Height-normalized indices of the body’s fat-free mass and fat mass: potentially useful indicators of nutritional status

Expressing fat-free mass (FFM) and body fat mass (BFM) as percentages of body weight or by weight is unsatisfactory. For example, tall patients with protein-energy malnutrition (PEM) can exhibit values for FFM and BFM similar to those of shorter well-nourished individuals. To obviate such difficulties, we propose use of height-normalized indices, namely, a FFM index [FFM (kg)/height (m)2, or FFMI] and a BFM index [BFM (kg)/height (m)2, or BFMI]. We calculated these indices in a reference population of 124 healthy young men and in 32 nonobese young men (from the Minnesota Study) before, during, and after experimental semistarvation. When values for FFMI and BFMI falling below the reference cohort’s 5th percentile cutoff point were used as a criterion for PEM, these indices, together with basal oxygen-consumption rate, diagnosed PEM in 27 of the 32 Minnesota Study subjects after 12 wk of semi-starvation. These findings indicate that FFMI and BFMI may be useful in nutritional assessment.