAD CORPORAL Y FACTORES ASOCIADOS EN ADULTOS: Introduction: obesity is a public health problem that MÉTODO Y LOGÍSTICA DE UN ESTUDIO has increased considerably. Several techniques have been POBLACIONAL developed and used to measure the amount of body fat, or a combination of excess fat with some comorbidities. The Body Adiposity Index is a new method proposed to Resumen determine body fat and its validation is still limited. Me- Introducción: la obesidad es un problema de salud pú- thods and logistics of a population-based study reported blica que ha aumentado considerablemente. Se han desa- in the literature are few, mainly multidiciplinas team. rrollado distintas técnicas para medir la cantidad de grasa Objective: the objective was to report the proceedings corporal, o una combinación de exceso de grasa con ciertas of a population-based study, the denouement is the index comorbilidades. El Índice de Adiposidad Corporal es un of adiposity in adults. nuevo método propuesto para determinar la grasa corporal Design: the design of this study was cross-sectional, y su validación es aún limitada. Solo hay algunos métodos with a sample of 1085 adults aged 20-59 years living in y logísticas de estudios poblacionales recogidos en la biblio- the city of Viçosa, MG. A questionnaire was applied at grafía, la mayoría de equipos multidisciplinares. home with sociodemographic, behavioral issues, health Objetivo: el objetivo consistió en informar de los procedi- and level of physical activity. Then anthropometric and mientos de un estudio poblacional, para concluir en el índice biochemical data were collected. The training for data de adiposidad en adultos. collection involved the calibration of evaluators, being Diseño: el diseño de este estudio fue transversal, con una the correlation between the measurements checked by muestra de 1.085 adultos con edades entre 20 y 59 años, que the intraclass correlation test and was adopted as the ac- vivían en la ciudad de Viçosa, MG. Se aplicó un cuestiona- ceptable value of 0.60. rio para completar en casa, con aspectos sociodemográfi- Results: it is noted that, with the exception of assessors 1, cos, conductuales, de salud y del nivel de actividad física. the triceps and subscapular skin folds, and the evaluator 4, Después se recopilaron los valores antropométricos y bio- in the pectoral skinfolds and suprailiac, all other measures químicos. La formación para la recogida de datos incluyó el reached acceptable cutoff point for agreement among eva- calibrado de los evaluadores, estableciéndose la correlación luators. entre las mediciones a partir de una comprobación median- Conclusions: multidisciplinary research is important te una prueba de correlación intraclase, siendo 0,60 el valor to understand the various factors that may be operating definido como aceptable. in health and disease process tool. Methodological and Resultados: se observa que, a excepción del evaluador logistical aspects described in this study should be fo- 1, para los pliegues cutáneos subescapulares, y del evalua- llowed, which will lead to a steady decrease in research dor 4, para los pliegues cutáneos pectorales y suprailiacos, biases. el resto de mediciones alcanzaron un nivel aceptable de (Nutr Hosp. 2015;32:101-109) acuerdo entre los evaluadores. Conclusiones: la investigación multidisciplinar es impor- DOI:10.3305/nh.2015.32.1.8391 tante para comprender los distintos factores que podrían Key words: Body adiposity index. Obesity. Method. intervenir en la herramienta de evaluación de salud y en- Cross-sectional study. fermedad. Se deberían seguir los aspectos metodológicos y logísticos descritos en este estudio, los cuales llevan a una reducción continua de los sesgos de la investigación. Correspondence: Wellington Segheto. Av. Darcy Vargas, 623, CEP 36031-100, Juiz de Fora. (Nutr Hosp. 2015;32:101-109) Minas Gerais, Brasil. DOI:10.3305/nh.2015.32.1.8391 E-mail: [email protected] Recibido: 23-XI-2014. Palabras clave: Índice de adiposidad corporal. Obesidad. Aceptado: 23-IV-2015. Método. Estudio transversal. 