Scaling of human body composition to stature: new insights into body mass index

Background: Although Quetelet first reported in 1835 that adult weight scales to the square of stature, limited or no information is available on how anatomical body compartments, including adipose tissue (AT), scale to height. Objective: We examined the critical underlying assumptions of adiposity-body mass index (BMI) relations and extended these analyses to major anatomical compartments: skeletal muscle (SM), bone, residual mass, weight (AT+SM+bone), AT-free mass, and organs (liver, brain). Design: This was a cross-sectional analysis of 2 body-composition databases: one including magnetic resonance imaging and dual-energy X-ray absorptiometry (DXA) estimates of evaluated components in adults (total n = 411; organs = 76) and the other a larger DXA database (n = 1346) that included related estimates of fat, fat-free mass, and bone mineral mass. Results: Weight, primary lean components (SM, residual mass, AT-free mass, and fat-free mass), and liver scaled to height with powers of approximate to 2 (all P < 0.001); bone and bone mineral mass scaled to height with powers > 2 (2.31-2.48), and the fraction of weight as bone mineral mass was significantly (P < 0.001) correlated with height in women. AT scaled weakly to height with powers of approximate to 2, and adiposity was independent of height. Brain mass scaled to height with a power of 0.83 (P = 0.04) in men and non significantly in women; the fraction of weight as brain was inversely related to height in women (P = 0.002). Conclusions: These observations suggest that short and tall subjects with equivalent BMIs have similar but not identical body composition, provide new insights into earlier BMI-related observations and thus establish a foundation for height-normalized indexes, and create an analytic framework for future studies.