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Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors

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Abstract

Purpose

This study aims to examine whether body mass index (BMI) overestimates the prevalence of overweight or obese firefighters when compared to waist circumference (WC) and skinfold-based percent body fat (PBF) and to investigate differential relationships of the three adiposity measures with other biological cardiovascular disease (CVD) risk factors.

Methods

The adiposity of 355 (347 males and eight females) California firefighters was assessed using three different measures. Other CVD risk factors (high blood pressure, high lipid profiles, high glucose, and low VO2 max) of the firefighters were also clinically assessed.

Results

The prevalence of total overweight and obesity was significantly (p < 0.01) higher by BMI (80.4 %) than by WC (48.7 %) and by PBF (55.6 %) in male firefighters. In particular, the prevalence of overweight firefighters was much higher (p < 0.01) by BMI (57.3 %) than by WC (24.5 %) and PBF (38.3 %). 60–64 % of male firefighters who were assessed as normal weight by WC and PBF were misclassified as overweight by BMI. When overweight by BMI was defined as 27.5–29.9 kg/m2 (vs. the standard definition of 25.0–29.9 kg/m2), the agreement of the adiposity classification increased between BMI and other two adiposity measures. Obese firefighters had the highest CVD risk profiles across all three adiposity measures. Only when overweight by BMI was defined narrowly, overweight firefighters had substantially higher CVD risk profiles. Obesity and overweight were less prevalent in female and Asian male firefighters.

Conclusions

BMI overestimated the prevalence of total overweight and obesity among male firefighters, compared to WC and skinfold-based PBF. Overweight by BMI needs to be more narrowly defined, or the prevalence of BMI-based overweight (27.5–29.9 kg/m2) should be reported additionally for prevention of CVD among male firefighters.

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Acknowledgments

We express our sincere thanks to the fire department and local union of the International Association of Fire Fighters (IAFF) in Southern California for their support and input into this study. This study was supported by the Centers for Disease Control and Prevention (CDC)/National Institute for Occupational Safety and Health (NIOSH) (Grant No. 5R21OH009911-02). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC/NIOSH.

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  1. Center for Occupational and Environmental Health, University of California, Irvine, 100 Theory, Suite 100, Irvine, CA, 92617, USA

    BongKyoo Choi, Dale Steiss, Javier Garcia-Rivas, Stacey Kojaku, Peter Schnall, Marnie Dobson & Dean Baker

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  1. BongKyoo Choi
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  2. Dale Steiss
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Correspondence to BongKyoo Choi.

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Choi, B., Steiss, D., Garcia-Rivas, J. et al. Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors. Int Arch Occup Environ Health 89, 435–448 (2016). https://doi.org/10.1007/s00420-015-1082-6

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