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Differentiating between body fat and lean mass—how should we measure obesity?

Nature Clinical Practice Endocrinology & Metabolism volume 4, pages 322–323 (2008)Cite this article

Opinion in the scientific community remains divided over the usefulness of BMI as a tool to diagnose obesity and obesity-related risk. Some researchers and physicians believe BMI is an essential element of adiposity. Others question its use, however, as several studies have reported enhanced survival and reduced cardiovascular events in individuals with and without coronary artery disease who have a mildly elevated BMI (25.0–29.9 kg/m2),1,2 a phenomenon termed the 'obesity paradox'.

The unexpected results of these studies have, therefore, challenged the association between adiposity and mortality or cardiovascular events. Nevertheless, it is possible that the surprisingly favorable prognostic implications associated with a mildly elevated BMI might actually reflect intrinsic limitations of BMI to differentiate adipose tissue from lean mass. This potential weakness could have important clinical consequences. Increased body fat has been associated with a broad spectrum of cardiometabolic disturbances. By contrast, physical fitness, exercise capacity and cardiometabolic profiles are all improved in patients with cardiovascular disease who have increased lean mass.3

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Acknowledgements

A Romero-Corral and F Lopez-Jimenez are supported by the American Heart Association. J Sierra-Johnson is supported by the Board of Post-Graduate Education of the Karolinska Institute and the European Foundation for the Study of Diabetes. VK Somers is supported by NIH grants HL-65176, HL-70302, HL-73211, and M01-RR00585.

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Authors and Affiliations

  1. and VK Somers is a Professor in the Division of Cardiovascular Diseases, A Romero-Corral and J Sierra-Johnson are Research Fellows, F Lopez-Jimenez is an Assistant Professor, Mayo Clinic College of Medicine, Rochester, MN, USA. J Sierra-Johnson is also a Research Fellow in the Atherosclerosis Unit, Karolinska Institute, Stockholm, Sweden.,

    Abel Romero-Corral, Francisco Lopez-Jimenez, Justo Sierra-Johnson & Virend K Somers

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  1. Abel Romero-Corral
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  2. Francisco Lopez-Jimenez
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Correspondence to Abel Romero-Corral.

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Competing interests

A Romero-Corral, F Lopez-Jimenez and VK Somers have received research support from Select Research. J Sierra-Johnson declared no competing interests.

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Romero-Corral, A., Lopez-Jimenez, F., Sierra-Johnson, J. et al. Differentiating between body fat and lean mass—how should we measure obesity?. Nat Rev Endocrinol 4, 322–323 (2008). https://doi.org/10.1038/ncpendmet0809

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