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Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y

Abstract

Objective: To determine reference values for fat-free mass index (FFMI) and fat mass index (FMI) in a large Caucasian group of apparently healthy subjects, as a function of age and gender and to develop percentile distribution for these two parameters.

Design: Cross-sectional study in which bioelectrical impedance analysis (50 kHz) was measured (using tetrapolar electrodes and cross-validated formulae by dual-energy X-ray absorptiometry in order to calculate FFMI (fat-free mass/height squared) and FMI (fat mass/height squared).

Subjects: A total of 5635 apparently healthy adults from a mixed non-randomly selected Caucasian population in Switzerland (2986 men and 2649 women), varying in age from 24 to 98 y.

Results: The median FFMI (18–34 y) were 18.9 kg/m2 in young males and 15.4 kg/m2 in young females. No difference with age in males and a modest increase in females were observed. The median FMI was 4.0 kg/m2 in males and 5.5 kg/m2 in females. From young to elderly age categories, FMI progressively rose by an average of 55% in males and 62% in females, compared to an increase in body mass index (BMI) of 9 and 19% respectively.

Conclusions: Reference intervals for FFMI and FMI could be of practical value for the clinical evaluation of a deficit in fat-free mass with or without excess fat mass (sarcopenic obesity) for a given age category, complementing the classical concept of body mass index (BMI) in a more qualitative manner. In contrast to BMI, similar reference ranges seems to be utilizable for FFMI with advancing age, in particular in men.

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References

  1. Kolata G . Obesity declared a disease Science 1985 227: 1019–1020.

    Article  CAS  Google Scholar 

  2. James WPT, Ralph A . New understanding in obesity research Proc Nutr Soc 1999 58: 385–393.

    Article  CAS  Google Scholar 

  3. Garn SM, Leonard WR, Hawthorne VM . Three limitations of the body mass index Am J Clin Nutr 1986 44: 996–997.

    Article  CAS  Google Scholar 

  4. McLaren DS . Three limitations of the body mass index. (Letter.) Am J Clin Nutr 1987 46: 121.

    Article  CAS  Google Scholar 

  5. Micozzi MS, Albanes D . Three limitations of the body mass index. (Letter.) Am J Clin Nutr 1987 46: 376–377.

    Article  CAS  Google Scholar 

  6. Garrow JS . Three limitations of the body mass index. (letter.) Am J Clin Nutr 1988 47: 553.

    Article  CAS  Google Scholar 

  7. Seidell JC, Verschuren WM, van Leer EM, Kromhout D . Overweight, underweight, and mortality. A prospective study of 48,287 men and women Arch Intern Med 1996 156: 958–963.

    Article  CAS  Google Scholar 

  8. Kuczmarski RJ, Carroll MD, Flegal KM, Troiano RP . Varying body mass index cutoff points to describe overweight prevalence among U.S. adults: NHANES III (1988–1994) Obes Res 1997 5: 542–548.

    Article  CAS  Google Scholar 

  9. Seidell JC, Flegal KM . Assessing obesity: classification and epidemiology Br Med Bull 1997 53: 238–252.

    Article  CAS  Google Scholar 

  10. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994 Int J Obes Relat Metab Disord 1998 22: 39–47.

    Article  CAS  Google Scholar 

  11. Seidell JC, Visscher TL, Hoogeveen RT . Overweight and obesity in the mortality rate data: current evidence and research issues Med Sci Sports Exerc 1999 31 (Suppl): S597–S601.

    Article  CAS  Google Scholar 

  12. Ferraro KF, Both TL . Age, body mass index, and functional illness J Gerontol B Psychol Sci Soc 1999 54: S339–S348.

    Article  CAS  Google Scholar 

  13. Kuczmarski RJ, Flegal KM . Criteria for definition of overweight in transition: background and recommendations for the United States Am J Clin Nutr 2000 72: 1074–1081.

