Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity

Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. Objective: We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat...

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Published in:International Journal of Obesity Vol. 36; no. 2; pp. 286 - 294
Main Authors: Gómez-Ambrosi, J, Silva, C, Galofré, J C, Escalada, J, Santos, S, Millán, D, Vila, N, Ibañez, P, Gil, M J, Valentí, V, Rotellar, F, Ramírez, B, Salvador, J, Frühbeck, G
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01.02.2012
Nature Publishing Group
Subjects:
Adipose Tissue
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Biomarkers - blood
Blood
Body composition
Body fat
Body mass
Body Mass Index
C-Reactive Protein - metabolism
Cardiorespiratory
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Classification
Cross-Sectional Studies
Decision Making
Diagnosis
Endocrinology
Epidemiology
Evaluation
Female
Females
Gender
Health Promotion and Disease Prevention
Health risks
Humans
Insulin
Internal Medicine
Lipids
Male
Measurement
Medical sciences
Medicine
Medicine & Public Health
Men
Metabolic Diseases
Metabolism
Middle Aged
Morbidity
Mortality
Obesity
Obesity - classification
Obesity - diagnosis
Obesity - epidemiology
original-article
Overweight
Physiological aspects
Plethysmography - methods
Prevalence
Proteins
Public Health
Risk Assessment
Risk Factors
Sensitivity
Spain - epidemiology
Task forces
Weight control
White people
Women
Womens health
Young Adult
Spain
diagnosis
adiposity
fat mass
BMI
Human
Obesity
Adipose tissue
Nutrition
Nutrition disorder
Cardiovascular disease
Metabolic diseases
Fat mass
Body mass index
Adiposity
Classification
Cardiovascular risk
Diagnosis
Nutritional status
ISSN:0307-0565, 1476-5497, 1476-5497
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Abstract Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. Objective: We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. Design: We performed a cross-sectional study. Subjects: A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18–80 years. Methods: BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. Results: We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3±9.2, women 4.9±19.5 mg l −1 ) as well as in obese BMI-classified individuals (men 4.2±5.5, women 5.1±13.2 mg l −1 ) compared with lean volunteers with normal body fat amounts (men 0.9±0.5, women 2.1±2.6 mg l −1 ; P <0.001 for both genders). Conclusion: Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
AbstractList Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. We performed a cross-sectional study. A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); P<0.001 for both genders). Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Subjects: A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. International Journal of Obesity (2012) 36, 286-294; doi: 10.1038/ijo.2011.100; published online 17 May 2011
Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. We performed a cross-sectional study. A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); P<0.001 for both genders). Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. Objective: We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%. Design: We performed a cross-sectional study. Subjects: A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18–80 years. Methods: BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. Results: We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3±9.2, women 4.9±19.5 mg l −1 ) as well as in obese BMI-classified individuals (men 4.2±5.5, women 5.1±13.2 mg l −1 ) compared with lean volunteers with normal body fat amounts (men 0.9±0.5, women 2.1±2.6 mg l −1 ; P <0.001 for both genders). Conclusion: Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat.4:00 PM Objective: We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI- classified subjects with similar BF%. Design: We performed a cross-sectional study. Subjects: A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. Methods: BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. Results: We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg T1) as well as in obese BMI-classified individuals (men 4.2 ±5.5, women 5.1 ±13.2 mg [l.sup.-1]) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 [+ or -] 2.6 mg [l.sup.-1]; P < 0.001 for both genders). Conclusion: Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable. International Journal of Obesity (2012) 36, 286-294; doi: 10.1038/ijo.2011.100; published online 17 May 2011 Keywords: BMI; adiposity; diagnosis; fat mass
Context:Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat. Objective: We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%.Design:We performed a cross-sectional study.Subjects:A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years. Methods: BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured. Results: We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3+/-9.2, women 4.9+/-19.5 mg l super(-1)) as well as in obese BMI-classified individuals (men 4.2+/-5.5, women 5.1+/-13.2 mg l super(-1)) compared with lean volunteers with normal body fat amounts (men 0.9+/-0.5, women 2.1+/-2.6 mg l super(-1); P<0.001 for both genders). Conclusion: Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat.CONTEXTBody mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body fat.We assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%.OBJECTIVEWe assessed the degree of misclassification on the diagnosis of obesity using BMI as compared with direct body fat percentage (BF%) determination and compared the cardiovascular and metabolic risk of non-obese and obese BMI-classified subjects with similar BF%.We performed a cross-sectional study.DESIGNWe performed a cross-sectional study.A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years.SUBJECTSA total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years.BMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured.METHODSBMI, BF% determined by air displacement plethysmography and well-established blood markers of insulin sensitivity, lipid profile and cardiovascular risk were measured.We found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); P<0.001 for both genders).RESULTSWe found that 29% of subjects classified as lean and 80% of individuals classified as overweight according to BMI had a BF% within the obesity range. Importantly, the levels of cardiometabolic risk factors, such as C-reactive protein, were higher in lean and overweight BMI-classified subjects with BF% within the obesity range (men 4.3 ± 9.2, women 4.9 ± 19.5 mg l(-1)) as well as in obese BMI-classified individuals (men 4.2 ± 5.5, women 5.1 ± 13.2 mg l(-1)) compared with lean volunteers with normal body fat amounts (men 0.9 ± 0.5, women 2.1 ± 2.6 mg l(-1); P<0.001 for both genders).Given the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.CONCLUSIONGiven the elevated concentrations of cardiometabolic risk factors reported herein in non-obese individuals according to BMI but obese based on body fat, the inclusion of body composition measurements together with morbidity evaluation in the routine medical practice both for the diagnosis and the decision-making for instauration of the most appropriate treatment of obesity is desirable.
