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Misquotation of percent body fat

Posted by rknguyen on 11 Oct 2012 at 05:32 GMT

We agree with the authors that BMI is an imperfect indicator of obesity, because it can not differentiate between fat mass and lean tissue mass. However, we would like to point out a misquotation in the paper regarding the threshold of percent body fat (PBF). In the paper, the authors state that “In 1995, the World Health Organization (WHO) defined obesity based on a percent body fat ≥25% for men and ≥35% for women” and attribute these criteria to a WHO Technical Report (1). As a matter of fact, the Technical Report makes no such recommendation. We have pointed this misquotation out in a previous communication (2).

The percent body fat thresholds were first mentioned in a 1998 paper which was published in the International Journal of Obesity (3) which states that “Obesity is characterised by an increased amount of body fat, defined in young adults as body fat >25% in males and >35% in females, corresponding to a body mass index (BMI) of 30 kg/m2 in young Caucasians,” with reference for this statement being a 1995 WHO Technical Report (1). However, the 1995 WHO Report does not recommend any PBF threshold for defining obesity. In fact, the WHO Report refers to a Swedish study in which the average PBF (measured by underwater weighing) was 25% in men and 30% in women aged 45-49 years (1). Nevertheless, subsequent papers (4-13) kept referring to the 1998 International Journal of Obesity paper (3) or the Techinical Report (1) as the primary sources for the PBF thresholds. Thus, an initial erroneous citation has led to a trail of subsequent misquotations.

To our knowledge, to date, there is no validated threshold of body fat for defining obesity.

Tuan V. Nguyen
Garvan Institute of Medical Research
Sydney, Australia

Lan T. Ho-Pham
Pham Ngoc Thach University of Medicine
Ho Chi Minh City, Vietnam

References:

1. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854: 1–452.

2. Ho-Pham LT, Campbell LV, Nguyen TV. More on Body Fat Cutoff Points. Mayo Clin Proc. 2011 June; 86(6): 584.

3. Deurenberg P, Yap M, van Staveren WA. Body mass index and percent body fat: a meta analysis among different ethnic groups. Int J Obes Relat Metab Disord 1998;22:1164-1171.

4. Gurrici S, Hartriyanti Y, Hautvast JG, Deurenberg P. Differences in the relationship between body fat and body mass index between two different Indonesian ethnic groups: the effect of body build. Eur J Clin Nutr 1999;53:468-472.

5. Sardinha LB, Teixeira PJ. Obesity screening in older women with body mass index: a receiver operating characteristic (ROC) analysis. Sci Sports 2000;15:212-219.

6. Ko GT, Tang J, Chan JC, Sung R, Wu MM, Wai HP, Chen R. Lower BMI cut-off value to define obesity in Hong Kong Chinese: an analysis based on body fat assessment by bioelectrical impedance. Br J Nutr 2001;85:239-242.

7. Deurenberg P. Universal cut-off BMI points for obesity are not appropriate. Br J Nutr 2001; 85:135-136.

8. Deurenberg-Yap M, Chew SK, Deurenberg P. Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Obes Rev 2002;3:209-215.

9. Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 2002;3:141-146.

10. Chang CJ, Wu CH, Chang CS, Yao WJ, Yang YC, Wu JS, Lu FH. Low body mass index but high percent body fat in Taiwanese subjects: implications of obesity cutoffs. Int J Obes Relat Metab Disord 2003;27:253-259.

11. Goh VH, Tain CF, Tong TY, Mok HP, Wong MT. Are BMI and other anthropometric measures appropriate as indices for obesity? A study in an Asian population. J Lipid Res 2004;45:1892-1898.

12. Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, Allison TG, Batsis JA, Sert-Kuniyoshi FH, Lopez-Jimenez F. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond) 2008;32:959-966.

13. Okorodudu DO, Jumean MF, Montori VM, Romero-Corral A, Somers VK, Erwin PJ, Lopez-Jimenez F. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes (Lond) 2010; 34(5):791-9.

No competing interests declared.