101 016_8391 Body adiposity index.indd 101 12/06/15 15:54 Abbreviations been recommended in the literature10. These different patterns can be found in population-based studies that BAI: Body Adiposity Index. evaluate representative samples of the population, IBGE: Instituto Brasileiro de Geografia e Estatística. allowing the evaluation of individuals with distinct SIMTEL: Monitoring System of Risk Factors for sociodemographic, behavioral, anthropometric and Chronic Noncommunicable Diseases for Telephonic biochemical characteristics through the methodology. Interviews. Knowledge of body fat based on representative sam- IPAq: International Physical Activity Questionnair. ples of the population is still limited, especially in the ISAK: International Standards for Anthropometric Zona da Mata region of Minas Gerais State, although Assessment. such research may contribute to a broad knowledge of VIGITEL: Surveillance System of Risk Factors and individuals and reduce costs, especially when working Protection for Chronic Diseases by Telephone Survey. with a multidisciplinary team and seeking to meet se- ESA/Viçosa: Study on Health and Nutrition of veral objectives. Studies based on cross-sectional me- Viçosa. thodologies, as well as their challenges and solutions, are scarcely reported in the literature11. Seeking to contribute to the discussion on the me- Introduction thodological aspects and logistics of a population-ba- sed study conducted by a multidisciplinary team and Obesity is a public health problem that has increa- reduce the gap in the literature concerning the des- sed considerably. In 2008, the worldwide prevalence cription of these aspects, the aim of this study is to of obesity in men was 9.8% and 13.8% in women and describe the procedures for a population-based study is almost double the values seen in 1980. The estima- in Viçosa, Minas Gerais, Brazil, with the focus on the tes are that in 2008 approximately 205 million men body adiposity index in adults. and 297 million women older than 20 years were obe- se worldwide1. Projections for 2030 show that 2.16 billion people will be overweight and 1.12 billion Methods will be obese with associated comorbidities2. Excess weight is associated with some comorbidities such as The study used a population-based cross-sectional ischemia, stroke, type 2 diabetes, some cancers and design. It was conducted in Viçosa – MG, in the State osteoarthritis3. of Minas Gerais, located in the Zona da Mata region. In Brazil, studies have found that obesity reached The reference population consisted of 20-59 year-old 11% of the population over the period 2002-2003, individuals. Individuals of both sexes living in the which amounted to 10.5 million people4. Data collec- urban area of the municipality of Viçosa were eligi- ted in the capitals of Brazilian states showed that the ble. Data from the 2010 Census indicated that this age prevalence of obesity in Belo Horizonte, Minas Ge- group is composed of 52% of the total population, the rais5 was 9.3%. In 2012, the prevalence of obesity in equivalent to 43,431 people12. Brazil6 was 15.8%, indicating a rapid increase of this condition in approximately 10 years. Techniques were developed and used to measure Population sample size the amount of body fat or the association of excess fat with few comorbidities, including the body mass The sample size was calculated using the Epi-Info index, waist circumference, waist-hip ratio, the skin- software, considering the following parameters: refe- folds, bioimpedance, dual-energy X-ray absorptiome- rence population of 43,431 individuals; outcome pre- try and hydrostatic weighing7, but some of them are valence of 23.4%13, expected sampling error of 3.5%; complex and expensive to be routinely used. Anthro- effect of study design, estimated at 1.5, to which was pometry has then been referenced as a good alterna- added 20% relating to losses or refusals and 10% for tive to assess the collective nutritional status because the control of confounding factors, yielding a final of the ease of obtaining the measurements that can be sample of 1,085 individuals. both reliable and valid, provided there is proper trai- The process of sampling was used, with the first-sta- ning and the measurements are standardized8. ge units being the census tracts, IBGE census units Considering these factors, Bergman et al.9 sugges- and then households. ted a new method, the Body Adiposity Index (BAI), for determining body fat. BAI is calculated from the measurements of height and hip circumference, Number of households visited allowing its determination without the need of measu- ring a person’s body fat as to calculate the Body mass To determine the number of sectors14, 30 census index9. tracts were selected by draw among the 99 existing The BAI validation in different populations and tracts in the urban area of Viçosa, maintaining the with different patterns of body fat distribution has non-replacement policy. After obtaining the census 102 Nutr Hosp. 2015;32(1):101-109 Wellington Segheto et al. 016_8391 Body adiposity index.indd 102 12/06/15 15:54 tract maps, each had the blocks identified and num- Individuals who refused to participate in the study bered. A block number was selected by draw and then were contacted again by the research supervisors. Tho- a corner was also drawn, starting fieldwork clockwise se who maintained no agreement to participate were from the drawn corner.