Audience Academic
Author Ibañez, P
Frühbeck, G
Escalada, J
Silva, C
Gómez-Ambrosi, J
Valentí, V
Salvador, J
Vila, N
Gil, M J
Santos, S
Millán, D
Rotellar, F
Galofré, J C
Ramírez, B
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  givenname: C
  surname: Silva
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  surname: Galofré
  fullname: Galofré, J C
  organization: Department of Endocrinology, Clínica Universidad de Navarra
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  surname: Escalada
  fullname: Escalada, J
  organization: Department of Endocrinology, Clínica Universidad de Navarra
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  fullname: Santos, S
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  fullname: Millán, D
  organization: Department of Endocrinology, Clínica Universidad de Navarra
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  organization: Department of Endocrinology, Clínica Universidad de Navarra
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  surname: Ibañez
  fullname: Ibañez, P
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  givenname: M J
  surname: Gil
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  surname: Salvador
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  surname: Frühbeck
  fullname: Frühbeck, G
  email: gfruhbeck@unav.es
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ISSN 0307-0565
1476-5497
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IsPeerReviewed true
IsScholarly true
Issue 2
Keywords diagnosis
adiposity
fat mass
BMI
Human
Obesity
Adipose tissue
Nutrition
Nutrition disorder
Cardiovascular disease
Metabolic diseases
Fat mass
Body mass index
Adiposity
Classification
Cardiovascular risk
Diagnosis
Nutritional status
Language English
License http://www.springer.com/tdm
CC BY 4.0
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PQID 921748816
PQPubID 38864
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crossref_citationtrail_10_1038_ijo_2011_100
crossref_primary_10_1038_ijo_2011_100
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PublicationCentury 2000
PublicationDate 2012-02-01
PublicationDateYYYYMMDD 2012-02-01
PublicationDate_xml – month: 02
  year: 2012
  text: 2012-02-01
  day: 01
PublicationDecade 2010
PublicationPlace London
PublicationPlace_xml – name: London
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PublicationTitle International Journal of Obesity
PublicationTitleAbbrev Int J Obes
PublicationTitleAlternate Int J Obes (Lond)
PublicationYear 2012
Publisher Nature Publishing Group UK
Nature Publishing Group
Publisher_xml – name: Nature Publishing Group UK
– name: Nature Publishing Group
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Snippet Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an...
Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess of body...
Context: Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an...
Subjects: A total of 6123 (924 lean, 1637 overweight and 3562 obese classified according to BMI) Caucasian subjects (69% females), aged 18-80 years....
Context:Body mass index (BMI) is widely used as a measure of overweight and obesity, but underestimates the prevalence of both conditions, defined as an excess...
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SubjectTerms Adipose Tissue
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Biomarkers - blood
Blood
Body composition
Body fat
Body mass
Body Mass Index
C-Reactive Protein - metabolism
Cardiorespiratory
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Classification
Cross-Sectional Studies
Decision Making
Diagnosis
Endocrinology
Epidemiology
Evaluation
Female
Females
Gender
Health Promotion and Disease Prevention
Health risks
Humans
Insulin
Internal Medicine
Lipids
Male
Measurement
Medical sciences
Medicine
Medicine & Public Health
Men
Metabolic Diseases
Metabolism
Middle Aged
Morbidity
Mortality
Obesity
Obesity - classification
Obesity - diagnosis
Obesity - epidemiology
original-article
Overweight
Physiological aspects
Plethysmography - methods
Prevalence
Proteins
Public Health
Risk Assessment
Risk Factors
Sensitivity
Spain - epidemiology
Task forces
Weight control
White people
Women
Womens health
Young Adult
Title Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity
URI https://link.springer.com/article/10.1038/ijo.2011.100
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Volume 36
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