Scientists May Have a New Body Measurement That’s Better than BMI

When my oldest son was in high school, we got a Wii Fit. The first time he played it, he was putting his stats into the game—height, weight, age, sex—and his little MeWii guy went from the average size to a larger one. My son threw the remote, said, “This is stupid,” and never played it. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Body mass index (BMI), a calculation of height-to-weight ratio, has been used for many years by researchers and the medical community to determine one’s health status and risk. But it’s flawed—big time. For example, athletes with greater muscle mass, like my son, will naturally weigh more. So according to the BMI charts, he was “obese” for his height. But the reality was that his body fat percentage was low and his lean tissue—including muscle and bones—was high, providing a healthy body composition.

BMI also cannot determine where body fat is distributed. We know that visceral or belly fat, the fat that lies deeper in the abdomen and surrounds vital organs, can put people at higher risk for disease and death when there’s too much of it (some of it is necessary to help cushion the organs). But two people with the same BMI may have dramatically different builds. One may carry more fat in their lower body—hips, legs and butt—and the other carries more fat in their middle. So they weigh the same and are the same height, but because they carry fat in different places, the one with more visceral fat could be at higher risk for chronic inflammation, heart disease, diabetes and cancer.

Thankfully, researchers have caught on and there is now a newer, hopefully more accurate, way to determine health risk—the Body Roundness Index (BRI). It’s calculated using an equation incorporating height, weight and waist circumference. And a newly-released study published in JAMy. There was a racial and ethnic mix that included Mexican-American, non-Hispanic Black, non-Hispanic White and other races and ethnicities—American Indian, Alaska Native, Native Hawaiian, Pacific Islander and non-Hispanic Asian.

Since researchers were looking at death rates during the study period up to December 31, 2019, mortality data was obtained through the Centers for Disease Control and Prevention’s (CDC) website and linked to the NHANES database.

Covariates—variables that may or may not affect or skew results—included age, sex, race and ethnicity, education level, poverty income ratio, smoking status, drinking (alcohol) status, family history of heart disease and family history of diabetes. Covariates also allow researchers to see if there are trends within any of the variables—like if age or education level affects risk for disease or death.

Several statistical analyses were run on the data, before and after adjusting for the covariates.

Because BRI is so new, categories and ranges—like, low, normal and high BRI—have not yet been established. Because of this, researchers needed to create their own categories. At the study’s halfway point, researchers noticed a U-shaped association between BRI and deaths. From this, they formed various categories called quintiles with Q1 being the lowest BRI and Q5 the highest. Q3 was assigned as the reference group.

What they found was very interesting. Because it’s been shown in previous studies that higher amounts of visceral (belly) fat place people at higher risk of chronic disease and death, it might not be surprising that these researchers found that people who fell into Q5—which suggests a high level of visceral fat—were 50% more likely to die from any cause compared to the reference group (Q3).

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