Should People Considered ‘Skinny Fat’ Be Screened for Diabetes?

Research suggests body fat percentage may be a better predictor of type 2 diabetes than BMI, the commonly used measurement for health risk.

A new study suggests that healthcare providers who are conducting diabetes screenings according to high body mass index (BMI) alone may be missing a chunk of the normal-weight population that could actually be at a higher risk of the disease.

The research, published in April 2018 in the journal BMJ Open, found that individuals with a normal BMI but a high body fat percentage (a group popularly described as “skinny fat”) were more likely to have prediabetes or type 2 diabetes than people with a BMI that is considered overweight but who have a lower percentage of body fat.

To draw their results, researchers from the University of Florida (UF) used information from a 1999–2006 National Health and Nutrition Survey, the most recent national health data available that includes whole-body DXA measurement. This technology uses a whole-body dual-energy X-ray and is considered the gold standard to calculate body fat.

BMI vs. Body Fat: Which Is a Better Predictor of Type 2 Diabetes?

A common way to measure BMI is by dividing a person’s weight in kilograms by his or her height in meters, and dividing again by height. The formula works for both men and women. The Centers for Disease Control and Prevention (CDC) divides BMI into four categories: underweight, normal, overweight, and obese. According to the National Institutes of Health, a BMI of under 18.5 is underweight, a BMI between 18.5 and 24.9 is normal, a BMI between 25 and 29.9 is overweight, and a BMI of 30 or more is obese.

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