How Useful Is Body Mass Index for Comparison of Body Fatness across Age, Sex, and Ethnic Groups?
Abstract
This study tested the hypothesis that body mass index (BMI) is representative of body fatness independent of age, sex, and ethnicity. Between 1986 and 1992, the authors studied a total of 202 black and 504 white men and women who resided in or near New York City, were ages 20-94 years, and had BMIs of 18-35 kg/m2. Total body fat, expressed as a percentage of body weight (BF%), was assessed using a four-compartment body composition model that does not rely on assumptions known to be age, sex, or ethnicity dependent. Statistically significant age dependencies were observed in the BF%-BMI relations in all four sex and ethnic groups (p values < 0.05-0.001) with older persons showing a higher BF% compared with younger persons with comparable BMIs. Statistically significant sex effects were also observed in BF%-BMI relations within each ethnic group (p values < 0.001) after controlling first for age. For an equivalent BMI, women have significantly greater amounts of total body fat than do men throughout the entire adult life span. Ethnicity did not significantly influence the BF%-BMI relation after controlling first for age and sex even though both black women and men had longer appendicular bone lengths relative to stature (p values < 0.001 and 0.02, respectively) compared with white women and men. Body mass index alone accounted for 25% of between-individual differences in body fat percentage for the 706 total subjects; adding age and sex as independent variables to the regression model increased the variance (r2) to 67%. These results suggest that BMI is age and sex dependent when used as an indicator of body fatness, but that it is ethnicity independent in black and white adults.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
BMI is not a direct measure of body fatness.
“it is important to highlight that BMI was used as an indicator of body fat and obesity, and it is not a direct measure of body fatness”
From Chronological Age Does not Influence<i>Ex-vivo</i>Mitochondrial Respiration and Quality Control in Skeletal Muscle (2016) · cites this paper as [40]
For an equivalent BMI, older subjects have a higher percentage body fat than young subjects.
“for an equivalent BMI, older subjects have a higher percentage body fat than young subjects (40).”
From Chronological Age Does not Influence<i>Ex-vivo</i>Mitochondrial Respiration and Quality Control in Skeletal Muscle (2016) · cites this paper as [40]
Cites
Increasing Prevalence of Overweight Among US Adults
Kuczmarski, R. J. (1994) · JAMA · doi:10.1001/jama.272.3.205 · Cited by 2,538 · see citing works
Indices of relative weight and obesity
Keys, A. B., Fidanza, F., Karvonen, M. J., Kimura, N., & TAYLOR, H. L. (1972) · Journal of Chronic Diseases · doi:10.1016/0021-9681(72)90027-6 · Cited by 2,085 · see citing works
Body mass index as a measure of body fatness: age- and sex-specific prediction formulas
Deurenberg, P., Weststrate, J., & Seidell, J. C. (1991) · British Journal of Nutrition · doi:10.1079/bjn19910073 · Cited by 1,397 · see citing works
Methods for the assessment of human body composition: traditional and new
Lukaski, H. C. (1987) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/46.4.537 · Cited by 1,150 · see citing works
Trotter, M., & Gleser, G. C. (1958) · American Journal of Physical Anthropology · doi:10.1002/ajpa.1330160106 · Cited by 930 · see citing works
Roche, A. F., Heymsfield, S. B., & Lohman, T. G. (2005) · Medical Entomology and Zoology · Cited by 743 · see citing works
Self-citationAdvances in Body Composition Assessment
Lohman, T. G. (1993) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199306000-00021 · Cited by 641 · see citing works
The Body Cell Mass and Its Supporting Environment
BOUMAN, H. D. (1963) · Physical Therapy · doi:10.1093/ptj/43.9.695a · Cited by 627 · see citing works
Lumbar disc degeneration: correlation with age, sex, and spine level in 600 autopsy specimens.
Miller, J. A., Schmatz, C., & Schultz, A. B. (1988) · PubMed · Cited by 566 · see citing works
Indices of obesity derived from body weight and height.
Khosla, T., & Lowe, C. R. (1967) · Journal of Epidemiology & Community Health · doi:10.1136/jech.21.3.122 · Cited by 557 · see citing works
A simplified method for determination of residual lung volumes.
