Percentage body fat ranges associated with metabolic syndrome risk: results based on the third National Health and Nutrition Examination Survey (1988–1994)1–3

Background: Increasing attention has focused on the association between body fatness and related metabolic risk factors. The quantitative link between percentage body fat (%BF) and the risk of metabolic syndrome is unknown. Objectives: The objectives were to determine the risk [odds ratios (ORs)] of metabolic syndrome based on %BF in black and white men and women in the United States and to provide corresponding ranges of %BF associated with a risk equivalent to body mass index (BMI; in kg/m2). Design: The subjects were participants in the third National Health and Nutrition Examination Survey and were divided into those with and without the metabolic syndrome. OR equations were derived from logistic regression models for %BF and BMI, with the 25th percentile in the study population as the reference. Ranges were developed by associating %BF with the equivalent risk of metabolic syndrome based on established BMI cutoffs. Results: Four sets (men, women, black, and white) of OR curves were generated for %BF and for BMI by using data from 8259 adults. The ORs for metabolic syndrome were lower in blacks than in whites at any given %BF or BMI. The developed cutoffs for %BF differed between men and women but showed only small race and age effects. A simplified set of sex-specific %BF ranges for the risk of metabolic syndrome were developed. Conclusions: The risk of metabolic syndrome can be established from measured %BF by using either the developed OR curves or %BF thresholds at traditional BMI cutoffs. This information should prove useful in both clinical and research settings. Am J Clin Nutr 2003;78:228–35.