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To the Editor: In their study of body weight and mortality, Dr Flegal and colleagues¹ demonstrated that, relative to a BMI between 18.5 and less than 25, a low BMI (<18.5) was associated with higher mortality rates, a moderately increased BMI (25 to <30) with lower mortality rates, and a high BMI (30) with higher mortality rates. However, the conclusion that being underweight increases mortality while being overweight (but not obese) decreases mortality does not take into account critical problems with the use of BMI as a measure of body habitus. A moderately increased BMI does not distinguish between muscularity and increased total body fat or its distribution. Among adults with a BMI in the range of 25 to 34.9, public health guidelines specifically indicate that waist circumference must also be taken into account to assess health risks, since BMI in this range is an inadequate biomarker of body . . . [Full Text of this Article]

Howard D. Strickler, MD, MPH
strickle@aecom.yu.edu

Charles Hall, PhD; Judy Wylie-Rosett, EdD; Thomas Rohan, MD, PhD
Department of Epidemiology & Population Health
Albert Einstein College of Medicine
Bronx, NY

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