is bmi discrete or continuous

Development of health-related waist circumference thresholds within BMI categories. Relation of body fat distribution to metabolic complications of obesity. Choosing the Right Statistical Test | Types & Examples - Scribbr Thus, these waist circumference threshold values were designed to be used in place of BMI as an alternative way to identify obesity and consequently were not developed based on the relationship between waist circumference and adverse health risk. Shaded areas represent 95% confidence intervals. Notice that for the last (highest) blood pressure category, the cumulative frequency is equal to the sample size (n=3,533) and the cumulative relative frequency is 100% indicating that all of the patients are at the highest level or below. The raw BMI is a quantitative continuous variable but the categorization of the BMI makes the transformed variable a qualitative (ordinal) variable, where the levels are in this case underweighted < normal . Wang J, et al. The evaluation of the utility of any biomarker, such as waist circumference, for risk prediction requires a thorough understanding of the epidemiological context in which the risk assessment is evaluated. R.R., I.J.N. Association of Body Shape Index (ABSI) with cardio-metabolic risk It is not surprising that waist circumference and BMI alone are positively associated with morbidity15 and mortality13 independent of age, sex and ethnicity, given the strong association between these anthropometric variables across cohorts. Although guidelines for the management of obesity from several professional societies recognize the importance of measuring waist circumference, in the context of risk stratification for future cardiometabolic morbidity and mortality, these guidelines limit the recommendation to measure waist circumference to adults defined by BMI to have overweight or obesity. Santos FL, Esteves SS, da Costa Pereira A, Yancy WS, Jr., Nunes JP. For example: For simplicity, we usually referred to years, kilograms (or pounds) and centimeters (or feet and inches) for age, weight and height respectively. eCollection 2023 May. Time-Restricted Feeding Modifies the Fecal Lipidome and the Gut Microbiota. By clicking Subscribe, I agree to the WebMD, Jean's Story: Ice Hockey and a Healthy BMI, BMI, Waist Size, and Other Ways to See if You're Overweight, Need to Lose Weight? Obesity in the USMLE Step 1 examination: A call to action. Obes Rev. Explaining adult obesity, severe obesity, and BMI: Five decades of change. I recently heard that body mass index isnt the best way to determine whether youre overweight or obese. O'Neill, T., Shalev-Goldman, E. & Ross, R. in. Consequently, although adopting a standard approach to waist circumference measurement would add to the utility of waist circumference measures for obesity-related risk stratification, the prevalence estimates of abdominal obesity in predominantly white populations using the iliac crest or midpoint protocols do not seem to be materially different. A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. The .gov means its official. Compared with the previous measurements, the waistheight ratio shows similar and sometimes slightly stronger associations with the risk of CVD or T2DM28,29. Suppose the sample of 10 diastolic blood pressures looked like the following: 62 63 64 67 70 72 76 77 81 140. -. Thus, for a given waist circumference, a larger BMI might represent a phenotype with elevations in lower body subcutaneous adipose tissue. http://www.myhealthywaist.org/evaluating-cmr/clinical-tools/waist-circumference-measurement-guidelines/index.html. Lahti-Koski M, Harald K, Mannisto S, Laatikainen T, Jousilahti P. Fifteen-year changes in body mass index and waist circumference in Finnish adults. These observations are promising and support, at least for white adults, the clinical utility of the BMI category-specific waist circumference thresholds givenin Table1. Despres JP. Abdominal obesity was defined as waist circumference 88cm and 102cm for women and men, respectively. 1. See this image and copyright information in PMC. Accuracy of the pooled cohort equation to estimate atherosclerotic cardiovascular disease risk events by obesity class: a pooled assessment of five longitudinal cohort studies. However, we may work with only the number of weeks since birth and thus transforming the age into a discrete variable. However, it is also well established that, for any given BMI, the variation in waist circumference is considerable, and, in any given BMI category, adults with higher waist circumference values are at increased adverse health risk compared with those with a lower waist circumference3840. Quantitative variables are divided into two types: discrete and continuous. The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Short KR, et al. Their BMI puts them in the obesity range. Among children, obesity was associated with $116 (95% CI $14-$201) excess costs per person and $1.32 billion (95% CI $0.16-$2.29) of medical spending, with severe obesity associated with $310 (95% CI $124-$474) excess costs per child. If this true, can you tell me what changed? Waist circumference as a measure for indicating need for weight management. Of note, to our knowledge every study that has reported a reduction in waist circumference has also reported a corresponding reduction in VAT. What is the prevalence of type II diabetes at the end of the study . For example, a systematic review and meta-regression analysis of 18 studies comprising >680,000 European participants with up to 24 years of follow-up demonstrated that waist circumference was associated with increased all-cause death above values of 95cm for men and 80cm for women60. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. The general formula for the sample mean is: The X with the bar over it represents the sample mean, and it is read as "X bar". Note that the cumulative frequencies reflect the number of patients at the particular blood pressure level or below. "The standard definition of overweight is a BMI of 25 or above. What Are the Drawbacks of BMI? 6 Limitations - MedicineNet doi: 10.1377/hlthaff.28.5.w822. Discrete variables (also called categorical variables) are divided into 2 subtypes: (unordered) and (ordered). An explanation for why adding height increases the prediction of disease risk might be because short stature is associated with increased risk of CVD30. Ideally, the person is seated with the arm hanging loosely at his side. Waist circumference as a vital sign in clinical practice: a Consensus Available from: Fryar CD, Carroll MD, Ogden CL. Upon careful review of the various protocols described within the literature, the panel recommended that the waist circumference protocol described by the WHO guidelines98 (the midpoint between the lower border of the rib cage and the iliac crest) and the NIH guidelines99 (thesuperior border of the iliac crest) are probably more reliable and feasible measures for both the practitioner and the general public. Higher health care costs are associated with excess body weight across a broad range of ages and BMI levels, and are especially high for people with severe obesity. Pendergast K, et al. The influences of height and age on waist circumference as an index of adiposity in adults. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? There are n=3,530 valid responses to the marital status question (9 participants did not provide marital status data). Table 6 - Frequency Distribution Table for Smoking Status, return to top | previous page | next page. Phillips CM. The difference is explained in the following two sections. The authors have declared that no competing interests exist. At a minimum, scatterplots require two continuous variables. We recommend that prospective studies using representative populations are carried out to address the need for BMI category-specific waist circumference thresholds across different ethnicities (such as those proposed in Table, Disease prevention, Obesity, Metabolic syndrome, Predictive markers. Consequently, if we select a man at random from this population and ask what is the probability his BMI . www.drweil.com. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. Furthermore, similar CVD risk estimates were observed when MHO was defined by criteria other than the absence of the metabolic syndrome5. This method of determining whether you are of normal weight, overweight or obese has been around for about 200 years and has long been criticized as inadequate because it doesnt tell us the ratio of body fat to lean muscle mass in the body. 211 2 10 There is no clear answer for either BMI or age. Discrete vs. The lack of inclusion of waist circumference in global obesity surveillance might inadequately characterize the health risk associated with the global obesity prevalence, as it seems that the prevalence of abdominal obesity is increasing. Ethnicity-specific values for waist circumference that have been optimized for the identification of adultswith elevated CVD risk have been developed (Table2). Eye color is another example of a nominal variable because there is no order among blue, brown or green eyes. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. When there is an odd number of observations in the sample, the median is the value that holds as many values above it as below it in the ordered data set. The superior border of the wing of the ilium. When this process becomes saturated or in situations where adipose tissue has a limited ability to expand, there is a spillover of the excess energy, which must be stored in visceral adipose tissue as well as in normally lean organs such as the skeletal muscle, the liver, the pancreas and the heart, a process described as ectopic fat deposition. General obesity was defined as BMI 30kg/m2. Taken together, these observations highlight the critical role of waist circumference reduction through lifestyle behaviours in downstream reduction in morbidity and mortality (Fig. The research team that conducted the latest study also tested their participants levels of leptin, a hormone secreted by body fat, and reported that the results seem to mirror DEXA findings. Epub 2009 Jul 27. However, both men and women tend to underestimate their waist circumference measures compared with the technician-measured values, with differences ranging between about 1cm and 3cm. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. BMI is what type of data? Continuous Data: Differences & Examples By Jim Frost Leave a Comment Discrete vs continuous data are two broad categories of numeric variables. Despite these gaps in our knowledge, overwhelming evidence presented here suggests that the measurement of waist circumference improves patient management and that its omission from routine clinical practice for the majority of patients is no longer acceptable. Kissebah AH, et al. The exercise intensity at which the blood concentration of lactate and/or lactic acid begins to exponentially increase. Simulation of Growth Trajectories of Childhood Obesity into Adulthood. R.R., I.J.N. Han TS, et al. For example, the variable gender is nominal because there is no order in the levels female/male. Comparison of various surrogate obesity indicators as predictors of cardiovascular mortality in four European populations. Created by Lisa Sullivan, PhD and Wayne W. LaMorte, MD, PhD, MPH, Boston University School of Public Health, Numerical Summaries for Discrete Variables, Frequency Distribution Tables for Dichotomous Variables, Frequency Distribution Tables for Categorical Variables, Frequency Distribution Tables for Ordinal Variables, Normal: systolic blood pressure <120 and diastolic blood pressure <80, Pre-hypertension: systolic blood pressure between 120-139 or diastolic blood pressure between 80-89, Stage I hypertension: systolic blood pressure between 140-159 or diastolic blood pressure between 90-99, Stage II hypertension: systolic blood pressure of 160 or more or diastolic blood pressure of 100 or more, Borderline high risk:total cholesterol between 200239 mg/dL and, High risk:total cholesterol of 240 mg/dL or greater. For the assessment of the effectiveness of lifestyle changes in adults, waist circumference might be preferred as a simple tool. Examples of quantitative characteristics are age, BMI, creatinine, and time from birth to death. I suggest you review previous literature on this decision if you want to do what editors and reviewers find acceptable. And yet on every level that we look at, their health is actually quite good," he says. Waist-to-height ratio: This compares your waist measurement to your height. 2023 Apr 17;10:1110748. doi: 10.3389/fnut.2023.1110748. Despres JP, et al. Slentz CA, et al. For example, 2,658 patients have normal blood pressure or pre-hypertension. Paajanen TA, Oksala NK, Kuukasjarvi P, Karhunen PJ. Continuous Data: What's the Difference? Their observations are consistent with those of Slentz and colleagues, whereby differences in exercise intensity did not affect waist circumference reductions. official website and that any information you provide is encrypted Sometimes it is of interest to compare two or more groups on the basis of a dichotomous outcome variable. The location of your fat makes a difference to your health. Dr. Weil on Healthy Aging for Healthy Eating, Looking For A Sense Of Calm? People of Indian descent face higher health risks at relatively lower BMIs, Atkinson says. FFA, free fatty acid. Suppose the diastolic blood pressures had been: 62 63 64 64 70 72 76 77 81 81. Hlatky MA, et al. (If the mean and median are very different, it suggests that there are outliers affecting the mean.). Mason C, Katzmarzyk PT. or Healthy Lifestyle Brands. In scientific research, a variable is anything that can take on different values across your data set (e.g., height or test scores). Originally published at https://statsandr.com on December 30, 2019. The prevalence of adult overweight and obesity as defined using BMI has increased worldwide since the 1980s, with no country demonstrating any successful declines in the 33 years of recorded data1. For example, Ian Janssen and colleagues examined the changes in waist circumference for a given BMI over a 30-year period in a Canadian sample35. You also agree to receive emails from DrWeil.com, and you may opt Over 30 units of BMI, each one-unit BMI increase was associated with an additional cost of $253 (95% CI $167-$347) per person. 10.1016/S0140-6736(16)30175-1 6 potential drawbacks of BMI as a measure of body composition. Despite the numerical classification, the variable gender is still a qualitative variable and not a discrete variable as it may look. The rightmost column contains the body mass index (BMI) computed using the height and weight measurements. However, no significant differences were observed in VAT reduction by single slice CT between high-intensity and low-intensity groups. Another good example is health, which can take values such as poor, reasonable, good, or excellent. NCI's Dictionary of Cancer Terms provides easy-to-understand definitions for words and phrases related to cancer and medicine. reports grants and personal fees from Kowa Company, Ltd., Otsuka Pharmaceutical Co., Ltd., Shionogi & Co., Ltd., Bayer Yakuhin, Ltd., MSD K.K., Takeda Pharmaceutical Company, Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Astellas Pharma Inc., Daiichi-Sankyo Company, Ltd., Astra Zeneka K.K. Seidell JC. reports his role as a scientific adviser for PROMINENT (Kowa Company Ltd.) and being on the advisory committees for Novo Nordisk and Sanofi/Regeneron. For example, suppose we wish to compare the extent of treatment with antihypertensive medication in men and women, as summarized in the table below. However, when BMI and waist circumference are considered as continuous variables in the same risk prediction model, risk prediction by waist circumference improves, whereas the association between BMI and adverse health risk is weakened10,43. Goff DC, Jr., Lloyd-Jones DM, Bennett G, Coady S. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.
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