How does Body Roundness Index correlate with mortality risk ?

Summary of the article

1. Title of the article:
Body Roundness Index and All-Cause Mortality Among US Adults

2. First two Authors followed by et al:
Xiaoqian Zhang, MD; Ning Ma, MD; et al.

3. One line summary of the article:
The study highlights a U-shaped association between Body Roundness Index (BRI) and all-cause mortality among US adults, showing both low and high BRI values increase mortality risk.

4. Six key points from the article:

1. Increasing BRI Trend: Between 1999 and 2018, the mean BRI increased from 4.80 to 5.62 with a biennial change of 0.95%.
2. U-Shaped Mortality Risk: Both low BRI (<3.4) and high BRI (>6.9) were associated with significantly higher mortality risk compared to a middle BRI range (4.5–5.5).
3. Higher Risk for High BRI: Individuals with BRI ≥6.9 had a 49% increased mortality risk (HR 1.49; 95% CI, 1.31–1.70).
4. Demographic Variations: BRI trends were more pronounced among women, elderly individuals, and Mexican Americans.
5. Visceral Fat Representation: BRI was superior to BMI in reflecting visceral adiposity, which is more associated with mortality.
6. Practical Utility: BRI shows potential as a non-invasive and comprehensive screening tool for mortality risk prediction in clinical and public health settings.

5. Practical take-home message:
The Body Roundness Index (BRI) is an effective tool to assess visceral obesity and mortality risk. Clinicians should consider BRI alongside traditional measures like BMI for a more accurate evaluation of obesity-related risks.

6. Citation for the article in Vancouver format:
Zhang X, Ma N, Lin Q, Chen K, Zheng F, Wu J, et al. Body Roundness Index and All-Cause Mortality Among US Adults. JAMA Netw Open. 2024;7(6):e2415051. doi:10.1001/jamanetworkopen.2024.15051

Body Roundness Index (BRI): An Overview

• The Body Roundness Index (BRI) is a geometric tool introduced in 2013 to quantify body shape and estimate total and visceral body fat. It is considered a potential improvement over traditional metrics like Body Mass Index (BMI).

BRI Calculation

• BRI is calculated using the following formula:
  

Required Measurements:

i. Waist circumference
ii. Height

• Both measurements must be in the same unit (e.g., centimeters).

BRI Interpretation

• BRI scores typically range from 1 to 16, with most individuals falling between 1 and 10. The values can be interpreted as follows:
  • Less than 3: Indicates midsection leanness.
  • Around 5: Medium index, considered normal.
  • 6.9 and above: Suggests wider, rounder bodies and is associated with increased health risks.

Health Risks:

• Research indicates that individuals with a BRI of 6.9 or higher face an increased risk of all-cause mortality by up to 49% compared to those with a medium BRI of 5.

Advantages of BRI

• Provides a more accurate estimation of body fat and visceral adipose tissue compared to BMI.
• Combines waist circumference and height to better represent body shape.
• Useful for identifying obesity-related health risks.

Limitations of BRI

• Relatively new metric with less research compared to BMI.
• May favor more slender body types, potentially underestimating fat in some individuals.
• Should not be used as a standalone health assessment tool.

Conclusion

• The Body Roundness Index offers an advanced way to evaluate body shape and associated health risks. While it has advantages over BMI, BRI should be interpreted alongside other health metrics and medical evaluations for a more comprehensive understanding of an individual’s health status.

Mini-Application

• Use this mini-application to calculate BRI and it's interpretation : Body Roundness Index Calculator