Percent body fat versus body mass index among Ghanaian adults in different districts

Background: The debate regarding use of WHO body mass index (BMI) cut-offs for the assessment of nutritional status continues in the scientific community. That is, BMI may not be a true reflection of body composition. Researchers have investigated BMI and percent body fat (%BF) as risk factors for some chronic diseases. Objectives: The current study sought to evaluate the use of BMI to assess %BF and their relationship with high blood pressure (HBP) among Ghanaian adults. Methods: A total of 512 men and women were enrolled in a cross-sectional study, conducted in urban (Accra Metropolitan District [AMD; 276]) and peri-urban (Upper Manya Krobo District [UMKD; 236]) Ghana. BMI and %BF were determined and proportions of underweight, normal weight, and overweight/obese participants were compared. Relationship between BMI, %BF and HBP was investigated. Results and discussion: Mean BMI was greater for participants in the AMD than UMKD (25.69±4.85 and 24.51±4.89; p=0.007). %BF was also greater for men (p=0.001) and women (p=0.012) in the AMD than UMKD, respectively. Participants in the AMD (underweight-7%, normal weight-48%, overweight-24%, obese-21%) and UMKD (underweight-14%, normal weight-55%, overweight-17%, obese-15%) had different %BF (p=0.009) but not BMI (p=0.090). A significantly higher number of participants in the AMD had HBP (26%) than UMKD (19%) (p=0.038). Overweight/obese participants had significantly higher blood pressure compared to underweight/normal weight participants, in both AMD (by BMI; p=0.002 and by %BF; p<0.0001) and UMKD (by BMI and %BF; p<0.0001). BMI correlated moderately and significantly with %BF in both urban AMD (r=0.578; p<0.0001) and peri-urban UMKD (r=0.693; p<0.0001). Conclusion: BMI seems to be a good indicator for the assessment of adiposity among Ghanaian adults and may be used to assess adiposity in the absence of %BF.