Wilmore, J. H. (1969) · Journal of Applied Physiology · doi:10.1152/jappl.1969.27.1.96 · Cited by 531 · see citing works
Three limitations of the body mass index
Sm, G., Leonard, W. R., & Hawthorne, V. M. (1986) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/44.6.996 · Cited by 500 · see citing works
Forbes, G. B. (1987) · doi:10.1007/978-1-4612-4654-1 · Cited by 431 · see citing works
Seidell, J. C., Oosterlee, A., Thijssen, M. A. O., Burema, J., Deurenberg, P., Hautvast, J. G. A. J., & Ruijs, J. H. J. (1987) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/45.1.7 · Cited by 315 · see citing works
Reassessment of body mass indices
Smalley, K., Knerr, A., Kendrick, Z., Colliver, J., & Owen, O. (1990) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.3.405 · Cited by 306 · see citing works
A Treatise on Man and the Development of His Faculties
Quetelet, L. (1994) · Obesity Research · doi:10.1002/j.1550-8528.1994.tb00047.x · Cited by 299 · see citing works
Womersley, J., & Durnin, J. V. G. A. (1977) · British Journal Of Nutrition · doi:10.1079/bjn19770088 · Cited by 291 · see citing works
Ortiz, O., Russell, M., Daley, T., Baumgartner, R., Waki, M., Lichtman, S. W., Wang, J., Pierson, R., & Heymsfield, S. (1992) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/55.1.8 · Cited by 285 · see citing works
Self-citationHeymsfield, S. B., Lichtman, S. W., Baumgartner, R., Wang, J., Kamen, Y., Aliprantis, A. O., & Pierson, R. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.1.52 · Cited by 280 · see citing works
Self-citationDensities of Bones of White and Negro Skeletons
Trotter, M., Broman, G. E., & Peterson, R. R. (1960) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-196042010-00005 · Cited by 271 · see citing works
Bortz, W. M. (1982) · PubMed · Cited by 269 · see citing works
An underwater weighing system utilizing "force cube" transducers
Akers, R. F., & BUSKIRK, E. R. (1969) · Journal of Applied Physiology · doi:10.1152/jappl.1969.26.5.649 · Cited by 193 · see citing works
Sjöström, L. (1991) · PubMed · Cited by 182 · see citing works
Total-body potassium in health: effects of age, sex, height, and fat
Pierson, R., Lin, D., & Phillips, R. H. (1974) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1974.226.1.206 · Cited by 171 · see citing works
Self-citationRace-Dependent Health Risks of Upper Body Obesity
Dowling, H. J., & Pi-Sunyer, F. (1993) · Diabetes · doi:10.2337/diab.42.4.537 · Cited by 167 · see citing works
Equations for Predicting Stature in White and Black Elderly Individuals
Chumlea, W. C., & Guo, S. (1992) · Journal of Gerontology · doi:10.1093/geronj/47.6.m197 · Cited by 158 · see citing works
Techniques for the measurement of body composition: a practical guide.
Jebb, S. A., & Elia, M. (1993) · PubMed · Cited by 155 · see citing works
Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study.
Heitmann, B. L. (1990) · PubMed · Cited by 120 · see citing works
Body elemental composition: comparison between black and white adults.
Cohn, S. H., Abesamis, C., ZANZI, I., Aloia, J. F., Yasumura, S., & Ellis, K. J. (1977) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1977.232.4.e419 · Cited by 108 · see citing works
Multicomponent Molecular-Level Models of Body Composition Analysis
Wang, Z., Shen, W., Withers, R. T., & Heymsfield, S. B. (2005) · doi:10.5040/9781492596950.ch-012 · Cited by 106 · see citing works
Self-citationAssessment of cellular mass and lean body mass by noninvasive nuclear techniques.
Cohn, S., Vaswani, A., Yasumura, S., Yuen, K., & Ellis, K. J. (1985) · PubMed · Cited by 103 · see citing works
Body Composition in Humans: Advances in the Development of Multicompartment Chemical Models
Heymsfield, S. B., & Waki, M. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.1991.tb02997.x · Cited by 90 · see citing works
Self-citationRussell-Aulet, M., Wang, J., Thornton, J. C., & Pierson, R. N. (1991) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650060413 · Cited by 77 · see citing works
Self-citationWeight-height indices as estimators of fatness in men.
Norgan, N. G., & Ferro-Luzzi, A. (1982) · PubMed · Cited by 69 · see citing works
Mazariegos, M., Wang, Z.-M., Gallagher, D., Baumgartner, R., Allison, D. B., Wang, J., Pierson, R. N., & Heymsfield, S. B. (1994) · Journal of Gerontology · doi:10.1093/geronj/49.5.m201 · Cited by 68 · see citing works
Self-citationThe relationship of weight-height indices of obesity to body fat content.
Strain, G. W., & Zumoff, B. (1992) · Journal of the American College of Nutrition · doi:10.1080/07315724.1992.10718272 · Cited by 67 · see citing works
Body mass index as a measure of body fatness in the elderly.
Deurenberg, P., Kooy, K. V. D., Hulshof, T. G., & Evers, P. (1989) · PubMed · Cited by 66 · see citing works
Exercise, Nutrition and Aging ,
Evans, W. J. (1992) · Journal of Nutrition · doi:10.1093/jn/122.suppl_3.796 · Cited by 64 · see citing works
Measuring body fat: calibrating the rulers. Intermethod comparisons in 389 normal Caucasian subjects
Pierson, R. N., Wang, J., Heymsfield, S. B., Russell-Aulet, M., Mazariegos, M., Tierney, M., Smith, R. C., Thornton, J. C., Kehayias, J. J., Weber, D. A., et al. (1991) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1991.261.1.e103 · Cited by 63 · see citing works
Self-citationBody composition and gonadal steroids in older white and black women
Kleerekoper, M., Nelson, D. A., Peterson, E. L., Wilson, P. S., Jacobsen, G., & Longcope, C. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.3.8077360 · Cited by 59 · see citing works
Three limitations of the body mass index
McLaren, D. S. (1987) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/46.1.121-b · Cited by 44 · see citing works
Skeletal differences between black and white men and their relevance to body composition estimates
Gerace, L., Aliprantis, A. O., Russell, M., Allison, D. B., Buhl, K. M., Wang, J., Wang, Z., Pierson, R. N., & Heymsfield, S. B. (1994) · American Journal of Human Biology · doi:10.1002/ajhb.1310060215 · Cited by 41 · see citing works
Self-citationProthro, J. W., & Rosenbloom, C. (1993) · Journal of Gerontology · doi:10.1093/geronj/48.1.m15 · Cited by 39 · see citing works
Body Composition and Aging: A Study by In Vivo Neutron Activation Analysis
Heymsfield, S. B., Wang, Z., Baumgartner, R., Dilmanian, F. A., Ma, R., & Yasumura, S. (1993) · Journal of Nutrition · doi:10.1093/jn/123.suppl_2.432 · Cited by 37 · see citing works
Self-citationMetheny, E. (1939) · Research Quarterly American Association for Health Physical Education and Recreation · doi:10.1080/10671188.1939.10622510 · Cited by 27 · see citing works
Race-dependent health risks of upper body obesity
Dowling, H. J., & Pi‐Sunyer, F. X. (1993) · Diabetes · doi:10.2337/diabetes.42.4.537 · Cited by 26 · see citing works
Pierson, R. N., Wang, J., Heymsfield, S., Dilmanian, F. A., & Weber, D. A. (1990) · Springer eBooks · doi:10.1007/978-1-4613-1473-8_44 · Cited by 18 · see citing works
Self-citationGoldstein, R. E. (1992) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607192016002181 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
(2004) · The Lancet · doi:10.1016/s0140-6736(03)15268-3 · Cited by 12,717 · see citing works
Prevalence and Trends in Obesity Among US Adults, 1999-2008
Flegal, K. M. (2010) · JAMA · doi:10.1001/jama.2009.2014 · Cited by 7,580 · see citing works
Prospective Studies Collaboration (2009) · The Lancet · doi:10.1016/s0140-6736(09)60318-4 · Cited by 4,807 · see citing works
Chooi, Y. C., Ding, C., & Magkos, F. (2018) · Metabolism · doi:10.1016/j.metabol.2018.09.005 · Cited by 2,849 · see citing works
Trends in Obesity Among Adults in the United States, 2005 to 2014
Flegal, K. M., Kruszon-Moran, D., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2016) · JAMA · doi:10.1001/jama.2016.6458 · Cited by 2,803 · see citing works
Elevated C-reactive protein levels in overweight and obese adults
Visser, M. (1999) · JAMA · doi:10.1001/jama.282.22.2131 · Cited by 2,494 · see citing works
Self-citationGarvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914 · see citing works
Wildman, R. P. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.15.1617 · Cited by 1,618 · see citing works
The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030
Vogel, B., Mónica Acevedo, B., Appelman, Y., Merz, C. N. B., Chieffo, A., Figtree, G. A., Guerrero, M. E., Kunadian, V., Lam, C. S. P., Maas, A. H. E. M., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00684-x · Cited by 1,536 · see citing works
Deurenberg, P., Deurenberg‐Yap, M., & Gurrici, S. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00065.x · Cited by 1,322 · see citing works
Willett, W. C., Dietz, W. H., & Colditz, G. A. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908053410607 · Cited by 1,127 · see citing works
