Is body mass index still a good tool for obesity evaluation?

Waist-height ratio and waist are the best estimators of visceral fat in type 1 diabetes

“…A plausible explanation for why WC and WHtR can estimate the percentage of body lean mass is the negative association between BLM% and VFM%. Although a recent publication showed that the fat-free mass was not associated with CVD 7 , it does not exclude the relevance of our findings, since one has to take into consideration that the fat-free mass measured by bioimpedance includes not only the muscle mass and, in our study, we measured the body lean mass by DXA, which has better accuracy than the bioimpedance 5 . From a clinical perspective, we found a simple and accessible tool to estimate the body lean mass in individuals with type 1 diabetes, independently of albuminuria.…”

“…Although the level of misclassification by BMI in our study is lower than in a previous study 31 , it might be explained by the different methods used to assess the body composition. In the previous study, they used bioimpedance while we used DXA, which provides better accuracy 5 . However, such as misclassification is clinically relevant, since individuals considered to have normal body weight by BMI might, in fact, have an excess of body fat and visceral fat, which are both closely associated with cardiovascular mortality 8 , 13 , 32 , 33 .…”

“…BMI is the most commonly used tool to classify obesity, although it is an inadequate biomarker of abdominal obesity 4 . It does not differentiate muscle from fat nor give the precise information regarding the amount of body fat mass, which better defines obesity 5 and which is positively associated with cardiovascular disease (CVD) 6 , 7 . Furthermore, BMI neither distinguishes women from men concerning their body fat nor provides any information about the fat distribution, which is relevant for the risk of CVD 8 .…”

“…The Dual-energy X-ray Absorptiometry (DXA) is a well-recognized method to study fat distribution and body composition 5 . Unfortunately, the high cost hinders its use in routine clinical practice.…”

Overweight and Aging Increase the Risk of Atrial Fibrillation After Cardiac Surgery Independently of Left Atrial Size and Left Ventricular Ejection Fraction

“…However, almost all studies reporting such association have used the Body Mass Index (BMI, Kg/m 2 ) to evaluate weight excess [6]. Indeed, BMI is still considered the most practical parameter taken to represent the role played by overweight [7], while other recognized risk factors for POAF are advanced age [8,9], left atrial dimension [10,11] and left ventricular systolic dysfunction [12,13].…”