Obesity and overweight are associated with development of cardiovascular diseases (CVD) and related risk factors such as hypertension, diabetes mellitus (DM), and metabolic syndrome, as well as clinical conditions resulting from the consequent atherosclerotic cardiovascular diseases like stroke, heart attacks and peripheral artery disease. According to the World Health Organization (WHO), obesity and overweight refer to abnormal or excessive fat accumulation in the body that negatively impacts on health. Over the previous decades, several measures were developed and became standardised forms of measuring obesity amongst individuals.
The WHO developed the Body Mass Index (BMI) as measure of overweight and obesity for use in epidemiological studies. However, as BMI increases with body weight, the weight increase may be due to different reasons; spanning from an increase in muscle mass, adiposity, or bone density. This makes (BMI) a poor risk discriminator as it does not distinguish between weight increases from fat, lean muscle, or bone, deriving from the fact that all pathology arising from overweight and obesity is due to excess fat mass. Resulting from this, there was a shift to the use of percentage body fat as a better anthropometric index for CVD risk prediction.
Further observations showed that it is not just the amount fat, but it’s location in the body that relates to cardiometabolic disease. Measures of central obesity became of high interest, following the finding that visceral adipose tissue is the principal contributor to cardiometabolic diseases. The result was the development of anthropometric indices like waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) ratio, which proved to be more accurate than BMI in CVD risk prediction. It also does not uniformly to the same degree of accuracy predict the different CVD phenotypes.
Coming home to sub-Saharan Africa (SSA), the WHO standard measurement of BMI has shown to be somewhat unsuitable, as genetic factors modify its association with CVD risk; calling for the need to find some other appropriate anthropometric measure. This may also apply to other populations that have limited representation in large scale CVD risk studies related to body composition. WC, which is simple and works well among Asian populations, does not always reflect visceral obesity as it includes abdominal subcutaneous fat. It also does not factor in individual ethnic and gender differences in phenotype and body composition. Some authors have posited that anthropometric measures in different ethnic, gender and groups have different predictive powers in cardiometabolic diseases, hence, the need to establish appropriate cut-off points for each index in different populations. This gave rise to the abdominometer concept with the abdominal height (AH) being the anthropometric measure considered appropriate for SSA. Considering non-anthropometric approaches like use of bioimpedance measures now coupled with simple weighing scales (hence affordable) for body composition measurement is also worth exploring.
This issue on Cardiovascular Anthropometry For Large Scale Population Studies in Frontiers in Cardiovascular Medicine aims to highlight the latest research on cardiovascular anthropometry in large population groups. Articles that discuss and refine the WHO recommended measure, BMI, making it more predictive of cardiometabolic diseases in under-represented ethnic groups are of special interest in this collection. Furthermore, studies which investigate sex differences in the accuracy of anthropometric measurements for cardiovascular risk prediction are also welcome.
Obesity and overweight are associated with development of cardiovascular diseases (CVD) and related risk factors such as hypertension, diabetes mellitus (DM), and metabolic syndrome, as well as clinical conditions resulting from the consequent atherosclerotic cardiovascular diseases like stroke, heart attacks and peripheral artery disease. According to the World Health Organization (WHO), obesity and overweight refer to abnormal or excessive fat accumulation in the body that negatively impacts on health. Over the previous decades, several measures were developed and became standardised forms of measuring obesity amongst individuals.
The WHO developed the Body Mass Index (BMI) as measure of overweight and obesity for use in epidemiological studies. However, as BMI increases with body weight, the weight increase may be due to different reasons; spanning from an increase in muscle mass, adiposity, or bone density. This makes (BMI) a poor risk discriminator as it does not distinguish between weight increases from fat, lean muscle, or bone, deriving from the fact that all pathology arising from overweight and obesity is due to excess fat mass. Resulting from this, there was a shift to the use of percentage body fat as a better anthropometric index for CVD risk prediction.
Further observations showed that it is not just the amount fat, but it’s location in the body that relates to cardiometabolic disease. Measures of central obesity became of high interest, following the finding that visceral adipose tissue is the principal contributor to cardiometabolic diseases. The result was the development of anthropometric indices like waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) ratio, which proved to be more accurate than BMI in CVD risk prediction. It also does not uniformly to the same degree of accuracy predict the different CVD phenotypes.
Coming home to sub-Saharan Africa (SSA), the WHO standard measurement of BMI has shown to be somewhat unsuitable, as genetic factors modify its association with CVD risk; calling for the need to find some other appropriate anthropometric measure. This may also apply to other populations that have limited representation in large scale CVD risk studies related to body composition. WC, which is simple and works well among Asian populations, does not always reflect visceral obesity as it includes abdominal subcutaneous fat. It also does not factor in individual ethnic and gender differences in phenotype and body composition. Some authors have posited that anthropometric measures in different ethnic, gender and groups have different predictive powers in cardiometabolic diseases, hence, the need to establish appropriate cut-off points for each index in different populations. This gave rise to the abdominometer concept with the abdominal height (AH) being the anthropometric measure considered appropriate for SSA. Considering non-anthropometric approaches like use of bioimpedance measures now coupled with simple weighing scales (hence affordable) for body composition measurement is also worth exploring.
This issue on Cardiovascular Anthropometry For Large Scale Population Studies in Frontiers in Cardiovascular Medicine aims to highlight the latest research on cardiovascular anthropometry in large population groups. Articles that discuss and refine the WHO recommended measure, BMI, making it more predictive of cardiometabolic diseases in under-represented ethnic groups are of special interest in this collection. Furthermore, studies which investigate sex differences in the accuracy of anthropometric measurements for cardiovascular risk prediction are also welcome.
