Advances in Obesity, Weight Management & Control Review Article Open Access Historical review of developing body weight indices: meaning and purpose Abstract Volume 6 Issue 6 - 2017 Rationale: The last century was blossoming with the development of multiple Marina Komaroff indices to measure body weight. Many researchers aimed to explore the association Department of Epidemiology and Biostatistics, SUNY of extra body weight with various diseases using different approaches of body weight Downstate Medical Center, USA measures. However, there is no summary of developed body mass indices highlighting their strengths and/or weaknesses. Correspondence: Marina Komaroff, Department of Epidemiology and Biostatistics, SUNY Downstate Medical Objective: This paper reviews and compares the existing body weight indexes that Center, Brooklyn, NY, 11203, USA, Email [email protected] were developed particularly to define overweight and obesity in relation to adverse health outcomes. Received: May 08, 2017 | Published: June 09, 2017 Methods: A systematic literature review was performed to chronologically summarize the development of body weight measures from the first index developed by Quetelet (BMI) in 1832 to Body Adiposity Index (BAI) in 2011. Conclusion: The paper provides summary of the development and validation of existing body weight indexes. Knowledge of the historical approaches to the measurements of obesity will help researchers to utilize the appropriate body weight assessments to address their objectives. Latin Proverb: “A good beginning ensures a good ending”. Keywords: body weight index, overweight, obesity, epidemic, chronic, body weight Abbreviations: FFM, fat-free-mass; BFM, body fat mass; increased mortality became documented by insurance companies. PBF, percent body fat; SAD, sagittal abdominal diameter; BMI, body After the World War II, the interest shifted to the association between mass index body weight and morbidity with a question how to classify the excess of body weight that can adversely affect health. This paper reviews Introduction the process of development and validation of different body weight indexes. The major milestones of this process are presented in Table 1. In the beginning of the 20th century the association of obesity and Table 1 Development of indexes to measure body weight Date Who Index Technique used Population Purpose Conclusion [Ref] Quetelet suggested first anthropological Index based on Quatelet Anthropometric Adolphe Belgium men Define a “Normal observation that 18321 Index=weight/ methods - Direct Quetelet and women man” weight increases proportionally to height2 W/H2 measure height squared. Ponderal Index: Anthropometric Height divided by Measure of Proposed to measure adiposity or 18972 Livi methods - Direct UK cube root of weight Obesity obesity measure H/W1/3 1. All three indexes highly correlate W. Z. Billewicz, with adiposity W/H Anthropometric Compare 3 W. F. F. Kemsley, 2. W/H2 is less biased (each index 19625 W/H2 methods - English indexes to and A. M. selects different proportions of H/W1/3 (PI) Direct measure measure obesity Thomson individuals according to their height) Submit Manuscript | http://medcraveonline.com Adv Obes Weight Manag Control;6(6):184‒192. 184 © 2017 Komaroff. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Historical review of developing body weight indices: meaning and purpose ©2017 Komaroff 185 Table Continued.... Date Who Index Technique used Population Purpose Conclusion [Ref] UK,Birmingham Compare 3 study of the indexes to distribution measure obesity I : r =0.97 r = .3 I : r =0.85 r ~ I = W/H Anthropometric of arterial 1 1 2 2 1 2 T. Khosla and 1 by 2 criteria: 1) 0 I : r =0.6 r =-0.3 I is the most 19676 I = W/H2 methods - pressure in 3 1 2 2 C. R. Lowe 2 Correlate with appropriate for epidemiological H/W1/3 (PI) Direct measure an industrial weight (r ) 2) studies ( at least for British pop.) population 1 Independent of N=5000 men height (r ) employed 2 I = W/H 1 US, Framingham I = W/H2 2 Study, 1. Western male population was I = W/H3= 3 Massachusetts Quetelet Index (W/H2), probable (Rohrer Index-as N=5127 free Compare 3 in Western female population variation of H/ Anthropometric Charles du V. from coronary indexes to was W/H; and the least likely for 19703 W1/3 (PI)) Triceps methods - Direct Florey disease at first measure obesity both sexes was Ponderal Index. skinfold & measure exam N=4541 and adiposity 2. All indexes are poor Intrascapullar persons were measurements of skinfold (as best reexamined Adiposity adiposity during Exam IV measurements) Several countries in Europe, Japan, men in South Africa, white Criteria of PI is the poorest men in the correlation W/H United with height A. Keys, F. W/H2 – is the best W/H2 States (lowest is Fidanza, M. J. Anthropometric PI 7424 ‘healthy’ best) and to 19727 Karvonen N. methods - Direct Body Mass Index (BMI) %W (%from weight men in measures Kimura And H. measure which is W/H2 is standard at given 12 cohorts in of L. Taylor preferable measure to height) five body fatness “all populations in all countries. (highest times” Body density in is best) N=180 young men and in 248 men aged 49-59. TOBEC by 124 healthy and To demonstrate electromagnetic 32 Non-obese Theodore B the clinical value scanning young Vanltaiie, Mei- of FFMI = FFM (kg)/ instrument (EM- men (from the Uih Yang, the FFMI and the Defined FFMI and BFMI that may H(m)2, SCAN, model HA- Minnesota Steven B BFMI be used in nutritional assessment 199018 2, Springfield, IL) - Study) Heymsfield, (can be helpful (cutoff points should be chosen in BFMI = BFM (kg)/ FFM before, during, Robert C Funk, in the more representative population H(m)2 Hydrodensitometry and and Richard A nutritional in all 32 subjects after Boileau assessment for Body experimental of patients). Composition semi-starvation. In 1229 subjects, 521 males and 708 Child %BF = (1.51 x BMI) Paul %BF - females, with a %Body Fat %BF – (0.70 x Age) – (3.6 x Deurenberg, densitometry wide Sex)+1.4; Jan A. (underwater range in body Compare BMI and 199115 Formula for Weststrate, weight + Siri’s mass %BF children and Adult %BF = (1.20 x BMI) and Jaap C. formula) BMI- index (BMI; adult using BMI + (0.23 x Age) – (10.8 x Seidell anthropometry 13.9-40.9kg/ Sex) – 54. m2), and an age range of 7-83years Citation: Komaroff M. Historical review of developing body weight indices: meaning and purpose. Adv Obes Weight Manag Control. 2017;6(6):184‒192. DOI: 10.15406/aowmc.2017.06.00177 Copyright: Historical review of developing body weight indices: meaning and purpose ©2017 Komaroff 186 Table Continued.... Date Who Index Technique used Population Purpose Conclusion [Ref] 5635 apparently To determine healthy adults reference values Bioelectrical from a for impedance FFMI (fat-free mixed non- fat-free mass analysis (50 kHz) Reference intervals for mass=height randomly index was measured FFMI and FMI Y Schutz, UUG squared) selected (FFMI) and fat (using tetrapolar 200219 Kyle and C and Caucasian mass index (FMI) electrodes (BMI international criteria was used Pichard FMI (fat population in as a function of and cross- validated as cutoff points for calculation of mass=height Switzerland age and formulae by dual- corresponding FFMI and FMI values) squared). (2986 men and gender and to energy X- ray 2649 women), develop percentile absorptiometry at age from 24 distribution for to 98y. them. Iribarren, Association Association SAD was a strong 101,765 adult Carlos; between between predictor of CHD independently members Darbinian, visceral obesity Anthropometric visceral obesity of BMI; of Kaiser 200622 Jeanne A.; measured by SAD measure: Standing measured by SAD the joint consideration of BMI/SAD Permanente of Lo, Joan C.; and SAD (cm) and coronary categories as better assessment risk Northern Fireman, Bruce coronary heart heart disease of CHD compared with use of BMI California H.; Go, Alan S disease (CHD) (CHD) alone A longitudinal Anthropometric study measure: Standing included 6,583 SAD (cm) - members of distance between Kaiser the back surface Permanente of Whitmer, R. A.; Visceral obesity Association and the top of the Northern Gustafson, D. Association increases risk of between abdomen at the California; R.; Barrett- between dementia independent of visceral obesity level of the iliac (SAD) 200826 Connor, E.; visceral obesity diabetes and measured by SAD crest after gentle measured in Haan, M. N.; measured by SAD cardiovascular co- and expiration with the 1964 to 1973, Gunderson, E. and dimensia morbidities among mid- dementia patient in a 1,049 P.; Yaffe, K aged population standing position participants using an (15.9%) were anthropometer; diagnosed with High SAD ≥25 cm dementia Low SAD <25 cm 36years later Abel Romero- Using the Accuracy of Corral, Virend World Health BMI≥30kg/m2 to K. Somers, Organization detect excess in 13,601 subjects Diagnostic accuracy of Justo Sierra- reference body adiposity (age BMI to diagnose obesity is limited Johnson,, standard for compared to Body 20–79.9years; (for individuals Randal J. obesity (based Fat% Bioelectrical 48% men) from in the intermediate BMI ranges). Thomas, Kent on BMI cut offs): BMI-defined obesity impedance analysis the A BMI cut-off of ≥30kg/m2 has a R. Bailey, Maria Obesity of BF % > 200817 (≥30kg/m2) was was used Third National good L Collazo- 25% in men and > present in 21% of to estimate body fat Health and specificity but misses more than Clavell, Thomas 35% in women. men and 31% of percent (BF %). Nutrition half of people with excess fat. May G. Allison, Josef women, while Examination explain differences in shapes (U or Korinek, Correlation BF %-defined Survey. J) of association between BMI and John A.