title: Why are there race/ethnic differences in adult body mass index-adiposity relationships? A quantitative critical review.
abstract: Body mass index (BMI) is now the most widely used measure of adiposity on a global scale. Nevertheless, intense discussion centers on the appropriateness of BMI as a phenotypic marker of adiposity across populations differing in race and ethnicity. BMI-adiposity relations appear to vary significantly across race/ethnic groups, but a collective critical analysis of these effects establishing their magnitude and underlying body shape/composition basis is lacking. Accordingly, we systematically review the magnitude of these race-ethnic differences across non-Hispanic (NH) white, NH black and Mexican American adults, their anatomic body composition basis and potential biologically linked mechanisms, using both earlier publications and new analyses from the US National Health and Nutrition Examination Survey. Our collective observations provide a new framework for critically evaluating the quantitative relations between BMI and adiposity across groups differing in race and ethnicity; reveal new insights into BMI as a measure of adiposity across the adult age-span; identify knowledge gaps that can form the basis of future research and create a quantitative foundation for developing BMI-related public health recommendations.
authors.affiliation: Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Heymsfield
authors.affiliation: Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Peterson
authors.affiliation: Montclair State University, Montclair, NJ, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Thomas
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Heo
authors.affiliation: College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Schuna
mesh_terms: D050154:Adiposity / Q000208:ethnology*; D001823:Body Composition; D001827:Body Height; D001828:Body Image; D015992:Body Mass Index; D005006:Ethnicity; D005069:Evaluation Studies as Topic; D006801:Humans; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D044469:Racial Groups; D055105:Waist Circumference
keywords: Adiposity; allometric analysis; body composition; body shape; nutritional assessment