Abstract
Body mass index (BMI), while routinely used in evaluating adiposity, cannot distinguish between fat and lean mass, and thus can misclassify weight status particularly among athletic, physically active, and tall- and short-statured individuals, whose lean-to-fat ratios and body proportions vary considerably from average individuals. Believing that the traditional BMI formula divides weight by too much with short people and by too little with tall people, University of Oxford professor L. N. Trefethen proposed a modified formula in computing BMI. This study was conducted among a sample of Filipino young adults (n = 190) to assess the performance of the modified BMI formula against the traditional one in: (1) predicting body fat percentage (%BF) measured using bioelectric impedance analysis, and (2) diagnosing overweight/obesity. Using robust polynomial regression analysis (covariates: age, waist circumference, smoking history and alcohol intake), the BMI quadratic models had the highest adjusted R2 and the lowest AIC and BIC for both sexes compared to the linear models. The AuROCs of the traditional BMI were higher than those of the proposed BMI, albeit nonsignificant. In conclusion, both traditional and modified BMIs significantly predicted %BF, as well as adequately discriminated between %BF-defined normal and overweight-obese states using optimal BMI cutoff values.
Highlights
Obesity, described as abnormal or excessive fat accumulation, has been steadily growing in prevalence since the 1970s and has more than tripled over a forty-year period[1,2]
Body mass index (BMI) is an accepted anthropometric measure used in screening for overweight and obesity, and for categorising individuals into different weight groups
The currently used body mass index (BMI) formula itself was developed more than 150 years ago by Belgian mathematician Adolphe Quetelet during a period when body fat estimation necessitated using more convenient methods that did not involve sophisticated calculations
Summary
Obesity, described as abnormal or excessive fat accumulation, has been steadily growing in prevalence since the 1970s and has more than tripled over a forty-year period[1,2]. In this same 2014 report, the estimated proportion of overweight Filipino adults was 23.6% While these figures are relatively low compared to the neighboring countries, they still translate to roughly 18 million obese and overweight individuals. Body mass index (BMI) is an accepted anthropometric measure used in screening for overweight and obesity, and for categorising individuals into different weight groups (underweight, normal, overweight, and obese). This is invariably due to its noninvasiveness and satisfactory correlation with body fat percentage (%BF)[7]. Its use can potentially misclassify the weight status of athletic, physically active, and tall- and short-statured individuals, whose lean-to-fat ratios and body proportions can vary considerably from average individuals. We aimed to assess and compare the measures of diagnostic accuracy of both BMI measures in identifying the overweightobese state
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