title: Adiposity rather than BMI determines metabolic risk.
abstract: OBJECTIVE
  There is increasing evidence suggesting that WHO body mass index (BMI) cut-off values are outdated and should not be applied to different population. To overcome misclassifications, direct measurements of percentage body fat (PBF) would be a better tool for preobesity and obesity diagnosis. The aim of this study was to analyze the body composition in a adult population in Centre-South of Italy, by age and gender, and to verify the accordance between BMI and PBF cut-off points for health status classification.
  
  
  METHODS
  The total subject pool cover a total of 4408 participants adults. A completed screening of anthropometry and body composition by Dual X-ray Absorptiometry, (DXA) was assessed on 3.258 subjects.
  
  
  RESULTS
  Distributions and quantitative reliable estimates of PBF, total body fat and lean, according to gender and age are provided. The prevalence of "at risk" subjects (preobese and obese) was 69% and 85%, for men and women respectively, according to PBF cut-off points. The agreement of BMI and PBF categories resulted low for the total and male population, even scarce for female population (all P ≤ 0.001). The false negative classification of BMI was stronger for women than men and for younger than older subjects.
  
  
  CONCLUSIONS
  Screening for adiposity in subjects with a normal BMI could better identify those at higher risk for cardiometabolic disturbances and cardiovascular mortality. The herein used cut-offs points of PBF, by age and gender, may provide a useful reference in clinical settings and public health services, in particular for the Italian Caucasian population.
authors.affiliation: Department of Neuroscience, Division of Human Nutrition, University of Tor Vergata, Via Montpellier 1, I-00133 Rome, Italy. delorenzo@uniroma2.it
authors.forename: Antonino
authors.initials: A
authors.lastname: De Lorenzo
authors.forename: Alessia
authors.initials: A
authors.lastname: Bianchi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Maroni
authors.forename: Annarita
authors.initials: A
authors.lastname: Iannarelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Daniele
authors.forename: Leonardo
authors.initials: L
authors.lastname: Iacopino
authors.forename: Laura
authors.initials: L
authors.lastname: Di Renzo
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods / Q000592:standards*; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008659:Metabolic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult