Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults
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Background Body mass index (BMI), waist circumference (WC), and the waist-stature ratio (WSR) are considered to be possible proxies for adiposity.Objective The objective was to investigate the relations between BMI, WC, WSR, and percentage body fat (measured by dual-energy X-ray absorptiometry) in adults in a large nationally representative US population sample from the National Health and Nutrition Examination Survey (NHANES).Design BMI, WC, and WSR were compared with percentage body fat in a sample of 12,901 adults.Results WC, WSR, and BMI were significantly more correlated with each other than with percentage body fat (P < 0.0001 for all sex-age groups). Percentage body fat tended to be significantly more correlated with WC than with BMI in men but significantly more correlated with BMI than with WC in women (P < 0.0001 except in the oldest age group). WSR tended to be slightly more correlated with percentage body fat than was WC. Percentile values of BMI, WC, and WSR are shown that correspond to percentiles of percentage body fat increments of 5 percentage points. More than 90% of the sample could be categorized to within one category of percentage body fat by each measure.Conclusions BMI, WC, and WSR perform similarly as indicators of body fatness and are more closely related to each other than with percentage body fat. These variables may be an inaccurate measure of percentage body fat for an individual, but they correspond fairly well overall with percentage body fat within sex-age groups and distinguish categories of percentage body fat.
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BMI correlates reasonably well with high body fat at BMI ≥30 but has considerable inter-individual variability, especially in the overweight range.
“BMI should be considered a screening tool that correlates reasonably well with high body fat at BMI ≥30, but has considerable inter-individual variability, particularly in the “overweight” range.15”
From Approach to Obesity Treatment in Primary Care: A Review (2024) · cites this paper as [15]
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- Authors
- 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.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Flegal, Katherine M
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 89
- Issue
- 2
- Pages
- 500-508
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC2647766
- OpenAlex
- W2168789854
- Cited by
- 819
- References
- 58
- Citations by year
- 2026: 18 · 2025: 44 · 2024: 36 · 2023: 58 · 2022: 50 · 2021: 68 · 2020: 49 · 2019: 37 · 2018: 61 · 2017: 48 · 2016: 48 · 2015: 51 · 2014: 53 · 2013: 50 · 2012: 45
- FWCI
- 22.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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 fat percentage, body mass index, waist circumference, adiposity, anthropometric indices, sex differences, age differences, NHANES
- MeSH terms
- Adipose Tissue, Adult, Aged, Aged, 80 and over, Body Composition, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, Obesity, Predictive Value of Tests, United States, Absorptiometry, Photon, Body Mass Index, Waist-Hip Ratio, Adiposity, Waist Circumference, Young Adult
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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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