    Article  CAS  Google Scholar 

  14. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey Br Med J 2000 320: 1240–1243.

    Article  CAS  Google Scholar 

  15. Visscher TL, Seidell JC, Menotti A, Blackburn H, Nissinen A, Feskens EJ, Kromhout D . Underweight and overweight in relation to mortality among men aged 40–59 and 50–69 y: the Seven Countries Study Am J Epidemiol 2000 151: 660–666.

    Article  CAS  Google Scholar 

  16. Flegal KM, Troiano RP . Changes in the distribution of body mass index of adults and children in the US population Int J Obes Relat Metab Disord 2000 24: 807–818.

    Article  CAS  Google Scholar 

  17. Fine JT, Colditz GA, Coakley EH, Moseley G, Manson JE, Willett WC, Kawachi I . A prospective study of weight change and health-related quality of life in women JAMA 1999 282: 2136–2142.

    Article  CAS  Google Scholar 

  18. Deurenberg P . Universal cut-off BMI points for obesity are not appropriate Br J Nutr 2001 85: 135–136.

    Article  CAS  Google Scholar 

  19. Ferro-Luzzi A, Sette S, Franklin M, James WP . A simplified approach of assessing adult chronic energy deficiency Eur J Clin Nutr 1991 46: 173–186.

    Google Scholar 

  20. Heber D, Ingles S, Ashley JM, Maxwell MH, Lyons RF, Elashoff RM . Clinical detection of sarcopenic obesity by bioelectrical impedance analysis Am J Clin Nutr 1996 64: 472S–477S.

    Article  CAS  Google Scholar 

  21. Van Itallie TB, Yang M-U, Heymsfield SB, Funk RC, Boileau R . Height-normalized indices of the body's fat-free mass and fat mass: potentially useful indicators of nutritional status Am J Clin Nutr 1990 52: 953–459.

    Article  CAS  Google Scholar 

  22. Deurenberg P, Schutz Y . Body composition: overview of methods and future directions of research Ann Nutr Metab 1995 39: 325–333.

    Article  CAS  Google Scholar 

  23. Deurenberg P, Weststrate JA, van der Kooy K . Body composition changes assessed by bioelectrical impedance measurements Am J Clin Nutr 1989 49: 401.

    Article  CAS  Google Scholar 

  24. Gray DS . Changes in biolectrical impedance during fasting Am J Clin Nutr 1988 48: 1184–1187.

    Article  CAS  Google Scholar 

  25. Kushner RF, Schoeller DA . Estimation of total body water by biolectrical impedance analysis Am J Clin Nutr 1986 44: 417–424.

    Article  CAS  Google Scholar 

  26. Lukaski HC . Assessment of fat-free mass using bioelectrical impedance measurements of the human body Am J Clin Nutr 1985 41: 810–817.

    Article  CAS  Google Scholar 

  27. Jackson AS, Pollock ML, Graces JE, Mahar MT . Reliability and validity of bioelectrical impedance in determining body composition J Appl Physiol 1988 64: 529–534.

    Article  CAS  Google Scholar 

  28. Segal KR . Use of bioelectrical impedance analysis measurements as an evaluation for participating in sports Am J Clin Nutr 1996 64: 469S–471S.

    Article  CAS  Google Scholar 

  29. Lukaski HC . Validation of tetrapolar bioelectrical impedance measurements to assess human body composition J Appl Physiol 1986 60: 1327–1332.

    Article  CAS  Google Scholar 

  30. Houtkooper LB, Lohman TG, Going SB, Howell WH . Why bioelectrical impedance analysis should be used for estimating adiposity Am J Clin Nutr 1996 64: 436S–448S.

    Article  CAS  Google Scholar 

  31. Earthman CP, Matthie JR, Reid PM, Harper IT, Ravussin E, Howell WH . A comparison of bioimpedance methods for detection of body cell mass change in HIV infection J Appl Physiol 2000 88: 944–956.

