body mass index (BMI)

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[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]

Introduction

BMI = mass in kg/ height in m2

(weight (mass) in kg divided by square of height in meters)

Pathology

  • low & high body mass index associated with increased mortality[4]
    • including elderly > 65 years of age, i.e. U-shaped mortality vs BMI
  • for BMI > 25, every 5-unit increase in BMI translates to:
  • lower BMI associated with higher mortality after adjustment for adiposity[11]
  • for BMI < 22, increased mortality is partly due to smoking
  • overweight in midlife, compared with normal BMI, is associated with greater long-term morbidity, but similar longevity[16] 
Risk of all-cause mortality by BMI[5]

BMI                     Hazzard Ratio
15.0-18.4.............. 1.5
18.5-19.9.............. 1.1
20.0-22.4.............. 1.0
22.5-24.9.............. 1.0
25.0-29.9.............. 1.1
30.0-34.9.............. 1.4
35.0-39.9.............. 1.9
40.0-49.9.............. 2.5

Different studies reach different conclusions:

  • BMI 25-30 associated with lower mortality than BMI 18.5-25 kg/m2 (RR 0.76) & BMI 30-34 not associated with increased mortality[6][7]
  • in the elderly, obesity may be paradoxically associated with a lower, not higher, mortality risk[10]
  • BMI with lowest all-cause mortality in Danish increased from 23.7 in 1976-1978 to 27.0 in 2003-2013[12]
  • Mortality rates lowest for BMIs between 27-29 kg/m2[15]

Genetics

Indications

Reference interval

-..........-

BMI: 22-25 kg/m2 = normal
BMI: 27-30 kg/m2 = mild obesity
BMI: 30-35 kg/m2 = moderate obesity
BMI: 35-40 kg/m2 = severe obesity
BMI: >40 kg/m2   = morbid obesity

A BMI calculator is available on the internet[3]

waist/hip ratio may be a better predictor of cardiovascular risk

Notes

More general terms

Additional terms

References

  1. ↑ Guide to Ambulatory Care, Brian Yee, Bristol Meyers Squibb, 1997
  2. ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 693-94
  3. ↑ Jump up to: 3.0 3.1 BMI calculator http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
  4. ↑ Jump up to: 4.0 4.1 Prospective Studies Collaboration Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies The Lancet 2009, Vol 373:(9669)1083-1096 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60318-4/abstract
  5. ↑ Jump up to: 5.0 5.1 Berrington de Gonzalez A et al Body-Mass Index and Mortality among 1.46 Million White Adults N Engl J Med. 2010 Dec 2;363(23):2211-9. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21121834 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1000367
  6. ↑ Jump up to: 6.0 6.1 Beleigoli AM et al Overweight and class I obesity are associated with lower 10-year risk of mortality in brazilian older adults: the bambui cohort study of ageing. PLoS One. 2012;7(12):e52111 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23251690
  7. ↑ Jump up to: 7.0 7.1 Flegal KM et al Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013 Jan 2;309(1):71-82 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23280227
    Heymsfield SB, Cefalu WT. Does body mass index adequately convey a patient's mortality risk? PMID: https://www.ncbi.nlm.nih.gov/pubmed/23280230
  8. ↑ Jump up to: 8.0 8.1 OMIM https://mirror.omim.org/entry/607514
  9. ↑ Cereda E, Pedrolli C, Zagami A et al Body mass index and mortality in institutionalized elderly. J Am Med Dir Assoc. 2011 Mar;12(3):174-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21333917
  10. ↑ Jump up to: 10.0 10.1 Oreopoulos A, Kalantar-Zadeh K, Sharma AM, Fonarow GC. The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med. 2009 Nov;25(4):643-59, viii. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19944265
  11. ↑ Jump up to: 11.0 11.1 Padwal R, Leslie WD, Lix LM, Majumdar SR. Relationship among body fat percentage, body mass index, and all-cause mortality: A cohort study. Ann Intern Med 2016 Mar 8; PMID: https://www.ncbi.nlm.nih.gov/pubmed/26954388
  12. ↑ Jump up to: 12.0 12.1 Afzal S, Tybjaerg-Hansen A, Jensen GB, Nordestgaard BG, Change in Body Mass Index Associated With Lowest Mortality in Denmark, 1976-2013 JAMA. 2016;315(18):1989-1996. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27163987
  13. ↑ World Health Organization (WHO) Global Database on Body Mass Index http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
  14. ↑ Jump up to: 14.0 14.1 Rubin R Postmenopausal Women With a "Normal" BMI Might Be Overweight or Even Obese. JAMA. Published online March 7, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29516084 https://jamanetwork.com/journals/jama/fullarticle/2674709
  15. ↑ Jump up to: 15.0 15.1 Talebraza S et al Geriatrics Evaluation & Management Tools American Geriatrics Society. 2021 https://geriatricscareonline.org/ProductAbstract/geriatrics-evaluation-management-tools/B007/
  16. ↑ Jump up to: 16.0 16.1 Khan SS, Krefman AE, Zhao L et al Association of Body Mass Index in Midlife With Morbidity Burden in Older Adulthood and Longevity. JAMA Netw Open. 2022;5(3):e222318 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35289856 PMCID: PMC8924714 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790100
  17. ↑ Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 2014;99(4):875-890 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24452240
  18. ↑ Jump up to: 18.0 18.1 18.2 Agbaje AO Body mass index triples overweight prevalence in 7600 children compared with waist-to-height ratio: the ALSPAC study. Obesity and Endocrinology. 2025. Feb 14 Not yet indexed in PubMed https://academic.oup.com/obendo/article/1/1/wjaf002/8011348

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