Title of article:

Varying body mass index cutoff points to describe overweight prevalence among U.S. adults: NHANES III ( 1988 to 1994)

Authors: Kuczmarski RJ, Carroll MD, Flegal KM, Troiano RP.
Journal: Obes Res, Nov 1997;5(6):542-8

Abstract

Body mass index (BMI; kg/m2) distributions are commonly reported in the scientific literature to describe weight for stature. These data are collected for various groups of subjects in local health and body composition studies, and comparisons with national distributions are often desirable. Tabular data for population prevalence estimates from the third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1994) at selected gender- and age-specific BMI levels ranging from < 18.0 to > 45.0 are presented and compared with various examples of BMI criteria reported in the scientific literature. NHANES III was a statistically representative national probability sample of the civilian, noninstitutionalized population of the United States in which height and weight were measured as part of a more comprehensive health examination. The implications of varying population prevalence estimates based on varying BMI cutoff points are briefly discussed for selected examples including World Health Organization over-weight/obesity criteria and the U.S. Dietary Guidelines for Americans. The median BMI for U.S. adults aged 20 years and older is 25.5 kg/m2. Median stature and weight for men are 175.5 cm and 80.0 kg and for women are 161.6 cm and 65.6 kg, respectively. The percentage of the population with BMI < 19.0 is 1.6% for men, 5.7% for women; BMI > or = 19.0 to < 25.0 is 39.0% for men, 43.6% for women; BMI > or = 25.0 is 59.4% for men, 50.7% for women. An estimated 97.1 million adults have a BMI > or = 25.0. Additional prevalence estimates based on other BMI cutoff points and ages are presented.

Comments and Key points

This is the publication that banished the old BMI criteria, and established new Body Mass Index criteria, for the definitions of overweight and Obesity at 25 and 30 kg/m2 respectively.

This article mentions the older BMI criteria1,2,3 which were: overweight definition was BMI of >=27.8 for men and >=27.3 for women. They were based on the 85th percentile values of persons age 20 to 29 years.

So, using the new definition of BMI >=25 results in 59.4% of men and 50.7% of women are defined as being overweight. If you used the old definition, only 33.3% of men and 36.4% of women would be defined as overweight. All data in this article came from the NHANES III study4 (1988-1994).

The median height of men was 175.5cm ( 69.1 inches) and the median height of women was 161.6cm (63.6 inches). The median weight of men was 80.0kg ( 176.0 lbs) and the median weight of women was 65.6kg ( 144.3 lbs). Median is the 50th percentile, which is very close to meaning the "average", for Americans. Median is a better statistic to use.

  Men Women
age mean
height
median
height
mean
weight
median
weight
mean
height
median
height
mean
weight
median
weight

20 to 29

175.6 175.8 78.4 75.3 162.7 162.6 64.4 60.5
30 to 59 176.3 176.3 84.3 81.9 162.8 162.8 71.6 68.0
60 + yrs 172.8 172.9 80.2 79.3 158.5 158.5 67.9 65.8
All ages 175.6 175.5 82.1 80.0 161.7 161.6 69.2 65.6

And here is the data for mean and median Body Mass Index (BMI) in kg/m2, of Americans during 1988 to 1994.

  Men Women
age mean
BMI
median
BMI
mean
BMI
median
BMI
20 to 29 25.2 24.4 24.3 22.8
30 to 59 27.1 26.3 27.0 25.5
60 + yrs 26.8 26.4 26.9 26.1
All ages 26.6 25.9 26.5 25.1

 

The rest of this article, discussed several alternative BMI cutoff schemes. The authors are careful to try to point out that there is no consensus on the terminology about overweight or obesity, nor do they specifically suggest that their cutoffs are superior. Nevertheless, despite this humble tone in their article, their criteria ended up cited as the new standard.

 

References

  1. National Center for Health Statistics. Plan and operation of the Third National Health and Nutrition Survey, 1988-1994. Vital Health Statistics, 1994; 1:32.
  2. National Institutes of Health Consensus Development Panel. Health Implications of obesity: National Institutes of Health consensus conference statement. Ann Intern Med. 1985: 103:1073-1077.
  3. US Department of Health and Human Services, PHS. Healthy People 2000: National Health Promotion and Disease Prevention Objectis. DHHS Publication No. PHS-90-50212. Washington, DC: US Government Printing Office, Publich Health Service; 1990;112-134.
  4. NHANES III. National Center for Health Statistics. Health, United States. 1995. Hyattsville, MD, Public Health Service, 1996.

Review & comments by Steven B. Halls, MD, Modified last on 23-June, 2008, Copyright.
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