Sex differences in human adipose tissues – the biology of pear shape
Karastergiou, K., Smith, S. R., Greenberg, A. S., & Fried, S. K. (2012) · Biology of Sex Differences · doi:10.1186/2042-6410-3-13 · Cited by 1,109 · see citing works
Adipose tissue and insulin resistance in obese
Ahmed, B., Sultana, R., & Greene, M. W. (2021) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2021.111315 · Cited by 1,094 · see citing works
The Public Health Impact of Obesity
Visscher, T. L. S., & Seidell, J. C. (2001) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.22.1.355 · Cited by 1,013 · see citing works
Appendicular skeletal muscle mass: effects of age, gender, and ethnicity
Gallagher, D., Visser, M., De Meersman, R. E., Sepúlveda, D., Baumgartner, R. N., Pierson, R. N., Harris, T., & Heymsfield, S. B. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.83.1.229 · Cited by 966 · see citing works
Self-citationOverweight, Obesity, and Health Risk
National Task Force on the Prevention and Treatment of Obesity (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.7.898 · Cited by 959 · see citing works
Assessing Adiposity: A Scientific Statement From the American Heart Association
Cornier, M.-A., Després, J.-P., Davis, N., Grossniklaus, D. A., Klein, S., Lamarche, B., Lopez-Jimenez, F., Rao, G., St-Onge, M.-P., Towfighi, A., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318233bc6a · Cited by 945 · see citing works
Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly
Baumgartner, R. N., Wayne, S. J., Waters, D. L., Janssen, I., Gallagher, D., & Morley, J. E. (2004) · Obesity Research · doi:10.1038/oby.2004.250 · Cited by 937 · see citing works
Self-citationBody mass index as a measure of adiposity among children and adolescents: A validation study
Pietrobelli, A., Faith, M. S., Allison, D. B., Gallagher, D., Chiumello, G., & Heymsfield, S. B. (1998) · The Journal of Pediatrics · doi:10.1016/s0022-3476(98)70433-0 · Cited by 933 · see citing works
Self-citationBeyond BMI: The value of more accurate measures of fatness and obesity in social science research
Burkhauser, R. V., & Cawley, J. (2007) · Journal of Health Economics · doi:10.1016/j.jhealeco.2007.05.005 · Cited by 849 · see citing works
Flegal, K. M., Shepherd, J. A., Looker, A. C., Graubard, B. I., Borrud, L. G., Ogden, C. L., Harris, T. B., Everhart, J. E., & Schenker, N. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26847 · Cited by 819 · see citing works
Self-citationAge-related changes in total and regional fat distribution
Kuk, J. L., Saunders, T. J., Davidson, L. E., & Ross, R. (2009) · Ageing Research Reviews · doi:10.1016/j.arr.2009.06.001 · Cited by 778 · see citing works
The paradigm of body condition: a critical reappraisal of current methods based on mass and length
Peig, J., & Green, A. J. (2010) · Functional Ecology · doi:10.1111/j.1365-2435.2010.01751.x · Cited by 719 · see citing works
Sun, S. S., Chumlea, W. C., Heymsfield, S. B., Lukaski, H. C., Schoeller, D., Friedl, K., Kuczmarski, R. J., Flegal, K. M., Johnson, C. L., & Hubbard, V. S. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.2.331 · Cited by 701 · see citing works
Self-citationOverweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem
Wyatt, S. B., Winters, K. P., & Dubbert, P. M. (2006) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200604000-00002 · Cited by 697 · see citing works
Jackson, A., Stanforth, P., Gagnon, J., Rankinen, T., Leon, A., Rao, D., Skinner, J., Bouchard, C., & Wilmore, J. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802006 · Cited by 694 · see citing works
Obesity Accelerates the Progression of Coronary Atherosclerosis in Young Men
McGill, H. C., McMahan, C. A., Herderick, E. E., Zieske, A. W., Malcom, G. T., Tracy, R. E., & Strong, J. P. (2002) · Circulation · doi:10.1161/01.cir.0000018121.67607.ce · Cited by 684 · see citing works
Obesity and C ‐reactive protein in various populations: a systematic review and meta‐analysis
Choi, J., Joseph, L., & Pilote, L. (2012) · Obesity Reviews · doi:10.1111/obr.12003 · Cited by 657 · see citing works
Adipocyte Turnover: Relevance to Human Adipose Tissue Morphology
Arner, E., Westermark, P. O., Spalding, K. L., Britton, T., Rydén, M., Frisén, J., Bernard, S., & Arner, P. (2010) · Diabetes · doi:10.2337/db09-0942 · Cited by 645 · see citing works
What aspects of body fat are particularly hazardous and how do we measure them?
Snijder, M. B., van Dam, R. M., Visser, M., & Seidell, J. C. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyi253 · Cited by 585 · see citing works
Self-citationDeurenberg-Yap, M., Schmidt, G., van Staveren, W., & Deurenberg, P. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801353 · Cited by 580 · see citing works
Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin
Shah, N. R., & Braverman, E. R. (2012) · PLoS ONE · doi:10.1371/journal.pone.0033308 · Cited by 554 · see citing works
Camhi, S. M., Bray, G. A., Bouchard, C., Greenway, F. L., Johnson, W. D., Newton, R. L., Ravussin, É., Ryan, D. H., Smith, S. R., & Katzmarzyk, P. T. (2010) · Obesity · doi:10.1038/oby.2010.248 · Cited by 553 · see citing works
MacDonald, A. A., Herbison, P., Showell, M. G., & Farquhar, C. M. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmp047 · Cited by 539 · see citing works
Daniels, S. R., Khoury, P. R., & Morrison, J. A. (1997) · PEDIATRICS · doi:10.1542/peds.99.6.804 · Cited by 538 · see citing works
Sex differences in the physiology of eating
Asarian, L., & Geary, N. (2013) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00446.2012 · Cited by 513 · see citing works
Body composition estimates from NHANES III bioelectrical impedance data
Chumlea, W., Guo, S., Kuczmarski, R., Flegal, K., Johnson, C., Heymsfield, S., Lukaski, H., Friedl, K., & Hubbard, V. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802167 · Cited by 510 · see citing works
Self-citationCondition indices for conservation: new uses for evolving tools
Stevenson, R. D., & Woods, W. A. (2006) · Integrative and Comparative Biology · doi:10.1093/icb/icl052 · Cited by 503 · see citing works
Sarcopenia – Molecular mechanisms and open questions
Wiedmer, P., Jung, T., Castro, J. P., Pomatto, L. C. D., Sun, P. Y., Davies, K. J. A., & Grune, T. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101200 · Cited by 489 · see citing works
Lee, D. H., Keum, N., Hu, F. B., Orav, E. J., Rimm, E. B., Willett, W. C., & Giovannucci, E. L. (2018) · BMJ · doi:10.1136/bmj.k2575 · Cited by 486 · see citing works
Relation of BMI to fat and fat-free mass among children and adolescents
Freedman, D. S., Wang, J., Maynard, L. M., Thornton, J. C., Mei, Z., Pierson, R. N., Dietz, W. H., & Horlick, M. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802735 · Cited by 483 · see citing works
Self-citationBatsis, J. A., Mackenzie, T. A., Barre, L. K., Lopez-Jimenez, F., & Bartels, S. J. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.117 · Cited by 479 · see citing works
Heymsfield, S. B., Peterson, C. M., Thomas, D. M., Heo, M., & Schuna, J. M. (2016) · Obesity Reviews · doi:10.1111/obr.12358 · Cited by 470 · see citing works
Self-citationOrgan-tissue mass measurement allows modeling of REE and metabolically active tissue mass
Gallagher, D., Belmonte, D., Deurenberg, P., Wang, Z., Krasnow, N., Pi-Sunyer, F. X., & Heymsfield, S. B. (1998) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1998.275.2.e249 · Cited by 470 · see citing works
Self-citationWeight stability masks sarcopenia in elderly men and women
Gallagher, D., Ruts, E., Visser, M., Heshka, S., Baumgartner, R. N., Wang, J., Pierson, R. N., Pi-Sunyer, F. X., & Heymsfield, S. B. (2000) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.2000.279.2.e366 · Cited by 466 · see citing works
Self-citationCottam, D. R., Mattar, S. G., Barinas-Mitchell, E., Eid, G., Kuller, L., Kelley, D. E., & Schauer, P. R. (2004) · Obesity Surgery · doi:10.1381/096089204323093345 · Cited by 461 · see citing works
Lomonaco, R., Ortiz‐Lopez, C., Orsak, B., Webb, A., Hardies, J., Darland, C., Finch, J., Gastaldelli, A., Harrison, S. A., Tio, F. O., et al. (2011) · Hepatology · doi:10.1002/hep.25539 · Cited by 460 · see citing works
Linden, A. (2006) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2005.00598.x · Cited by 448 · see citing works
Visscher, T., Seidell, J., Molarius, A., van der Kuip, D., Hofman, A., & Witteman, J. (2001) · International Journal of Obesity · doi:10.1038/sj.ijo.0801787 · Cited by 434 · see citing works
