British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

Is the body adiposity index (hip circumference/height1·5) more strongly related to skinfold thicknesses and risk factor levels than is BMI? The Bogalusa Heart Study

David S. Freedmana1 c1, Heidi M. Blancka1, William H. Dietza1, Pronabesh DasMahapatraa2, Sathanur R. Srinivasana2 and Gerald S. Berensona2

a1 Division of Nutrition and Physical Activity and Obesity, Centers for Disease Control and Prevention, CDC K-26, 4770 Buford Highway, Atlanta, GA 30341-3724, USA

a2 Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA


Because of its strong association (r 0·85) with percentage of body fat determined by dual-energy X-ray absorptiometry, hip circumference divided by height1·5 (the body adiposity index) has recently been proposed as an index of body fatness among adults. We examined whether this proposed index was more strongly associated with skinfold thicknesses and levels of CVD risk factors (lipids, fasting insulin and glucose, and blood pressure) than was BMI among 2369 18- to 49-year-olds in the Bogalusa Heart Study. All analyses indicated that the body adiposity index was less strongly associated with skinfold thicknesses and CVD risk factors than was either waist circumference or BMI. Correlations with the skinfold sum, for example, were r 0·81 (BMI) v. r 0·75 (body adiposity index) among men, and r 0·87 (BMI) v. r 0·80 among women; P< 0·001 for both differences. An overall index of seven CVD risk factors was also more strongly associated with BMI (r 0·58) and waist circumference (r 0·61) than with the body adiposity index (r 0·49). The weaker associations with the body adiposity index were observed in analyses stratified by sex, race, age and year of examination. Multivariable analyses indicated that if either BMI or waist circumference were known, the body adiposity index provided no additional information on skinfold thicknesses or risk factor levels. These findings indicate that the body adiposity index is likely to be an inferior index of adiposity than is either BMI or waist circumference.

(Received August 24 2011)

(Revised January 16 2012)

(Accepted February 09 2012)

(Online publication April 13 2012)

Key Words:

  • Obesity;
  • BMI;
  • Children;
  • Lipids;
  • Skinfolds;
  • Hip circumference;
  • Waist circumference


c1 Corresponding author: D. S. Freedman, fax +1 770 488 6027, email


  Abbreviations: DBP, diastolic blood pressure; HDL-C, HDL-cholesterol; LDL-C, LDL-cholesterol; SBP, systolic blood pressure