BMI as a Broadly Used, Misapplied, and Insufficient Measure: A Narrative Review
DOI:
https://doi.org/10.47611/jsr.v12i1.1851Keywords:
BMI, Obesity, MeasurementAbstract
There may not be a more widely known tool than the Body Mass Index (BMI). Its widespread acceptance, however, comes in spite of much evidence and history that suggests such should not be the case. The purpose of this narrative review was to examine the history, applications, and effectiveness of the BMI as an anthropometric tool. Relevant studies on the BMI’s origins, applications, and usefulness compared to other anthropometric measures were extracted from PubMed and Google Scholar and examined. The evidence posits that the BMI was not created for its present-day utility and is thus heavily misapplied. The literature also suggests that other anthropometric measures may be more effective at the assessments to which the BMI is popularly called upon. This narrative review concludes with a call for future research in developing a superior alternative to the BMI for assessing body composition in a similarly widespread fashion.
Downloads
Metrics
References or Bibliography
Alves Junior, C. A., Mocellin, M. C., Goncalves, E. C. A., Silva, D. A., & Trindade, E. B. (2017). Anthropometric Indicators as Body Fat Discriminators in Children and Adolescents: A Systematic Review and Meta-Analysis. Adv Nutr, 8(5), 718-727. https://doi.org/10.3945/an.117.015446
Body mass index-for-age (BMI-for-age). World Health Organization. Retrieved June 29 from https://www.who.int/toolkits/child-growth-standards/standards/body-mass-index-for-age-bmi-for-age
Data Table of BMI-for-age Charts. The U.S. Centers for Disease Control and Prevention. Retrieved June 29 from https://www.cdc.gov/growthcharts/html_charts/bmiagerev.htm
Defining Adult Overweight & Obesity. The U.S. Centers for Disease Control and Prevention. Retrieved June 29 from https://www.cdc.gov/obesity/basics/adult-defining.html
Dhurandhar, E. J. (2016). The downfalls of BMI-focused policies. International Journal of Obesity, 40(5), 729-730. https://doi.org/10.1038/ijo.2016.18
Di Renzo, L., Del Gobbo, V., Bigioni, M., Premrov, M. G., Cianci, R., & De Lorenzo, A. (2006). Body composition analyses in normal weight obese women. Eur Rev Med Pharmacol Sci, 10(4), 191-196. https://www.ncbi.nlm.nih.gov/pubmed/16910350
Eckel, R., Grundy, S., & Zimmet, P. (2005). The metabolic syndrome. Lancet, 366(9501), 1923-1923. https://doi.org/Doi 10.1016/S0140-6736(05)67781-1
Eckel, R. H., Krauss, R. M., & Comm, A. N. (1998). American Heart Association call to action: Obesity as a major risk factor for coronary heart disease. Circulation, 97(21), 2099-2100. https://doi.org/Doi 10.1161/01.Cir.97.21.2099
Eknoyan, G. (2008). Adolphe Quetelet (1796-1874)--the average man and indices of obesity. Nephrol Dial Transplant, 23(1), 47-51. https://doi.org/10.1093/ndt/gfm517
Exercise Prescription for Individuals with CVD Risk Factors. (2018). In D. Riebe (Ed.), ACSM's Guidelines for Exercise Testing and Prescription (Tenth ed., pp. 287). Wolters Kluwer.
FitnessGram® Healthy Fitness Zone Performance Standards. (2019). California Department of Education. Retrieved June 29 from pftdata.org/files/hfz-standards.pdf
Fletcher, I. (2014). Defining an epidemic: the body mass index in British and US obesity research 1960-2000. Sociol Health Illn, 36(3), 338-353. https://doi.org/10.1111/1467-9566.12050
Freedman, D. S., Wang, J., Maynard, L. M., Thornton, J. C., Mei, Z., Pierson, R. N., Dietz, W. H., & Horlick, M. (2005). Relation of BMI to fat and fat-free mass among children and adolescents. Int J Obes (Lond), 29(1), 1-8. https://doi.org/10.1038/sj.ijo.0802735
Groothof, D., Post, A., Polinder-Bos, H. A., Hazenberg, B. P. C., Gans, R. O. B., & Bakker, S. J. L. (2021). Muscle mass versus body mass index as predictor of adverse outcome. J Cachexia Sarcopenia Muscle, 12(2), 517-518. https://doi.org/10.1002/jcsm.12686
Hannan, W. J., Wrate, R. M., Cowen, S. J., & Freeman, C. P. (1995). Body mass index as an estimate of body fat. Int J Eat Disord, 18(1), 91-97. https://doi.org/10.1002/1098-108x(199507)18:1<91::aid-eat2260180110>3.0.co;2-m
Health-Related Physical Fitness Testing and Interpretation. (2018). In D. Riebe (Ed.), ACSM's Guidelines for Exercise Testing and Prescription (Tenth ed., pp. 77-80). Wolters Kluwer.
