Sichieri R, Everhart J E, Hubbard V S
Centro de Ciencias Biologicas e da Saude, Universidade Estadual de Maringa, Parana, Brazil.
Int J Obes Relat Metab Disord. 1992 Apr;16(4):303-12.
We compared five recent relative weight classifications based on body mass index for their estimates of prevalence of underweight and overweight in the adult population of the United States and for their ability to predict subsequent morbidity and mortality. The sources of the classifications were: the 1990 Dietary Guidelines for Americans of the US Departments of Agriculture and Health and Human Services, the National Academy of Sciences, the National Center for Health Statistics, the World Health Organization, and the Canadian Minister of National Health and Welfare. These classifications were applied to the body mass index distributions of the second National Health and Nutrition Examination Survey (1976-1980) and to the Hispanic Health and Nutrition Examination Survey (1982-1984). Depending on classification, a wide range of prevalence for the total population was found: 9-17% of the US population were categorized as underweight, and 25-45% were categorized as overweight. White women had the highest prevalence of underweight in all but the National Center for Health Statistics classification. Black and Mexican American women had the highest prevalence of overweight under all classifications (range: 38.4-58.6%). Associations with health outcomes were determined using all cause hospitalization and mortality in the 1971-1987 follow-up of the first National Health and Nutrition Examination Survey. Underweight and overweight as defined by the National Academy of Sciences classification had the highest population attributable risk for hospitalization and death: 5.0% of hospitalizations and 11.0% of deaths among men and 4.2% of hospitalizations and 11.4% of deaths among women were associated with weights outside the healthy range. Under this classification a greater proportion of both hospitalizations and mortality were associated with overweight than underweight. For all classifications, a higher proportion of hospitalizations were associated with overweight than underweight. All classifications performed better at predicting death than hospitalization.
我们比较了最近基于体重指数的五种相对体重分类方法，以评估它们对美国成年人群体重过轻和超重患病率的估计，以及预测后续发病和死亡的能力。这些分类方法的来源分别是：美国农业部和卫生与公众服务部的《1990年美国人膳食指南》、美国国家科学院、美国国家卫生统计中心、世界卫生组织以及加拿大国家卫生和福利部部长。这些分类方法应用于第二次全国健康和营养检查调查（1976 - 1980年）以及西班牙裔健康和营养检查调查（1982 - 1984年）的体重指数分布情况。根据分类的不同，发现总人口的患病率范围很广：9% - 17%的美国人口被归类为体重过轻，25% - 45%被归类为超重。除了美国国家卫生统计中心的分类外，白人女性在所有分类中体重过轻的患病率最高。在所有分类中，黑人和墨西哥裔美国女性超重的患病率最高（范围：38.4% - 58.6%）。使用第一次全国健康和营养检查调查1971 - 1987年随访中的全因住院率和死亡率来确定与健康结果的关联。美国国家科学院分类所定义的体重过轻和超重，在住院和死亡方面具有最高的人群归因风险：男性中5.0%的住院和11.0%的死亡以及女性中4.2%的住院和11.4%的死亡与健康范围之外的体重有关。按照这种分类，与超重相关的住院和死亡比例均高于体重过轻。对于所有分类，与超重相关的住院比例均高于体重过轻。在预测死亡方面，所有分类的表现都优于预测住院。
