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The effect of sex, age and race on estimating percentage body fat from body mass index: The Heritage Family Study


Objective: To study the effects of sex, age and race on the relation between body mass index (BMI) and measured percent body fat (%fat).

Design: Cross-sectional validation study of sedentary individuals.

Subjects: The Heritage Family Study cohort of 665 black and white men and women who ranged in age from 17 to 65 y.

Measurements: Body density determined from hydrostatic weighing. Percentage body fat determined with gender and race-specific, two-compartment models. BMI determined from height and weight, and sex and race in dummy coded form.

Results: Polynomial regression showed that the relationship between %fat and BMI was quadratic for both men and women. A natural log transformation of BMI adjusted for the non-linearity. Test for homogeneity of log transformed BMI and gender showed that the male–female slopes were within random variance, but the intercepts differed. For the same BMI, the %fat of females was 10.4% higher than that of males. General linear models analysis of the women's data showed that age, race and race-by-BMI interaction were independently related to %fat. The same analysis applied to the men's data showed that %fat was not just a function of BMI, but also age and age-by-BMI interaction. Multiple regression analyses provided models that defined the bias.

Conclusions: These data and results published in the literature show that BMI and %fat relationship are not independent of age and gender. These data showed a race effect for women, but not men. The failure to adjust for these sources of bias resulted in substantial differences in the proportion of subjects defined as obese by measured %fat.

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The Heritage Family Study is supported by the National Heart, Lung and Blood Institute through the following grants: HL45670 (C Bouchard, PI); HL47323 (AS Leon, PI); HL47317 (DC Rao, PI); HL47327 (JS Skinner, PI); and HL47321 (JH Wilmore, PI). Claude Bouchard is partially supported by the George A Bray Chair in Nutrition. Credit is also given to the University of Minnesota Clinical Research Center, NIH Grant MO1-RR000400. Further, Art Leon is partially supported by the Henry L Taylor Professorship in Exercise Science and Health Enhancement. Thanks are expressed to all of the co-principal investigators, investigators, co-investigators, local project coordinators, research assistants, laboratory technicians, and secretaries who have contributed to this study (see Bouchard et al10). Finally, the Heritage consortium is very thankful to those hard-working families whose participation has made these data possible.

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Jackson, A., Stanforth, P., Gagnon, J. et al. The effect of sex, age and race on estimating percentage body fat from body mass index: The Heritage Family Study. Int J Obes 26, 789–796 (2002).

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  • body composition
  • body mass index
  • overweight
  • obese

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