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Why are there race/ethnic differences in adult body mass index–adiposity relationships? A quantitative critical review
Open accessAbstract
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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“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]
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Metadata
- 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
- PMC
- PMC4968570
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › 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
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 ›
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