    Article  CAS  Google Scholar 

  32. Kyle UG, Genton L, Karsegard L, Slosman DO, Pichard C . Single prediction equation for bioelectrical impedance analysis in adults aged 20–94 y Nutrition 2001 17: 248–253.

    Article  CAS  Google Scholar 

  33. Micozzi MS, Albanes D, Jones DY, Chumlea WC . Correlations of body mass indices with weight, stature, and body composition in men and women in NHANES I and II Am J Clin Nutr 1986 44: 725–731.

    Article  CAS  Google Scholar 

  34. Frisancho AR . New standards of weight and body composition by frame size and height for assessment of nutritional status of adults and the elderly Am J Clin Nutr 1984 40: 808–819.

    Article  CAS  Google Scholar 

  35. MacDonald SM, Reeder BA, Chen Y, Despres JP . Obesity in Canada: a descriptive analysis. Canadian Heart Health surveys Research Group Can Med Assoc J 1997 157: S3–S9.

    Google Scholar 

  36. Bartlett HL, Puhl SM, Hodgson JL, Buskirk ER . Fat-free mass in relation to stature: ratios of fat-free mass to height in children, adults, and elderly subjects Am J Clin Nutr 1991 53: 1112–1116.

    Article  Google Scholar 

  37. Baarends EM, Schols AMWS, van Marten Lichtenbelt WD, Wouters EFM . Analysis of body water compartments in relation to tissue depletion in clinically stable patients with chronic obstructive pulmonary disease Am J Clin Nutr 1997 65: 88–94.

    Article  CAS  Google Scholar 

  38. Forbes GB . Exercise and lean weight: the influence of body weight Nutr Rev 1992 50: 157–161.

    Article  CAS  Google Scholar 

  39. Heymsfield SB, Gallagher D, Poehlman ET et al. Menopausal changes in body composition and energy expenditure Exp Gerontol 1994 29: 377–389.

    Article  CAS  Google Scholar 

  40. Guo SS, Zeller C, Chumlea WC, Siervogel RM . Aging, body composition, and lifestyle: the Fels Longitudinal Study Am J Clin Nutr 1999 70: 405–411.

    Article  CAS  Google Scholar 

  41. Beer-Borst S, Morabia A, Hercberg S, Vitek O, Bernstein MS, Glalan P, Galasso R, Giampaoli S, Houterman S, McCrum E, Panico S, Pannozzo F, Preziosi P, Ribas L, Serra-Majem, Verschuren WMM, Yarnell J, Northridge ME . Obesity and other health determinants across Europe: the EURALIM Project J Epidemiol Commun Health 2000 54: 424–430.

    Article  CAS  Google Scholar 

  42. Friedl KE, Moore RJ, Martinez-Lopez LE et al. Lower limit of body fat in healthy active men J Appl Physiol 1994 77: 933–940.

    Article  CAS  Google Scholar 

  43. Baumgartner RN, Koehler KM, Gallagher D et al. Epidemiology of sarcopenia among the elderly in New Mexico Am J Epidemiol 1998 147: 755–763.

    Article  CAS  Google Scholar 

  44. Deurenberg-Yap M, Schmidt G, van Staveren WA, Deurenberg P . The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore Int J Obes Relat Metab Disord 2000 24: 1011–1017.

    Article  CAS  Google Scholar 

  45. Pichard C, Kyle UG, Bracco D, Slosman DO, Morabia A, Schutz Y . Reference values of fat-free and fat masses by bioelectrical impedance analysis in 3393 healthy subjects Nutrition 2000 16: 245–254.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the Foundation Nutrition 2000 Plus for its financial support. We are indebted to the dietitians at the Geneva University Hospital for their help.

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Correspondence to Y Schutz.

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Schutz, Y., Kyle, U. & Pichard, C. Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y. Int J Obes 26, 953–960 (2002). https://doi.org/10.1038/sj.ijo.0802037

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