Publications

Discordance Between Body Mass Index (BMI) and a Novel Body Composition Change Index (BCCI) as Outcome Measures in Weight Change Interventions

Stephen D. Nugent, Gilbert R. Kaats &Harry G. Preuss

Journal of the American College of Nutrition Published online

February 9, 2018

Abstract

Objective: A general assumption is that the body mass index (BMI) reflects changes in fat mass (FM). However, it fails to distinguish the type of weight that is lost or gained—fat mass (FM) or fat-free mass (FFM). The BMI treats both changes the same although they have opposite health consequences. The objective of this study was to propose a more precise measure, a body composition change index (BCCI), which distinguishes between changes in FM and FFM, and this study compares it with using the BMI as an outcome measure.

Methods: Data were obtained from 3,870 subjects who had completed dual-energy x-ray absorptiometry (DEXA) total body scans at baseline and end-of-study when participating in a variety of weight-loss interventions. Since height remained constant in this adult cohort, changes in the BMI corresponded with scale weight changes (r = 0.994), allowing BMI changes to be converted to “lbs.” to match the statistic used for calculation of the BCCI. The BCCI is calculated by scoring increases in FFM (lbs.) and decreases in FM (lbs.) as positive outcomes and scoring decreases in FFM and increases in FM as negative outcomes. The BCCI is the net sum of these calculations. Differences between scale weight changes and BCCI values were subsequently compared to obtain “discordance scores.”

Results: Discordance scores ranged from 0.0 lbs. to >30.0 lbs. with a mean absolute value of between the two measures of 7.79 lbs. (99% confidence interval: 7.49-8.10, p <0.00001), SD = 7.4 lbs. Similar discordance scores were also found in subgroups of self-reported gender, ethnicity, and age.

Conclusions: A significant difference of 7.79 lbs. was found between the BCCI and the BMI to evaluate the efficacy of weight loss interventions. If assessing changes in body composition is a treatment goal, use of the BMI could result in significantly erroneous conclusions.

Using Changes in Body Composition Instead of Scale Weight as an Outcome Measure for Weight Loss Interventions

Nugent, S. D.

ProQuest

May 2015

There is compelling evidence that excess weight accelerates the risk factors for most major degenerative diseases and is associated with more than 30 other health concerns. Nearly 74% of all adult Americans are currently overweight or obese, a number that continues to grow steadily, despite enormous resource expenditures to reverse this trend. However, data also suggests that these increased health risks are more a function of excess body fat than excess body weight. In fact, weight loss can be counterproductive when it results in depletion of fat-free mass. A more appropriate outcome measure for weight control interventions could be to assess the extent to which an intervention reduces excess body fat without a concomitant depletion of FFM. This retrospective secondary data analysis examined the extent to which different conclusions were drawn from weight loss interventions using changes in body composition instead of changes in scale weight or body mass index. Results indicated significant differences when using changes in scale weight or BCI as outcome measures. The analyses suggest that the measures were affected by the gender, age, or ethnicity of participants. Any organization involved with weight management could benefit from more accurate methods for designing and assessing weight loss interventions.

Using a Body Composition Improvement Index (BCI) to Improve the Assessment of Nutritional Interventions

Kaats GR, Nugent S, Stohs SJ, Preuss HG

The Journal of Current Nutrition and Food Science

2015

Using either scale weight or the BMI fails to distinguish losses or gains of fat-mass (FM) from losses or gains of metabolically active fat-free mass (FFM) that is comprised of muscle tissue and bone minerals. Instead of using the BMI, the Body Composition Improvement (BCI) index, expressed in lbs., is the net result of scoring depletion of FM and increases of FFM as positive outcomes, while gains of FM and losses of FFM are negative outcomes. A recent study compared the difference between using the BCI index versus scale weight changes (which correlated 0.997 with the BMI) in 3,987 subjects 17- 87 years of age of varied ethnicity and geographic locations. All subjects completed baseline and ending measurements of scale weight and DEXA Total Body scans of FM and FFM *

Using either scale weight or the BMI fails to distinguish losses or gains of fat-mass (FM) from losses or gains of metabolically active fat-free mass (FFM) that is comprised of muscle tissue and bone minerals. Instead of using the BMI, the Body Composition Improvement (BCI) index, expressed in lbs., is the net result of scoring depletion of FM and increases of FFM as positive outcomes, while gains of FM and losses of FFM are negative outcomes. A recent study compared the difference between using the BCI index versus scale weight changes (which correlated 0.997 with the BMI) in 3,987 subjects 17- 87 years of age of varied ethnicity and geographic locations. All subjects completed baseline and ending measurements of scale weight and DEXA Total Body scans of FM and FFM * 

The Genetic Key Diet

The Alethia Corporation

2006

The Genetic Key Diet”. This book combined genetics and low glycemic eating for maximum positive changes in body composition (lean to fat ratio) vs. simply weight loss.

The Chain of Life

2005

How glycans (glyconutrients) form the very basis of all life functions. Published only in Japanese.

The Missing Nutrients

The Alethia Corporation

2005

Understanding glyconutrients (glycans) in basic terms. A must for anyone who wants to understand what glycans are and why you need them in simple language. This book has been sold in 12 countries and in its second edition it published in Mandarin (Chinese), Korean, German and English.

How to Survive on a Toxic Planet

The Alethia Corporation

2004

Analyzing the SMA 25 and CBC with Differential for Nutritional Needs

The Balancing Body Chemistry Group

1996

A major contributor, research analyst and co-author for the Balancing Body Chemistry Group publications. The publications include; “Analyzing the SMA 25 and CBC with Differential for Nutritional Needs”. A second manual was titled, “Nutritional Protocols That Work”. Thousands of doctors have used these manuals. The blood chemistry manual gives doctors insight on blood tests for illnesses, that they never conceived possible from their orthodox medical school training. It then tells the doctors which nutrients may be deficient based on the blood tests along with recommended protocols.

Nutritional Protocols That Work

The Balancing Body Chemistry Group

1996

“Nutritional Protocols That Work” was the follow up manual to “Analyzing the SMA 25 and CBC with Differential for Nutritional Needs”. Thousands of doctors have used these manuals. After understanding the interpretations of blood chemistry for functional nutritional needs in “Analyzing the SMA 25 and CBC with Differential for Nutritional Needs”, “Nutritional Protocols That Work” gave the doctors protocols to help their patients.

“Nutritional Protocols That Work” was the follow up manual to “Analyzing the SMA 25 and CBC with Differential for Nutritional Needs”. Thousands of doctors have used these manuals. After understanding the interpretations of blood chemistry for functional nutritional needs in “Analyzing the SMA 25 and CBC with Differential for Nutritional Needs”, “Nutritional Protocols That Work” gave the doctors protocols to help their patients.

Nugent’s Physician’s Desk Reference for Applied Clinical Nutrition

Nugent Information Systems

1994

For many years while in private practice, he published “Nugent’s Physician’s Desk Reference for Applied Clinical Nutrition”. This reference covered more than 200 health concerns and the natural therapies, as well as dietary requirements, predisposing conditions and medical referral and testing data where appropriate. Thousands of doctors have used this reference as their guide to natural therapies.