Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition.
The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between si...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0000127 |
| _version_ | 1797701266563923968 |
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| author | Tyler O Reese Pascal Bovet Candice Choo-Kang Kweku Bedu-Addo Terrence Forrester Jack A Gilbert Julia H Goedecke Estelle V Lambert Brian T Layden Lisa K Micklesfield Jacob Plange-Rhule Dale Rae Bharathi Viswanathan Amy Luke Lara R Dugas |
| author_facet | Tyler O Reese Pascal Bovet Candice Choo-Kang Kweku Bedu-Addo Terrence Forrester Jack A Gilbert Julia H Goedecke Estelle V Lambert Brian T Layden Lisa K Micklesfield Jacob Plange-Rhule Dale Rae Bharathi Viswanathan Amy Luke Lara R Dugas |
| author_sort | Tyler O Reese |
| collection | DOAJ |
| description | The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m2), obesity alone (BMI ≥ 30 kg/m2), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20-68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34-3.97] BMI units/silhouette unit in the US, 3.23 [2.93-3.74] in Seychelles, and 1.99 [1.72-2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m2 in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers' silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries. |
| first_indexed | 2024-03-12T04:33:00Z |
| format | Article |
| id | doaj.art-8c005a52ec124ef99faf2efe310bf2dc |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T04:33:00Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-8c005a52ec124ef99faf2efe310bf2dc2023-09-03T09:58:53ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0125e000012710.1371/journal.pgph.0000127Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition.Tyler O ReesePascal BovetCandice Choo-KangKweku Bedu-AddoTerrence ForresterJack A GilbertJulia H GoedeckeEstelle V LambertBrian T LaydenLisa K MicklesfieldJacob Plange-RhuleDale RaeBharathi ViswanathanAmy LukeLara R DugasThe Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m2), obesity alone (BMI ≥ 30 kg/m2), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20-68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34-3.97] BMI units/silhouette unit in the US, 3.23 [2.93-3.74] in Seychelles, and 1.99 [1.72-2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m2 in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers' silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries.https://doi.org/10.1371/journal.pgph.0000127 |
| spellingShingle | Tyler O Reese Pascal Bovet Candice Choo-Kang Kweku Bedu-Addo Terrence Forrester Jack A Gilbert Julia H Goedecke Estelle V Lambert Brian T Layden Lisa K Micklesfield Jacob Plange-Rhule Dale Rae Bharathi Viswanathan Amy Luke Lara R Dugas Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. PLOS Global Public Health |
| title | Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. |
| title_full | Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. |
| title_fullStr | Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. |
| title_full_unstemmed | Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. |
| title_short | Utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition. |
| title_sort | utility of silhouette showcards to assess adiposity in three countries across the epidemiological transition |
| url | https://doi.org/10.1371/journal.pgph.0000127 |
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