Relationships between body size and percent body fat among Melanesians in Vanuatu.

Obesity is a global epidemic, and measures to define it must be appropriate for diverse populations for accurate assessment of worldwide risk. Obesity refers to excess body fatness, but is more commonly defined by body mass index (BMI). Body composition varies among populations: Asians have higher percent body fat (%BF), and Pacific Islanders lower %BF at a given BMI compared to Europeans. Many researchers thus propose higher BMI cut-off points for obesity among Pacific Islanders and lower cut-offs for Asians. Because of the great genetic diversity in the Asia-Pacific region, more studies analyzing associations between BMI and %BF among diverse populations remain necessary. We measured height; weight; tricep, subscapular, and suprailiac skinfolds; waist and hip circumference; and %BF by bioelectrical impedance among 546 adult Melanesians from Vanuatu in the South Pacific. We analyzed relationships among anthropometric measurements and compared them to measurements from other populations in the Asia-Pacific region. BMI was a relatively good predictor of %BF among our sample. Based on regression analyses, the BMI value associated with obesity defined by %BF (>25% for men, >35% for women) at age 40 was 27.9 for men and 27.8 for women. This indicates a need for a more nuanced definition of obesity than provided by the common BMI cut-off value of 30. Rather than using population-specific cut-offs for Pacific Islanders, we suggest the World Health Organization's public health action cut-off points (23, 27.5, 32.5, 37.5), which enhance the precision of assessments of population-wide obesity burdens while still allowing for international comparison.