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Shape Up America! Announces Body Fat Percentage As a Leading Public Health Indicator

Launches New Initiative in Response to Research Findings

Washington, D.C. - (August 28, 2000) - To improve the odds in the fight against the second leading cause of preventable death in this country, Shape Up America! - the anti-obesity initiative launched by former U.S. Surgeon General Dr. C. Everett Koop - today issued an advisory stating that one's body fat percentage is superior to the currently accepted body mass index (BMI), as a measure of healthy weight.

In conjunction with a new study published in the September issue of The American Journal of Clinical Nutrition, Shape Up America! issued this advisory to inform physicians and the public that body fat percentage is as significant an indicator of health status as blood pressure and blood cholesterol levels. In fact, body fat percentage is a more direct assessment of healthy weight because it is able to distinguish fat from muscle.

"The new data on body fat percentage are compelling and should be a national call to action," said Dr. Koop. "This important finding impacts more than 90 million Americans considered overweight or obese according to current government BMI-based guidelines."

The decision by Shape Up America! to recommend body fat percentage as the measure of healthy weight is based on the findings of a major research study connecting body fat percentage to BMI and, in turn, relating body fat percentage to health risk. Dr. Steven Heymsfield and his colleagues at the Obesity Research Center at St. Luke's-Roosevelt Hospital Center in New York City, as well as major clinical centers in the United Kingdom and Japan, conducted this groundbreaking research. The findings are based on a study of 1,626 adults of diverse ethnicity and move us closer to the universal use of body fat percentage as a more targeted assessment of disease risk.

"Many studies have related BMI to disease risk. What we did was correlate body fat percentage to BMI, allowing us to take the first big step toward linking body fat percentage directly to disease risk," said Dr. Heymsfield. "This new research reveals the value of assessing body fat more directly using the latest scientific technology to measure body fat percentage."

A significant body of research has been conducted over the past several decades to demonstrate how increased BMI is associated with an increased risk for several leading causes of death in the United States: heart disease, stroke, type 2 diabetes and certain cancers. But while commonly accepted standards use BMI - a mathematical formula based on an individual's height and weight - to identify healthy and unhealthy weight, BMI cannot distinguish fat from muscle.

The use of BMI alone leads to two common forms of misclassification: The first is the judgment of highly muscular individuals with a high BMI as being "overfat" when they are not. The disease risk faced by these individuals is significantly lower than BMI would indicate. At the same time, using BMI can fail to identify people at increased risk who are in the "healthy" BMI zone of 18.5-24.9 but have an elevated body fat content. If these individuals relied solely on their BMI, they would be unaware they face an increased disease risk. Regular monitoring of body fat percentage will reduce both forms of misclassification.

"Measuring body fat percentage solves the problem of misclassification and is a more direct assessment of health and fitness than the use of BMI," said Dr. Barbara J. Moore, president of Shape Up America! "Monitoring body fat percentage is no longer just a research technique. It can now be conveniently done in the home or in a health club and is an improvement over the use of BMI to assess disease risk."

For people who want to take action, Shape Up America! has added a "Body Fat Lab" to its web site - www.shapeup.org - which is designed to identify the healthy range of body fat percentage and the disease risk associated with higher levels of body fat percentage. The Body Fat Lab is an interactive tool that will be of greatest use to those who already know their body fat percentage. For those who don't, Shape Up America! will continue to offer the proxy of BMI as an indicator of disease risk.

The Heymsfield study is significant because it is the first to convert BMI into body fat percentage in adults. Specifically, the study links the upper and lower limits of the healthy BMI zone with the corresponding range for body fat percentage. BMI guidelines established by the National Institutes of Health and the World Health Organization defined the disease risk associated with BMI, but this study permits a more targeted assessment of disease risk based on body fat percentage.

According to the new research findings, the following defines the healthy range of body fat percentage for adult men and women:

Adult Females

 Age Increased Risk (BMI less than 18.5) Healthy (BMI 18.5-24.9)  Increased Risk (BMI 25.0-29.9) Greatly Increased Risk (BMI 30.0 +)
20-39 Less than 21% 21% to 32% 33% to 38% 39% +
40-59 Less than 23% 23% to 33% 34% to 39% 40% +
60-79 Less than 24% 24% to 35% 36% to 41% 42% +

Adult Males

Age Increased Risk (BMI less than 18.5) Healthy (BMI 18.5-24.9) Increased Risk (BMI 25.0-29.9) Greatly Increased Risk (BMI 30.0 +)
20-39 Less than 8% 8% to 19% 20% to 24% 25% +
40-59 Less than 11% 11% to 21% 22% to 27% 28% +
60-79 Less than 13% 13% to 24% 25% to 29% 30% +

Adapted by Shape Up America! from Gallagher et al. Am J Clin Nutr, Vol. 72, Sept., 2000

"The measurement of body fat content will become the new standard for assessing disease risk in adults. As such, it is of vital public health significance," said Dr. Koop. "It may also serve to replace the American obsession with body weight with a more appropriate measure of good health."

Shape Up America! is the national non-profit educational campaign founded by former Surgeon General Dr. C. Everett Koop in 1994 to elevate healthy weight and physical activity as priority concerns. A nationwide network of more than 50 organizations representing the leading associations in the fields of medicine, public health, nutrition and physical activity, provide support for this initiative. Recognizing the growing power of the Internet as a source for health information, Shape Up America! launched an award-winning Web site - www.shapeup.org - to provide the public, health professionals, policy makers and the media with the latest facts on nutrition and physical activity as they relate to responsible weight management.

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