Birth weight, body mass index and asthma in young adults
Shaheen, S. O., Sterne, J. A. C., Montgomery, S., & Azima, H. (1999) · Thorax · doi:10.1136/thx.54.5.396 · Cited by 428 · see citing works
Sex Differences in Lipid and Lipoprotein Metabolism: It's Not Just about Sex Hormones
Wang, X., Magkos, F., & Mittendorfer, B. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2061 · Cited by 424 · see citing works
Neck Circumference as a Simple Screening Measure for Identifying Overweight and Obese Patients
Ben-Noun, L. L., SOHAR, E., & Laor, A. (2001) · Obesity Research · doi:10.1038/oby.2001.61 · Cited by 420 · see citing works
Adipose Tissue Leptin Production and Plasma Leptin Kinetics in Humans
Klein, S., Coppack, S. W., Mohamed‐Ali, V., & Landt, M. (1996) · Diabetes · doi:10.2337/diab.45.7.984 · Cited by 418 · see citing works
Prevalence of Overweight and Obesity among Chinese Adults: Role of Adiposity Indicators and Age
Xu, W., Zhang, H., Paillard‐Borg, S., Zhu, H., Qi, X., & Rizzuto, D. (2016) · Obesity Facts · doi:10.1159/000443003 · Cited by 416 · see citing works
Large, V., Hellström, L., Reynisdottir, S., Lönnqvist, F., Eriksson, P. O., Lannfelt, L., & Arner, P. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119854 · Cited by 415 · see citing works
Obesity paradox in cardiovascular disease: where do we stand?
Carbone, S., Canada, J. M., Billingsley, H., Siddiqui, M. S., Elagizi, A., & Lavie, C. J. (2019) · Vascular Health and Risk Management · doi:10.2147/vhrm.s168946 · Cited by 410 · see citing works
Leeners, B., Geary, N., Tobler, P. N., & Asarian, L. (2017) · Human Reproduction Update · doi:10.1093/humupd/dmw045 · Cited by 407 · see citing works
Woolcott, O. O., & Bergman, R. N. (2018) · Scientific Reports · doi:10.1038/s41598-018-29362-1 · Cited by 399 · see citing works
Measures of body composition in blacks and whites: a comparative review
Wagner, D. R., & Heyward, V. H. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.6.1392 · Cited by 397 · see citing works
Misra, A., & Vikram, N. K. (2004) · Nutrition · doi:10.1016/j.nut.2004.01.020 · Cited by 396 · see citing works
Shariq, O. A., & McKenzie, T. J. (2020) · Gland Surgery · doi:10.21037/gs.2019.12.03 · Cited by 396 · see citing works
Lin, W.-Y., Lee, L.-T., Chen, C.-Y., Lo, H., Hsia, H.-H., Liu, I.-L., Lin, R.-S., Shau, W., & Huang, K.-C. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802040 · Cited by 393 · see citing works
Elevated body mass index and mortality risk in the elderly
Janssen, I., & Mark, A. E. (2006) · Obesity Reviews · doi:10.1111/j.1467-789x.2006.00248.x · Cited by 381 · see citing works
Price, G. M., Uauy, R. D., Breeze, E., Bulpitt, C. J., & FLETCHER, A. E. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.1.449 · Cited by 375 · see citing works
Dietary phytochemicals and their potential effects on obesity: A review
González-Castejón, M., & Rodríguez‐Casado, A. (2011) · Pharmacological Research · doi:10.1016/j.phrs.2011.07.004 · Cited by 375 · see citing works
BMI does not accurately predict overweight in Asian Indians in northern India
Dudeja, V., Misra, A., Pandey, R. M., Devina, G., Kumar, G. S. H., & Vikram, N. K. (2001) · British Journal Of Nutrition · doi:10.1079/bjn2001382 · Cited by 371 · see citing works
A multilevel analysis of race, community disadvantage, and body mass index among adults in the US
Robert, S., & Reither, E. N. (2004) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.03.034 · Cited by 365 · see citing works
Batsis, J. A., Barre, L. K., Mackenzie, T. A., Pratt, S. I., Lopez‐Jimenez, F., & Bartels, S. J. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12260 · Cited by 330 · see citing works
Siffert, W., Forster, P., Jöckel, K., Mvere, D., Brinkmann, B., Naber, C. K., Crookes, R. L., Heyns, A. D. P., Epplen, J. T., Fridey, J. L., et al. (1999) · Journal of the American Society of Nephrology · doi:10.1681/asn.v1091921 · Cited by 330 · see citing works
Obesity – a risk factor for postoperative complications in general surgery?
