Cited by 470Body Composition Measurement TechniquesObesity, Physical Activity, DietDiabetes, Cardiovascular Risks, and Lipoproteins

Why are there race/ethnic differences in adult body mass index–adiposity relationships? A quantitative critical review

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Heymsfield, S. B., Peterson, C. M., Thomas, D. M., Heo, M., Schuna, J. M.·2016·Obesity Reviews

Abstract

Summary: Body mass index (BMI) is now the most widely used measure of adiposity on a global scale. Nevertheless, intense discussion centers on the appropriateness of BMI as a phenotypic marker of adiposity across populations differing in race and ethnicity. BMI–adiposity relations appear to vary significantly across race/ethnic groups, but a collective critical analysis of these effects establishing their magnitude and underlying body shape/composition basis is lacking. Accordingly, we systematically review the magnitude of these race‐ethnic differences across non‐Hispanic (NH) white, NH black and Mexican American adults, their anatomic body composition basis and potential biologically linked mechanisms, using both earlier publications and new analyses from the US National Health and Nutrition Examination Survey. Our collective observations provide a new framework for critically evaluating the quantitative relations between BMI and adiposity across groups differing in race and ethnicity; reveal new insights into BMI as a measure of adiposity across the adult age‐span; identify knowledge gaps that can form the basis of future research and create a quantitative foundation for developing BMI‐related public health recommendations.

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  • The BMI classification as per the World Health Organization guideline may not apply to Asian populations given that these were generated mostly from White populations.

    “Of note, the BMI classification as per the World Health Organization (WHO) guideline (35) may not apply to Asian populations given that these were generated mostly from the White populations (46).”

    From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [46]

    The Concluding perspectives (page unavailable) report higher body-fat percentages in Asians than in Caucasians of similar age and BMI, and warn that cross-group comparisons can misclassify overweight or obesity. That supports caution about applying a common BMI classification, but the paper does not say WHO classifications were generated mostly from White populations. Its Conclusions (page unavailable) also caution against introducing race-specific cutoffs based solely on adiposity. (LLM, conf=0.84)

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Authors
Heymsfield, S. B., Peterson, C. M., Thomas, D. M., Heo, M., & Schuna, J. M.
Affiliations
  • Pennington Biomedical Research Center (US)
  • Montclair State University (US)
  • Albert Einstein College of Medicine (US)
  • Oregon State University (US)
Corresponding author
Heymsfield, S. B.
Venue
Obesity Reviews
Publisher
Wiley
Published
2015-12-11
Volume
17
Issue
3
Pages
262-275
ISSN
  • 1467-7881 (ISSN-L)
  • 1467-789X
OpenAlex
W2195967324
Cited by
470
References
85
Citations by year
2026: 44 · 2025: 57 · 2024: 86 · 2023: 40 · 2022: 48 · 2021: 59 · 2020: 54 · 2019: 27 · 2018: 27 · 2017: 18 · 2016: 8 · 2015: 1
FWCI
2.20
Type
journal article
Language
en
Open access
Locations
  • Obesity Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of General Medical Sciences of the National Institutes of Health (1 U54 GM104940)
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, adiposity, racial and ethnic differences, body composition, Mexican Americans, Black people, body shape, NHANES
MeSH terms
Body Composition, Body Height, Body Image, Ethnicity, Evaluation Studies as Topic, Humans, Nutrition Surveys, Obesity, Nutrition Assessment, Body Mass Index, Racial Groups, Adiposity, Waist Circumference

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