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Int J Obes (Lond). 2006 Jun;30(6):918-25.

Validity of body mass index and waist circumference in the classification of obesity as compared to percent body fat in Chinese middle-aged women.

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Department of Community & Family Medicine, and the School of Public Health, The Chinese University of Hong Kong, Hong Kong SAR.



To evaluate the validity of currently recommended obesity cutoffs of body mass index (BMI, in kg/m(2)) and waist circumference (WC, in cm) for Asians by the WHO/IASO/IOTF and for Chinese by the Working Group on Obesity in China (WGOC) using the percentage body fat (%BF)-obesity criteria.


A cross-sectional study.


A total of 1122 community-based Hong Kong Chinese women aged between 41 and 63 years.


Total %BF and percent truncal fat (%TF) were measured using dual-energy X-ray absorptiometry. Anthropometric indices were measured using standard methods.


Regression analyses showed that the BMI cutoffs of 23, 24, 25, and 28 kg/m(2) corresponded to the %BF of 34.8, 35.9, 36.9 and 39.5%, and the 80 cm WC corresponded to 34% TF, respectively. Compared with the %BF obesity cutoff (>/=40%), the WHO/IASO/IOTF BMI-obesity criterion (>/=25) shows a good sensitivity (75%) and specificity (71%); and the WGOC criterion (BMI>/=28) had a low sensitivity (41%) but an excellent specificity (93%), respectively. Corresponding to the BMI cutoffs of 23, 24, 25 and 28 kg/m(2), the %BF cutoffs associated with peak kappa statistic were 33, 34, 35 and 40%, and the relevant %TF linked with 80 cm WC was 33%, respectively.


BMI and WC have a good accuracy in the prediction of obesity. Our findings suggest that the WGOC BMI cutoffs are appropriate, but 80 cm of WC is a very rigorous cutoff for this population when using the criteria of 34 and 40% of body fat or truncal fat for overweight and obesity.

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