Accuracy of alternative indexes for assessing the nutritional status of men and women

Pereira, Guilherme Adroaldo Moraes; Matheus, Silvana Corrêa; Both, Diego Rodrigo; Behenck, Mauri Schwanck

doi:10.5007/1980-0037.2017v19n3p290

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Revista Brasileira de Cineantropometria & Desempenho Humano

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Original Article • Rev. bras. cineantropom. desempenho hum 19 (3) • May-Jun 2017 • https://doi.org/10.5007/1980-0037.2017v19n3p290 copy

Accuracy of alternative indexes for assessing the nutritional status of men and women

Acurácia de índices alternativos para avaliar o estado nutricional de homens e mulheres

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

A good evaluation of the nutritional status requires knowledge on body composition, casting doubts on the accuracy of some indexes. Therefore, the aim of this study was to analyze the accuracy of the following nutritional status indexes: Body Mass Index (BMI), BMI elevated to 2.5 (BMI^2.5), Fat Mass Index (FMI) and BMI adjusted for fat mass (BMIfat). Participated of this study 280 subjects (aged 17-48 years), from which the results of BMI, BMI²⁵, FMI and BMIfat indexes were analyzed, having the Hydrostatic Weighing method as reference. FMI presented the highest concordance value, but classified as discrete (k=0.21). he other indexes presented small concordance with results of the reference method (k<0.20). In conclusion, none of the indexes investigated has good accuracy in assessing the nutritional status of the study group, considering that, although they show results of correlation with the reference method, they do not reach the minimum agreement criterion.

Key words
Anthropo metry; Body composition; Hydrostatic weighing; Nutritional evaluation

Equations for converting BD into BF% for specific populations
Ethnicity	Age	Sex	Equation to estimate BF%
Black	18 - 32	Male	[(4.37/Dc) - 3.93] x 100
	24 - 79	Female	[(4.85/Dc) - 4.39] x 100
White	20 - 80	Male	[(4.95/Dc) - 4.50] x 100
		Female	[(5.01/Dc) - 4.57] x 100
Cutoff points for BF% classification according to sex
Classification		Men	Women
Risk associated with malnutrition		≤ 5%	≤ 8%
Below mean		6% - 14%	9% - 22%
Mean		15%	23%
Above mean		16% - 24%	24% - 31%
Risk associated with obesity		≥25%	≥ 32%

Groups / Variables	Male (n = 210)		Female (n = 70)
Groups / Variables	Mean	sd	Mean	sd
Age (years)	23.7	5.3	21.9	3.2
Body weight (kg)	78.3	11.1	62.7	11.1
Height (cm)	177.2	6.4	165.2	7.1
BMI (kg /m²)	24.8	2.9	22.8	3.2
BF% (HW)	17.2	5.6	27	5.4

Groups HW / Indexes	Male		Female
Groups HW / Indexes	r	p	r	p
BMI	0.536	0.000	0.597	0.000
BMI²2 Acuna k, Cruz T. Avaliação do Estado Nutricional de Adultos e Idosos e Situação Nutricional da População Brasileira. Arq Bras Endocrinol Metab 2004;48(3):345-61.^,⁵5 A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chronic Dis 1972;25(6):329-43.	0.525	0.000	0.619	0.000
FMI	0.716	0.000	0.628	0.000
BMIfat	0.667	0.000	0.626	0.000

Groups HW / Indexes		Male					Female
Groups HW / Indexes		ABR	E	ACR	T (n)	k	ABR	E	ACR	T (n)	k
BMI	ABR	1	0	0	1	0.05	0	0	1	1	0.03
	E	56	6	55	117		13	4	39	56
	ACR	25	8	58	91		0	1	12	13
	T (n)	82	14	113	209		13	5	52	70
BMI2,5	ABR	3	0	0	3	0.09	0	0	1	1	0.05
	E	64	10	63	137		13	4	37	54
	ACR	15	4	51	70		0	1	14	15
	T (n)	82	14	114	210		13	5	52	70
FMI	ABR	27	1	11	39	0.21	6	1	11	18	0.08
	E	35	10	59	104		4	2	24	30
	ACR	0	0	29	29		0	0	3	3
	T (n)	62	11	99	172		10	3	38	51
BMIfat	ABR	52	4	34	90	0.19	10	3	19	32	0.09
	E	22	9	60	91		3	2	26	31
	ACR	0	0	17	17		0	0	6	6
	T (n)	74	13	111	198		13	5	51	69

Universidade Federal de Santa Catarina Universidade Federal de Santa Catarina, Campus Universitário Trindade, Centro de Desportos - RBCDH, Zip postal: 88040-900 - Florianópolis, SC. Brasil, Fone/fax : (55 48) 3721-8562/(55 48) 3721-6348 - Florianópolis - SC - Brazil
E-mail: rbcdh@contato.ufsc.br

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[1] Silvana Corrêa Matheus, Av. João Machado Soares, 1240 B3/313, Bairro Camobi Santa Maria - Rio Grande do Sul - Brasil, CEP : 97110-000. Email : silvanamatheus@gmail.com

Indexes	BMI and BMI²2 Acuna k, Cruz T. Avaliação do Estado Nutricional de Adultos e Idosos e Situação Nutricional da População Brasileira. Arq Bras Endocrinol Metab 2004;48(3):345-61.^,⁵5 A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chronic Dis 1972;25(6):329-43.	FMI	BMIfat	BF%	Adequacy of categories
References	WHO⁶6 Health Organization /WHO. Global Database on Body Mass Index: BMI clas-sification. WHO: Switzerland. 2006; Available from: <http://apps.who.int/bmi/index.jsp?introPage=intro_3.html> [2017 fev 15]. http://apps.who.int/bmi/index.jsp?introP...	Kelly et al.¹⁰10 Kelly TL, Wilson KE, Heymsfield SB. Dual Energy X-Ray Absorptiometry Body Composition Reference Values from NHANES. PLoS One 2009;4(9):1-10.	Mialich et al.¹²12 Mialich MS, Martinez EZ, Jordão Jr AA. Application of body mass index adjusted for fat mass (BMIfat) obtained by bioelectrical impedance in adults. Nutr Hosp 2014;30(2):417-24.	Lohman¹⁷17 Lohman TG. Advances in body composition assessment. Med Sci Sports Exerc 1993;25(6):762-63.	Adequacy of categories
Categories	Severe low weight	Severe deficit	Nutritional risk for malnutrition	Risk associated to malnutrition	Below reference
	Moderate low weight	Moderate deficit		Risk associated to malnutrition
	Mild low weight	Mild deficit		Below mean
	Normal weight	Normal weight	Normal weight	Mean	Normal weight
	Overweight	Excess weight	Obesity	Above mean	Above reference
	Obese class 1	Obese class 1		Risk associated toobesity
	Obese class 2	Obese class 2
	Obese class 3	Obese class 3