A Simple Model-Based Index of Abdominal Adiposity

J Clio EpidemiolVol. 44, No. 9, pp. 955-956, 1991 0895-4356/91$3.00+ 0.
00
Printed in Great Britain. All rights reserved Copyright 0 1991 Pergamon Press pk
Second Thoughts
A SIMPLE MODEL-BASED INDEX OF ABDOMINAL

ADIPOSITY
RODOLFO VALDEZ*
Department of Anthropology, 409 Carpenter Building, University Park, PA 16802, U.S.A.
(Received in revised form 2 January 1991)
Obesity has been found to be associated with Likewise, viewing the same person as a
several chronic diseases such a diabetes, hyper- double cone, the outermost circumference (C,)
tension, and atherosclerosis [l]. Furthermore, of such a double cone will be
abdominal obesity has been seen as the most
risky type of obesity [2]; yet the most extensively
used indicator of obesity, the body mass (or
C*=&&.
Quetelet’s) index [3], seems to be rather insensi- Assuming that the true abdominal girth (AG)
tive to regional fat depositions [4,5]. Therefore, of that person lies somewhere between those
the development of ad hoc indices sensitive to two circumferences, then the relationship can be
central fat patterning, such as the waist-to-hip expressed as
ratio [6] or the waist-to-thigh ratio [7], is
justified. C, < AG < C,.
Here, a model-based index of abdominal In order to have a more index-like inequality,
obesity, the “conicity index” or C index, is all terms are divided by C,:
presented. It is based upon the idea that as
people accumulate fat around the waist, the , <AG<s.
shape of their bodies seems to change from that ’ c, ’ c, ’
of a cylinder to that of a “double cone” (two that is to say,
cones with a common base). Similar geometric
approaches have been used in the past to esti- 1,+/X
mate human surface areas [8], or to look for 1
anthropometric predictors of metabolic rates The expression in the middle of this last
193.The derivation of the C index follows. inequality is the C index. To use it, we need a
If a person of a certain height (Ht, in m) and value for D (density). If the average human
weight (Wf, in kg) is viewed as a cylinder, the body density (1050 kg/m’) is used, the formula
external circumference (C,, in m) of such a of the C index becomes
cylinder will be
AG
1.71 C index =
c, =J45 JHr’ 0.109 /E’
where D is human body density (in kg/m3). If this model applies, it is to be expected that
the average of this index in a given popu-
*Present address: Dr R. Valdez, Department of Medi- lation will be within the range stated above;
cine/Epidemiology, University of Texas Health Science
Center, 7703 Floyd Curl Drive, San Antonio, TX 78284, but, given the uncertainty of the estimations of
U.S.A. human body density, the index may need some
CE u,eG
S155
956 Second Thoughts
adjustment. Theoretically, however, human be readily evaluated and, if supported by

body density should have a narrow range be- enough population data, the risk of disease
tween two extremes: the density of human fat associated with abdominal adiposity can be
(900 kg/m3); and the density of fat-free body assessed.
mass (1100 kg/m3) [8]. Individually, it is to be
expected that the larger the value of this index, Acknowledgements-The partial support of the Wen-
ner-Gren Foundation for Anthropological Research is
the more “biconical” the individual’s shape will gratefully acknowledged. The comments of Young Im Ahn
be as a result of the accumulation of abdominal and Adam Connor noticeably improved the readability of
this paper.
Supporting the rationale for this index, it has

been shown empirically that a similar ratio, REFERENCES
1. Burton BT, Foster WR, Hirsch J, Van Itallie TB.

hip circumference Health implications of obesity: an NIH consensus
wt ’ development conference. Int J Obesity 1985; 9:
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/- E 2. Bjijmtorp P. Classification of obese patients and com-
plications related to the distribution of surplus fat.
is remarkably constant in boys regardless of Nutrition 1990; 6: 131-137.
their height, age, and social status [9]. Addition- 3. Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor
ally, the ratio HL. Indices of relative weight and obesity. J Chma Dls
1972; 25: 329-343.
AG 4. Forbes GB. The abdomen: hip ratio. Normative data
and observations on selected patients. Int J Obesity
m 1990; 14: 149-157.
Garn SM, Leonard WR, Hawthorne VM. Three limi-
tations of the body mass index. Am J CBa Nutr 1986;
has been used in a four-step procedure to esti- 6 44: 996-997.
Rimm AA, Hartz AJ, Fischer ME. A weight shape
mate excess body fat in large-scale anthropo- ’ index for assessing risk of disease in 44,820 women.
metric studies among military personnel [lo]. J Clht Epidemlol 1988; 41: 459-465.
Hence, I propose this conicity index (C index) ‘. Ashwell M, Chinn S, Stalley S, Garrow JS. Female fat
distribution-a photographic and cellularity study. Int
as an indicator of abdominal adiposity and of J Obesity 1978; 2: 289-302.
the health risks associated with this type of 8. Behnke AR, Guttentag OE, Brodsky C. Quantification
obesity. Its advantages over other waist ratios of body weight and configuration from anthropo-
metric measurements. Hum Biol 1959; 31; 213-234.
are that is is based on a likely model, and its 9. Von Schelling H. Mathematical deductions from em-
denominator is amenable to tabulation within pirical relations between metabolism, surface area, and
the normal ranges of human heights and 1. weight. Ann NY Acrd Sei 1954; 56: 1143-1164.
Katch FI, Katch VL, Behnke AR. New approach for
weights. Consequently, the “conicity” of any ’ estimating excess body fat from changes in abdominal
waist value, for a given height and weight, can girth. Am J Ham Biol 1990; 2: 125-131.

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J Clio EpidemiolVol. 44, No. 9, pp. 955-956, 1991 0895-4356/91$3.00+ 0.

A SIMPLE MODEL-BASED INDEX OF ABDOMINAL

Department of Anthropology, 409 Carpenter Building, University Park, PA 16802, U.S.A.

(Received in revised form 2 January 1991)

adjustment. Theoretically, however, human be readily evaluated and, if supported by

Supporting the rationale for this index, it has

1. Burton BT, Foster WR, Hirsch J, Van Itallie TB.

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