Tjeertes, E. K. M., Hoeks, S. E., Beks, S. S. B. J. C., Valentijn, T. M., Hoofwijk, A. G. M., & Stolker, R. J. (2015) · BMC Anesthesiology · doi:10.1186/s12871-015-0096-7 · Cited by 321 · see citing works
Deurenberg‐Yap, M., Chew, S. K., & Deurenberg, P. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00069.x · Cited by 316 · see citing works
Liu, B., Du, Y., Wu, Y., Snetselaar, L., Wallace, R. B., & Bao, W. (2021) · BMJ · doi:10.1136/bmj.n365 · Cited by 313 · see citing works
Lauderdale, D. S., & Rathouz, P. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801365 · Cited by 306 · see citing works
Whittle, A. T., Marshall, I., Mortimore, I. L., WRAITH, P. K., Sellar, R. J., & Douglas, N. J. (1999) · Thorax · doi:10.1136/thx.54.4.323 · Cited by 302 · see citing works
Alterations in Glucose Disposal in Sleep-disordered Breathing
Punjabi, N. M., & Beamer, B. A. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200809-1392oc · Cited by 296 · see citing works
Nicklas, B. J. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh281 · Cited by 294 · see citing works
Reduced body size and cub recruitment in polar bears associated with sea ice decline
Rode, K. D., Amstrup, S. C., & Regehr, E. V. (2010) · Ecological Applications · doi:10.1890/08-1036.1 · Cited by 286 · see citing works
Beyond BMI: The Value of More Accurate Measures of Fatness and Obesity in Social Science Research
Cawley, J., & Burkhauser, R. V. (2006) · National Bureau of Economic Research · doi:10.3386/w12291 · Cited by 286 · see citing works
Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes
Abenhaim, H. A., Kinch, R. A., Morin, L., Benjamin, A., & Usher, R. (2006) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-006-0219-y · Cited by 285 · see citing works
Adipokines: a link between obesity and dementia?
Kiliaan, A. J., Arnoldussen, I. A. C., & Gustafson, D. (2014) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70085-7 · Cited by 284 · see citing works
Clinical Usefulness of a New Equation for Estimating Body Fat
Gómez‐Ambrosi, J., Silva, C., Catalán, V., Rodrı́guez, A., Galofré, J. C., Escalada, J., Valentí, V., Rotellar, F., Romero, S., Ramírez, B., et al. (2011) · Diabetes Care · doi:10.2337/dc11-1334 · Cited by 283 · see citing works
Sex dimorphism and depot differences in adipose tissue function
White, U. A., & Tchoukalova, Y. D. (2013) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2013.05.006 · Cited by 281 · see citing works
Diagnostic accuracy of body mass index to identify obesity in older adults: NHANES 1999–2004
Batsis, J. A., Mackenzie, T. A., Bartels, S. J., Sahakyan, K. R., Somers, V. K., & Lopez-Jimenez, F. (2016) · International Journal of Obesity · doi:10.1038/ijo.2015.243 · Cited by 275 · see citing works
Meeuwsen, S., Horgan, G. W., & Elia, M. (2010) · Clinical Nutrition · doi:10.1016/j.clnu.2009.12.011 · Cited by 275 · see citing works
Albanese, E., Launer, L. J., Egger, M., Prince, M. J., Giannakopoulos, P., Wolters, F. J., & Egan, K. (2017) · Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring · doi:10.1016/j.dadm.2017.05.007 · Cited by 272 · see citing works
Body composition phenotypes in pathways to obesity and the metabolic syndrome
Dulloo, A. G., Jacquet, J., Solinas, G., Montani, J.-P., & Schutz, Y. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.234 · Cited by 268 · see citing works
Role of Insulin Resistance and Lipotoxicity in Non-Alcoholic Steatohepatitis
Cusi, K. J. (2009) · Clinics in Liver Disease · doi:10.1016/j.cld.2009.07.009 · Cited by 263 · see citing works
Sundquist, J., & Johansson, S.-E. (1998) · International Journal of Epidemiology · doi:10.1093/ije/27.1.57 · Cited by 254 · see citing works
Schoeller, D. A., Tylavsky, F. A., Baer, D. J., Chumlea, W. C., Earthman, C. P., Fuerst, T., Harris, T. B., Heymsfield, S. B., Horlick, M., Lohman, T. G., et al. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.5.1018 · Cited by 253 · see citing works
