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      Parental Midlife Body Shape and Association with Multiple Adult Offspring Obesity Measures: North West Adelaide Health Study

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          Abstract

          There is compelling evidence that parental weight is a strong determinant of offspring weight status. The study used cross-sectional self-reported and measured data from a longitudinal cohort of Australian adults (n = 2128) from Stage 3 (2008–10) of the North West Adelaide Health Study (1999–2003, baseline n = 4056) to investigate the association between midlife parental body shape and four indicators of obesity and fat distribution. The analysis used measured body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and waist height ratio (WHtR) of adult offspring, together with pictograms for recall of parental body shape. Compared to both parents being a healthy weight, offspring were more likely to be overweight or obese if both parents were an unhealthy weight at age 40 (OR 2.14, 95% CI 1.67–2.76) and further, those participants whose mother was an unhealthy weight were more likely to be overweight or obese themselves (OR 1.50, 95% CI 1.14–1.98). There were similar but lower results for those with an overweight/obese father (OR 1.44, 95% CI 1.08–1.93). The effect of one or both parents being overweight or obese tended to be stronger for daughters than for sons across BMI, WC and WHtR. BMI showed the strongest association with parental body shape (OR 2.14), followed by WC (OR 1.78), WHtR (OR 1.71) and WHR (OR 1.45). WHtR (42–45%) and BMI (35–36%) provided the highest positive predictive values for overweight/obesity from parental body shape. Parental obesity increases the risk of obesity for adult offspring, both for overall body shape and central adiposity, particularly for daughters. Pictograms could potentially be used as a screening tool in primary care settings to promote healthy weight among young adults.

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          Waist circumference as a measure for indicating need for weight management.

          To test the hypothesis that a single measurement, waist circumference, might be used to identify people at health risk both from being overweight and from having a central fat distribution. A community derived random sample of men and women and a second, validation sample. North Glasgow. 904 men and 1014 women (first sample); 86 men and 202 women (validation sample). Waist circumference, body mass index, waist:hip ratio. Waist circumference > or = 94 cm for men and > or = 80 cm for women identified subjects with high body mass index (> or = 25 kg/m2) and those with lower body mass index but high waist:hip ratio (> or = 0.95 for men, > or = 0.80 women) with a sensitivity of > 96% and specificity > 97.5%. Waist circumference > or = 102 cm for men or > or = 88 cm for women identified subjects with body mass index > or = 30 and those with lower body mass index but high waist:hip ratio with a sensitivity of > 96% and specificity > 98%, with only about 2% of the sample being misclassified. Waist circumference could be used in health promotion programmes to identify individuals who should seek and be offered weight management. Men with waist circumference > or = 94 cm and women with waist circumference > or = 80 cm should gain no further weight; men with waist circumference > or = 102 cm and women with waist circumference > or = 88 cm should reduce their weight.
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            Relating body mass index to figural stimuli: population-based normative data for Caucasians.

            To establish body mass index (BMI) norms for standard figural stimuli using a large Caucasian population-based sample. In addition, we sought to determine the effectiveness of the figural stimuli to identify individuals as obese or thin. All Caucasian twins born in Virginia between 1915 and 1971 were identified by public birth record. In addition, 3347 individual twins responded to a letter published in the newsletter of the American Association of Retired Persons (AARP). All adult twins (aged 18 and over) from both of these sources and their family members were mailed a 16 page 'Health and Lifestyle' questionnaire. BMI and silhouette data were available on 16 728 females and 11 366 males ranging in age from 18-100. Self-report information on height-weight, current body size, desired body size and a discrepancy score using standard figural stimuli. Gender- and age-specific norms are presented linking BMI to each of the figural stimuli. Additional norms for desired body size and discrepancy scores are also presented. Receiver operating curves (ROC) indicate that the figural stimuli are effective in classifying individuals as obese or thin. With the establishment of these norms, the silhouettes used in standard body image assessment can now be linked to BMI. Differences were observed between women and men in terms of desired body size and discrepancy scores, with women preferring smaller sizes. The figural stimuli are a robust technique for classifying individuals as obese or thin.
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              Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample.

              To determine the frequency of cardiovascular risk factors in people categorised by previously defined "action levels" of waist circumference. Prevalence study in a random population sample. Netherlands. 2183 men and 2698 women aged 20-59 years selected at random from the civil registry of Amsterdam and Maastricht. Waist circumference, waist to hip ratio, body mass index (weight (kg)/height (m2)), total plasma cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, age, and lifestyle. A waist circumference exceeding 94 cm in men and 80 cm in women correctly identified subjects with body mass index of > or = 25 and waist to hip ratios > or = 0.95 in men and > or = 0.80 in women with a sensitivity and specificity of > or = 96%. Men and women with at least one cardiovascular risk factor (total cholesterol > or = 6.5 mmol/l, high density lipoprotein cholesterol or = 160 mm Hg, diastolic blood pressure > or = 95 mm Hg) were identified with sensitivities of 57% and 67% and specificities of 72% and 62% respectively. Compared with those with waist measurements below action levels, age and lifestyle adjusted odds ratios for having at least one risk factor were 2.2 (95% confidence interval 1.8 to 2.8) in men with a waist measurement of 94-102 cm and 1.6 (1.3 to 2.1) in women with a waist measurement of 80-88 cm. In men and women with larger waist measurements these age and lifestyle adjusted odds ratios were 4.6 (3.5 to 6.0) and 2.6 (2.0 to 3.2) respectively. Larger waist circumference identifies people at increased cardiovascular risks.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                10 September 2015
                2015
                : 10
                : 9
                : e0137534
                Affiliations
                [1 ]Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
                [2 ]School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
                University of Alabama at Birmingham, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: JFG CRC AWT. Analyzed the data: JFG CRC. Wrote the paper: JFG CRC AWT.

                Article
                PONE-D-15-06319
                10.1371/journal.pone.0137534
                4565704
                26355742
                7620e0fd-fdc3-4b55-a9b8-e153e1dc20bb
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 10 February 2015
                : 19 August 2015
                Page count
                Figures: 1, Tables: 4, Pages: 15
                Funding
                The research was internally funded by the South Australian Department of Human Services, including an allocation from the SA Health Human Services Research Initiatives (Large) Projects (HSRIP) fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                Data from the North West Adelaide Healthy Study (NWAHS) were accessed from a third party. The authors confirm that for approved reasons, some access restrictions apply to the data underlying the findings. To gain access to the data for this manuscript, ethics approval was sought and granted. Enquiries regarding requests for the NWAHS data can be directed to Prof Robert Adams, Principal Investigator (Clinical) (< robert.adams@ 123456adelaide.edu.au >).

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