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Body mass index (BMI) is one of the most widely used tools to assess weight and health risks, though it has received significant criticism over the years.
The body roundness index (BRI) offers a new model for evaluating obesity and related risks, using waist and hip measurements to determine the roundness of a person's midsection.
Body mass index (BMI) has long been used to assess health risks, but it's increasingly criticized for its limitations. The body roundness index (BRI) is emerging as a promising alternative, offering more accurate insights into health risks by factoring in body shape and fat distribution. Unlike BMI, which only considers weight and height, BRI looks at waist and hip measurements, providing a clearer picture of health.
Curious? Click on to learn more about BRI.
The simplicity of BMI, providing a quick numerical benchmark, is why it's still commonly used. However, more comprehensive measures like body scans offer a fuller picture, but are less accessible.
BMI misclassifies individuals by not accounting for factors like muscle mass or fat distribution. An athlete could fall into the "obese" category, while others with metabolic syndrome might be misclassified.
AMA recommends pairing BMI with additional measurements like waist circumference and visceral fat, which are linked to health risks such as type 2 diabetes and heart disease.
Research indicates that body composition (fat distribution, muscle, and bone) affects health more than total body weight. Fat around the midsection is especially linked to higher risks of heart disease and diabetes.
Visceral fat, found around vital organs, poses a higher health risk compared to subcutaneous fat, which is located under the skin. Measuring visceral fat is critical for assessing true health risks.
BRI was developed using data from the National Health and Nutrition Examination Survey (NHANES), which includes extensive health data from a diverse range of US participants.
BMI assumes a cylindrical body shape, but this doesn't account for natural curves, especially in women. By contrast, BRI uses a more accurate oval shape model to measure health.
BRI calculates the eccentricity of a person's midsection, or how round it is, offering a more individualized approach to understanding health risks compared to BMI.
Studies suggest that BRI is a better predictor of health outcomes like disease risk and mortality. It offers more nuance compared to BMI, which lacks accuracy in predicting individual health conditions.
BMI was created in the early 19th century using data mostly from white men. It gained popularity in the '50s when insurance companies linked weight to claim frequency, later becoming a health risk tool.
BMI doesn't consider racial, ethnic, gender, or age differences, which may affect health. The American Medical Association (AMA) now advocates using BMI alongside other metrics, due to its historical harm.
BMI is deeply embedded in clinical practices, including growth charts, drug dosing, and population studies. Replacing it with a new system like BRI would require significant changes across healthcare.
A study published in JAMA Network Open analyzed data from 33,000 US adults collected by NHANES (1999–2018), grouping participants by BRI to examine health and mortality outcomes.
Over the past decade, international studies have demonstrated BRI's potential to predict certain health risks, though its ability to assess all-cause mortality in the US remained unexamined until recently.
The data showed a U-shaped trend: individuals with the highest BRIs faced increased mortality risk, while those with the lowest scores also had poor outcomes. BRI offered more nuanced and reliable disease risk estimates than BMI.
Despite growing evidence of BRI's potential, experts stress that it is still in early stages of use. Further studies are necessary to fully evaluate its clinical applicability.
BRI scores range from one to 16, with higher scores indicating rounder bodies. Most individuals fall between one and 10, helping gauge health risks based on body shape and fat distribution.
BRI might supplement, but not replace, BMI. While it offers more personalized health insights, it's not yet widely used in clinical practice due to BMI's deep integration in healthcare systems.
BRI accounts for demographic differences, such as race and ethnicity, which is essential for assessing health risks. For example, Asian individuals may carry more visceral fat even at lower BMIs.
The most precise assessment of body composition comes from specialized scans. Magnetic resonance imaging (MRI) is the gold standard, though it remains costly and often challenging to access.
While BRI might supplement BMI, it doesn't require significant new technology. Implementing BRI alongside BMI in clinical practice could offer healthcare professionals a fuller picture of an individual's health.
Healthcare providers may start using BRI alongside BMI to track a patient's health goals, particularly when working to manage conditions like obesity, heart disease, or type 2 diabetes.
A more affordable option, the dual-energy X-ray absorptiometry (DEXA) scan, also provides accurate results.
Measuring body circumference, as with BRI, may exacerbate weight bias if not approached sensitively. Healthcare providers must ensure that measurements are taken in a non-judgmental, supportive manner.
While BMI is a tool for physical health measurement, it can contribute to weight stigma and negatively impact a patient's mental health, especially when used in isolation without considering body composition.
As research on BRI and other metrics grows, it could become key in predicting health risks. However, a shift from BMI will be gradual, with true progress relying on a holistic, individualized approach.
Sources: (Verywell Health) (Medical News Today)
See also: Important health checks by age
Some experts suggest moving away from general indices like BMI and BRI toward personalized health tools. Ideally, patients could be scanned for precise data upon entering a healthcare setting.
Understanding the limitations of BMI in health assessments
This is why BRI may be a better indicator of your health
HEALTH Bri
Body mass index (BMI) has long been used to assess health risks, but it's increasingly criticized for its limitations. The body roundness index (BRI) is emerging as a promising alternative, offering more accurate insights into health risks by factoring in body shape and fat distribution. Unlike BMI, which only considers weight and height, BRI looks at waist and hip measurements, providing a clearer picture of health.
Curious? Click on to learn more about BRI.