Self-citationBrambilla, P., Bedogni, G., Heo, M., & Pietrobelli, A. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.32 · Cited by 250 · see citing works
Body mass index and risk of autoimmune diseases: a study within the Danish National Birth Cohort
Harpsøe, M. C., Basit, S., Andersson, M., Nielsen, N. M., Frisch, M., Wohlfahrt, J., Nohr, E. A., Linneberg, A. R., & Jess, T. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu045 · Cited by 248 · see citing works
Sex Differences in the Relation between Body Mass Index and Asthma and Atopy in a Birth Cohort
Hancox, R. J., Milne, B. J., Poulton, R., Taylor, D. R., Greene, J. M., McLachlan, C. R., Cowan, J. O., Flannery, E. M., Herbison, P., & Sears, M. R. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200405-623oc · Cited by 247 · see citing works
Obesity: criteria and classification
Pi‐Sunyer, F. X. (2000) · Proceedings of The Nutrition Society · doi:10.1017/s0029665100000732 · Cited by 242 · see citing works
HUNTER, S. K., S. ANGADI, S., BHARGAVA, A., HARPER, J., HIRSCHBERG, A. L., D. LEVINE, B., L. MOREAU, K., J. NOKOFF, N., STACHENFELD, N. S., & BERMON, S. (2023) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003300 · Cited by 241 · see citing works
Obesity and reproduction: a committee opinion
Penzias, A. S., Azziz, R., Bendikson, K. A., Falcone, T., Hansen, K. R., Hill, M. J., Jindal, S., Kalra, S. K., Mersereau, J. E., Reindollar, R. H., et al. (2021) · Fertility and Sterility · doi:10.1016/j.fertnstert.2021.08.018 · Cited by 239 · see citing works
Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index
Palaniappan, L. P., Wong, E. C., Shin, J., Fortmann, S. P., & Lauderdale, D. S. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.152 · Cited by 236 · see citing works
Wåhlén, K., Sjölin, E., & Hoffstedt, J. (2007) · Journal of Lipid Research · doi:10.1194/jlr.m700448-jlr200 · Cited by 236 · see citing works
Insulin Action in Adipose Tissue and Muscle in Hypothyroidism
Dimitriadis, G., Mitrou, P., Lambadiari, V., Boutati, E., Maratou, E., Panagiotakos, D. B., Koukkou, E., Tzanela, M., Thalassinos, N., & Raptis, S. A. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0478 · Cited by 233 · see citing works
Lü, B., Hiraki, L. T., Sparks, J. A., Malspeis, S., Chen, C., Awosogba, J. A., Arkema, E. V., Costenbader, K. H., & Karlson, E. W. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2014-205459 · Cited by 231 · see citing works
Hypothesis Concerning the U-shaped Relation between Body Mass Index and Mortality
Allison, D. B., Faith, M. S., Heo, M., & Kotler, D. P. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009275 · Cited by 227 · see citing works
- Authors
- Gallagher, D., Visser, M., Sepulveda, D., Pierson, R. N., Harris, T., & Heymsfield, S. B.
- Affiliations
- St. Luke's-Roosevelt Hospital Center (US)
- Wageningen University & Research (NL)
- National Institutes of Health (US)
- Corresponding author
- Gallagher, D.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-02-01
- Volume
- 143
- Issue
- 3
- Pages
- 228-239
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2146056535
- Cited by
- 1,513
- References
- 48
- Citations by year
- 2026: 22 · 2025: 39 · 2024: 50 · 2023: 42 · 2022: 58 · 2021: 51 · 2020: 69 · 2019: 63 · 2018: 63 · 2017: 63 · 2016: 73 · 2015: 92 · 2014: 81 · 2013: 85 · 2012: 62
- FWCI
- 10.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (P01-DK37352)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- body mass index, body fat percentage, body composition, age differences, sex differences, ethnic differences, Black and White adults, four-compartment model, obesity indices
- MeSH terms
- Adipose Tissue, Adult, Age Factors, Aged, Aged, 80 and over, Anthropometry, Body Composition, Cross-Sectional Studies, Ethnicity, Female, Humans, Male, Middle Aged, New York City, Regression Analysis, Sex Factors, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
