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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

The relevance of the side-view in body image scales for public health: an example from two African populations

BMC Public Health > Ausgabe 1/2015
Emmanuel Cohen, Amadou Ndao, Gilles Boëtsch, Lamine Gueye, Patrick Pasquet, Michelle Holdsworth, Alexandre Courtiol
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2511-x) contains supplementary material, which is available to authorized users.

Competing interests

No conflict of interest and no competing financial of interests

Authors’ contributions

All authors have read and approved the final manuscript. EC, PP and AC developed the study concept and design. EC and PP developed the protocol of the field study. EC and AN conducted the field study. EC, PP and AC analysed and interpreted the data. EC, AC and MH drafted the manuscript and MH have provided critical revisions for important intellectual content. The study was supervised by PP, GB and LG. All authors read and approved the final manuscript.



Body size scales are a common method for diagnosing body image disturbances and assessing the cultural valorisation of stoutness, a phenomenon that plays a role in the development of overweight, especially among African populations. Traditionally, body size scales present a front view. In this study, we evaluated a complementary model of representing body shape: the side view of body outlines. In particular, we examined the association between the side-view and a set of bio-anthropometric indices in men and women.


To cover the inter-ethnic variability in the Niger-Congo area, we selected a balanced sex-ratio sample of 80 Cameroonians and 81 Senegalese. Individuals wearing close-fitting clothes were photographed from the front-and side-view, and measured following a bio-anthropometric protocol synthesizing body shape variation: Body Mass Index, percentage body fat, somatotype profile, waist circumference, waist-to-hip ratio, mean blood pressure and glycaemia. The shape of each front and side body outline was extracted and characterised by Normalized Elliptic Fourier Descriptors (NEFD). Finally, we assessed associations between NEFD and bio-anthropometric indices.


Variation in the shape of both front and side body outlines was associated with all bio-anthropometrics for at least one sex-population combination. Overall, the side view best captured body shape variation related to changes in almost all bio-anthropometrics in both sexes and populations, with the exceptions of female mesomorphy, male blood pressure and glycaemia (in both sexes). We found that the details of the relationship between bio-anthropometrics and body shape differed between the two male populations, a finding that was reflected in side-views for all criteria, but not front-views.


Variation in body shape assessed by several bio-anthropometrics related to health and nutritional status was larger for side than front body outlines. Integrating side views in body size scales would improve the accuracy of body size assessment and thus, the assessment of behaviours leading to overweight, as well as symptoms of body image disturbances, in Africa and potentially in other populations.
Additional file 1: Table S1. Summary table of the models testing the relationship between bio-anthropometrics and front-views of men’s body shapes. Table provide the Pillai’s trace statistic and associated F-tests from multivariate analyses of variance (MANOVA) performed on the first eight principal components of the Principal Component Analysis (PCA) on Fourier coefficients (see main text for details). Analyses were performed using the function Manova from the R package car. (XLSX 11 kb)
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