Kasper, A. M., Langan-Evans, C., Hudson, J. F., Brownlee, T. E., Harper, L. D., Naughton, R. J., Morton, J. P., & Close, G. L. (2021). Come Back Skinfolds, All Is Forgiven: A Narrative Review of the Efficacy of Common Body Composition Methods in Applied Sports Practice. Nutrients, 13(4). https://doi.org/10.3390/nu13041075
Keys, A., Fidanza, F., Karvonen, M. J., Kimura, N., & Taylor, H. L. (1972). Indices of relative weight and obesity. J Chronic Dis, 25(6), 329-343. https://doi.org/10.1016/0021-9681(72)90027-6
Lee, C. M. Y., Huxley, R. R., Wildman, R. P., & Woodward, M. (2008). Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. Journal of Clinical Epidemiology, 61(7), 646-653. https://doi.org/10.1016/j.jclinepi.2007.08.012
Loenneke, J. P., Barnes, J. T., Wilson, J. M., Lowery, R. P., Isaacs, M. N., & Pujol, T. J. (2013). Reliability of field methods for estimating body fat. Clin Physiol Funct Imaging, 33(5), 405-408. https://doi.org/10.1111/cpf.12045
Muth, N. D. (2010). What are the guidelines for percentage of body fat loss? https://www.acefitness.org/resources/everyone/blog/112/what-are-the-guidelines-for-percentage-of-body-fat-loss/
Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. (1995). World Health Organ Tech Rep Ser, 854, 1-452.
Prentice, A. M., & Jebb, S. A. (2001). Beyond body mass index. Obes Rev, 2(3), 141-147. https://doi.org/10.1046/j.1467-789x.2001.00031.x
Reis, J. P., Araneta, M. R., Wingard, D. L., Macera, C. A., Lindsay, S. P., & Marshall, S. J. (2009). Overall Obesity and Abdominal Adiposity as Predictors of Mortality in US White and Black Adults. Annals of Epidemiology, 19(2), 134-142. https://doi.org/10.1016/j.annepidem.2008.10.008
Savva, S. C., Lamnisos, D., & Kafatos, A. G. (2013). Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis. Diabetes Metab Syndr Obes, 6, 403-419. https://doi.org/10.2147/DMSO.S34220
Simmonds, M., Burch, J., Llewellyn, A., Griffiths, C., Yang, H., Owen, C., Duffy, S., & Woolacott, N. (2015). The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. Health Technol Assess, 19(43), 1-336. https://doi.org/10.3310/hta19430
Sims, E. A. (2001). Are there persons who are obese, but metabolically healthy? Metabolism, 50(12), 1499-1504. https://doi.org/10.1053/meta.2001.27213
Stefan, N., Kantartzis, K., Machann, J., Schick, F., Thamer, C., Rittig, K., Balletshofer, B., Machicao, F., Fritsche, A., & Haring, H. U. (2008). Identification and characterization of metabolically benign obesity in humans. Arch Intern Med, 168(15), 1609-1616. https://doi.org/10.1001/archinte.168.15.1609
Stoner, L., & Cornwall, J. (2014). Did the American Medical Association make the correct decision classifying obesity as a disease? Australas Med J, 7(11), 462-464. https://doi.org/10.4066/AMJ.2014.2281
Swainson, M. G., Batterham, A. M., Tsakirides, C., Rutherford, Z. H., & Hind, K. (2017). Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables. PLoS One, 12(5), e0177175. https://doi.org/10.1371/journal.pone.0177175
Tomiyama, A. J., Hunger, J. M., Nguyen-Cuu, J., & Wells, C. (2016). Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012. International Journal of Obesity, 40(5), 883-886. https://doi.org/10.1038/ijo.2016.17
Yusuf, S., Hawken, S., Ounpuu, S., Bautista, L., Franzosi, M. G., Commerford, P., Lang, C. C., Rumboldt, Z., Onen, C. L., Lisheng, L., Tanomsup, S., Wangai, P., Jr., Razak, F., Sharma, A. M., Anand, S. S., & Investigators, I. S. (2005). Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet, 366(9497), 1640-1649. https://doi.org/10.1016/S0140-6736(05)67663-5
Published
How to Cite
Issue
Section
Copyright (c) 2023 Kworweinski Lafontant
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright holder(s) granted JSR a perpetual, non-exclusive license to distriute & display this article.