Body Fat and Cardiometabolic Disease Burden and All-Cause Mortality in Adults With Normal Body Mass Index

Zhuo Chen; Jingen Li; Betsy J. Medina-Inojosa; Jose R. Medina-Inojosa; Kyla M. Lara-Breitinger; Virend K. Somers; Andres Acosta; Amir Lerman; Francisco Lopez-Jimenez

doi:10.1016/j.mayocp.2025.06.022

February 1, 2026Mayo Clinic Proceedings

Body Fat and Cardiometabolic Disease Burden and All-Cause Mortality in Adults With Normal Body Mass Index

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Why the study?

It was hypothesized that body adiposity measured by dual x-ray absorptiometry is associated with metabolic disorders and all-cause mortality in normal-weight individuals.

Does higher body fat percentage increase cardiometabolic disease burden and all-cause mortality in adults with normal body mass index?

Key Points

Higher body fat levels are linked to an increased burden of cardiometabolic disease and all-cause mortality in adults with a normal body mass index.
The analysis shows that even within a normal body mass index range, excess body fat can significantly impact health outcomes.
Analysis of data from adults indicates that normal body mass index alone does not guarantee lower disease risk or mortality rates.
Findings underline a crucial need to reassess health risk factors in individuals with normal body mass index based on body fat percentages.

Structured PICO

Does higher body fat percentage increase cardiometabolic disease burden and all-cause mortality in adults with normal body mass index?

P

Population

20,613 adults 20 to 65 years of age (including 6,424 with normal BMI 18.5-24.9 kg/m2) from the US National Health and Nutrition Examination Survey (NHANES) from 1999-2006 and 2011-2018.

I

Intervention

Higher body fat percentage (BF%) measured by dual x-ray absorptiometry (DXA)

C

Comparator

Lower body fat percentage (BF%) tertiles

O

Outcome

Metabolic disorders (insulin resistance, metabolic syndrome, dyslipidemia, type 2 diabetes mellitus, and hypertension) and all-cause mortalityhard clinical

Higher body fat percentage identifies increased cardiometabolic and mortality risk even among individuals with a normal BMI, highlighting the limitations of BMI alone for risk stratification.

Implication

Normal-BMI risk assessment may underestimate cardiometabolic burden; challenges BMI sufficiency and extends need for body composition research.

Discussion

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Cite This Study

Chen et al. (2026) studied this question.

synapsesocial.com/papers/69a7654fbadf0bb9e87d8aed https://doi.org/10.1016/j.mayocp.2025.06.022

Topics

Women and heart disease

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Body Fat and Cardiometabolic Disease Burden and All-Cause Mortality in Adults With Normal Body Mass Index

Key Points

Structured PICO

Implication

Discussion

Cite This Study

Topics

Body Fat and Cardiometabolic Disease Burden and All-Cause Mortality in Adults With Normal Body Mass Index

Key Points

Structured PICO

Implication

Discussion

Cite This Study

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