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      BMI-BFMNU: a structural index linked to fat mass Translated title: IMC-BFMNU: un índice estructural relacionado a la masa grasa

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          Abstract

          Abstract Introduction: Body mass index (BMI) provides little information on body composition. For example, two people with the same BMI might have different body compositions. In this sense, the development of a new BMI able to provide body composition information is of clinical and scientific interest. The aim of the study was to suggest a new modified BMI formula. Material and Methods: A total of 108 subject, females 56 and males 52, 0-73 years old, in various physiopathological conditions were evaluated. Data were collected and processed by a program that through anthropometric measurements calculates classic BMI, volume, surface, V/S (that we can defined like a body-thickness “pseudospessore”) and the new BMI-BFMNU. Results: The basic formula (BMI = Body Mass [kg] / Height [m2]) uses the height squared as the value of the body surface, although this is only an approximation of the real surface, whereas using the real surface instead, the new BMI reflects better the ratio between the body volume and its surface. The ratio called “pseudospessore” is already used in literature from the BFMNU (Italian acronym refereed to Biologia e Fisiologia Modellistica della Nutrizione Umana) method and has been shown to be related to the amount of fat. Conclusions: Using the BMI-BFMNU, it is possible to obtain an indication of the body structure related to the amount of fat. The consequence is that the obtained numerical values do not coincide with the traditional BMI's values and will refer to different normal ranges. For instance, a person may be in the range of normal weight for both BMI measurements, but only the BMI-BFMNU detects whether a person has a higher or lower fat content considering the individual's category. This study opens up to new possible future developments on the application of the new BMI that will allow a more accurate assessment and classification of patients.

          Translated abstract

          Resumen Introducción: El índice de masa corporal (IMC) proporciona poca información sobre la composición corporal. Por ejemplo, dos personas con el mismo IMC pueden presentar composiciones corporales muy diferentes. Por tanto, sería de gran interés clínico y científico encontrar un nuevo IMC que proporcione información adicional sobre la composición corporal. El objetivo del estudio fue encontrar una nueva fórmula de IMC. Material y Métodos: Un total de 108 sujetos, 56 mujeres y 52 hombres, de entre 0-73 años, con diversas condiciones fisiopatológicas fueron evaluados. Los datos fueron recolectados y procesados por un programa que a través de medidas antropométricas calculó el IMC clásico, volumen, superficie, V/S (que puede ser definido como pseudoespesor corporal “pseudospessore”) y el nuevo IMC-BFMNU. Resultados: La fórmula básica (IMC = Masa corporal [kg] / Altura [m2]) usa la altura al cuadrado como el valor de la superficie corporal, aunque esto es sólo una aproximación de la superficie real, mientras que, al usar la superficie real, el nuevo IMC refleja mejor la relación entre el volumen corporal y su superficie. La proporción denominada “pseudoespesor” ya se utiliza en la literatura dentro del método BFMNU (acrónimo italiano referido a Biologia e Fisiologia Modellistica della Nutrizione Umana) y que se ha demostrado que está relacionada con la cantidad de grasa. Conclusiones: Utilizando el IMC-BFMNU, es posible obtener una indicación de la estructura corporal relacionada con la cantidad de grasa. La consecuencia es que los valores numéricos obtenidos no coinciden con los valores del IMC tradicional y se refieren a diferentes rangos de normalidad. Por ejemplo, una persona puede estar en el rango de peso normal para ambas mediciones de IMC, pero sólo el IMC-BFMNU puede detectar si una persona tiene un mayor o menor contenido de grasa considerando la categoría del individuo. Este estudio se abre a nuevos posibles desarrollos futuros sobre la aplicación del nuevo IMC que permitirá una valoración y clasificación más precisa de los pacientes.

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          Most cited references26

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          Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.

          To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient's age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.
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            Beyond body mass index.

            Body mass index (BMI) is the cornerstone of the current classification system for obesity and its advantages are widely exploited across disciplines ranging from international surveillance to individual patient assessment. However, like all anthropometric measurements, it is only a surrogate measure of body fatness. Obesity is defined as an excess accumulation of body fat, and it is the amount of this excess fat that correlates with ill-health. We propose therefore that much greater attention should be paid to the development of databases and standards based on the direct measurement of body fat in populations, rather than on surrogate measures. In support of this argument we illustrate a wide range of conditions in which surrogate anthropometric measures (especially BMI) provide misleading information about body fat content. These include: infancy and childhood; ageing; racial differences; athletes; military and civil forces personnel; weight loss with and without exercise; physical training; and special clinical circumstances. We argue that BMI continues to serve well for many purposes, but that the time is now right to initiate a gradual evolution beyond BMI towards standards based on actual measurements of body fat mass.
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              BMI-related errors in the measurement of obesity.

              K Rothman (2008)
              Body mass index (BMI) has various deficiencies as a measure of obesity, especially when the BMI measure is based on self-reported height and weight. BMI is an indirect measure of body fat compared with more direct approaches such as bioelectrical impedance. Moreover, BMI does not necessarily reflect the changes that occur with age. The proportion of body fat increases with age, whereas muscle mass decreases, but corresponding changes in height, weight and BMI may not reflect changes in body fat and muscle mass. Both the sensitivity and specificity of BMI have been shown to be poor. Additionally, the relation between BMI and percentage of body fat is not linear and differs for men and women. The consequences of the errors in the measurement of obesity with BMI depend on whether they are differential or nondifferential. Differential misclassification, a potentially greater problem in case-control and cross-sectional studies than in prospective cohort studies, can produce a bias toward or away from the null. Nondifferential misclassification produces a bias toward the null for a dichotomous exposure; for measures of exposure that are not dichotomous, the bias may be away from the null. In short, the use of BMI as a measure of obesity can introduce misclassification problems that may result in important bias in estimating the effects related to obesity.
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                Author and article information

                Journal
                renhyd
                Revista Española de Nutrición Humana y Dietética
                Rev Esp Nutr Hum Diet
                Academia Española de Nutrición y Dietética (Pamplona, Navarra, Spain )
                2173-1292
                2174-5145
                March 2021
                : 25
                : 1
                : 104-110
                Affiliations
                [3] Milano orgnameUniversità degli Studi di Milano orgdiv1Dipartimento di Bioscienze, Facoltà di Scienze e Tecnologie Italy
                [2] Valencia orgnameUniversidad de Valencia-Instituto de Investigaciones Sanitarias La Fe orgdiv1Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica España
                [1] Paterna orgnameUniversidad de Valencia orgdiv1Instituto de Ciencia de Materiales orgdiv2Food & Health Lab España
                Article
                S2174-51452021000100104 S2174-5145(21)02500100104
                10.14306/renhyd.25.1.1161
                4b84cf4f-f353-4fd8-a441-3cdb9e493a7a

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 07 December 2020
                : 03 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 7
                Product

                SciELO Spain

                Categories
                Investigations

                Body Weights and Measures,Antropometría,Pesos y Medidas Corporales,Índice de Masa Corporal,Tejido Adiposo,Obesidad,Anthropometry,Body Mass Index,Adipose Tissue,Obesity

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