Correlation and discrepancies between obesity by body mass index and body fat in patients with coronary heart disease

De Schutter, Alban, Lavie, Carl J., Arce, Karla, Menendez, Sylvia Gra and Milani, Richard V. (2013) Correlation and discrepancies between obesity by body mass index and body fat in patients with coronary heart disease. Journal of Cardiopulmonary Rehabilitation and Prevention, 33 2: 77-83. doi:10.1097/HCR.0b013e31828254fc

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Author De Schutter, Alban
Lavie, Carl J.
Arce, Karla
Menendez, Sylvia Gra
Milani, Richard V.
Title Correlation and discrepancies between obesity by body mass index and body fat in patients with coronary heart disease
Journal name Journal of Cardiopulmonary Rehabilitation and Prevention   Check publisher's open access policy
ISSN 1932-7501
Publication date 2013-03
Year available 2013
Sub-type Article (original research)
DOI 10.1097/HCR.0b013e31828254fc
Open Access Status
Volume 33
Issue 2
Start page 77
End page 83
Total pages 7
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Collection year 2014
Language eng
Formatted abstract
BACKGROUND: Despite its many shortcomings, body mass index (BMI) is the most widely used screening tool for obesity, in part, because of its practicality. Other more physiologic measurements of obesity are based on body fat (BF). However, the correlation between BMI and BF has not been well-characterized, especially in patients with coronary heart disease (CHD).
METHODS: We retrospectively studied 581 patients with CHD following major CHD events, who were divided according to BMI (calculated as weight divided by height squared), based on the World Health Organization standard cutoff points (underweight [<18.5 kg/m], normal [≥18.5 and <25 kg/m], overweight [≥25 and <30 kg/m], and obese [≥30 kg/m]). Second, the population was divided according to BF, on the basis of the age- and gender-adjusted Gallagher BF classification into underweight, normal, overweight, and obese categories.
RESULTS: Body mass index and percent BF correlated significantly (r = 0.60; P < .0001) and classified patients in the same category in about 59% of patients. In approximately 27% of the sample, BMI underestimated BF, while in about 14% of cases BMI overestimated BF. The relationship between BMI and BF was influenced by age, gender, and BMI itself.
CONCLUSIONS: Even though a correlation exists between BMI and BF, they frequently classify individuals differently in a population of CHD patients. When defining overweight/obesity, care must be taken when using a crude screening tool such as BMI. While it is not expected for all clinicians to add BF assessments within routine patient assessments, the results of this study may be helpful to guide clinicians and researchers who are considering different aspects of body composition.
Keyword Body fat
Body mass index (BMI)
Coronary heart disease
Obesity paradox
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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Created: Sun, 31 Mar 2013, 00:18:41 EST by System User on behalf of School of Medicine