Correspondence
In Reply
;
In their review addressing the informative value of the body mass index (BMI) as compared to waist circumference (WC) and waist–hip ratio (WHR) with respect to cardiovascular risk, Huxley and colleagues found that no single marker is clearly superior to the others; rather, they point out contradicting study results and the need for further (longitudinal) studies (1). They also point out that BMI standard values are based on the data of a largely caucasian population, and that their transferability to other ethnic groups is at least questionable. In order to avoid the difficulty of dealing with limit values differently for different population groups, we have systematically excluded studies that use alternative limit values, for instance for Asian populations (2).
There are now a large number of alternative indices for assessing body fat percentage, such as the body roundness index (BRI). However, Rico-Martin and colleagues recently reported that the BRI is not superior to the known methods for predicting metabolic syndrome (3).
BMI, with its known limitations, therefore remains a widespread individual and epidemiological measure that is still largely used, even in guidelines and by international organizations. We agree that many lay people probably cannot calculate their BMI correctly or interpret the calculated number. Our study therefore dealt with the question of the extent to which test persons can verbally classify themselves as normal weight, overweight, or obese. Self-assessment of body weight or BMI was also recorded in some of the studies we included, as were other measurement data (e.g., WC and WHR), but these were not part of our research question. When considering patients individually, other factors besides BMI (such as a patient’s individual life situation) should of course be taken into account.
DOI: 10.3238/arztebl.2020.0659b
On behalf of the authors
Dr. med. Anne-Kathrin Geier, M. Sc. Public Health
Selbstständige Abteilung für Allgemeinmedizin, Universität Leipzig, Germany
Anne-Kathrin.Geier@medizin.uni-leipzig.de
PD Dr. rer. nat. Susanne Unverzagt
Selbstständige Abteilung für Allgemeinmedizin, Universität Leipzig, Germany
Institut für Allgemeinmedizin, Martin-Luther-Universität Halle-Wittenberg, Germany
Conflict of interest statement
The authors of each contribution declare that no conflict of interest exists.
| 1. | Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J: Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk--a review of the literature. Eur J Clin Nutr 2010; 64: 16–22 CrossRef MEDLINE |
| 2. | Freigang R, Geier AK, Schmid GL, Frese T, Klement A, Unverzagt S: Misclassification of self-reported body mass index categories—a systematic review and meta-analysis. Dtsch Arztebl Int 2020; 117: 253–60 VOLLTEXT |
| 3. | Rico-Martín S, Calderón-García JF, Sánchez-Rey P, Franco-Antonio C, Martínez Alvarez M, Sánchez Muñoz-Torrero JF: Effectiveness of body roundness index in predicting metabolic syndrome: a systematic review and meta-analysis. Obes Rev 2020 (Epub ahead of print) CrossRef MEDLINE |
