Although there is evidence that Asian Indians, Polynesians and Europeans differ in their body fat (BF)–BMI relationships, detailed comparative analysis of their underlying body composition and build characteristics is lacking. We investigated differences in the relationships between body fatness and BMI, fat distribution, muscularity, bone mineral mass, leg length and age-related changes in body composition between these ethnic groups. Cross-sectional analysis of 933 European, Maori, Pacific Island and Asian Indian adult volunteers was performed for total and percentage of BF, abdominal fat, thigh fat, appendicular muscle mass, bone mineral content and leg length measured by dual-energy X-ray absorptiometry. Asian Indian men and women (BMI of 24 and 26 kg/m², respectively) had the same percentage of BF as Europeans with a BMI of 30 kg/m² or Pacific men and women with BMI of 34 and 35 kg/m², respectively. Asian Indians had more fat, both total and in the abdominal region, with less lean mass, skeletal muscle and bone mineral than all other ethnic groups. Leg length was relatively longer in Pacific men and Asian and Pacific women than in other ethnic groups. In Asian Indians, abdominal fat increased with increasing age, while the percentage of BF showed little change. In the other ethnic groups, both abdominal and total BF increased with age. In conclusion, ethnic differences in fat distribution, muscularity, bone mass and leg length may contribute to ethnic-specific relationships between body fatness and BMI. The use of universal BMI cut-off points may not be appropriate for the comparison of obesity prevalence between ethnic groups.

Background: Data describing the nutritional status of patients with liver cirrhosis of diverse origin, as assessed by direct body-composition methods, are limited. Objective: We sought to provide a comprehensive assessment of nutritional status and metabolic activity in patients with liver cirrhosis by using the most accurate direct methods available. Design: Two hundred sixty-eight patients (179 M, 89 F; x̄ ± SEM age: 50.1 ± 0.6 y) with liver cirrhosis underwent measurements of total body protein by neutron activation analysis, of total body fat and bone mineral by dual-energy X-ray absorptiometry, of resting energy expenditure by indirect calorimetry, of grip strength by dynamometry, and of respiratory muscle strength by using a pressure transducer. Dietary intakes of energy and protein were assessed and indexed to resting energy expenditure and energy intake, respectively. Results: Significant protein depletion, seen in 51% of patients, was significantly (P < 0.0001) more prevalent in men (63%) than in women (28%). This sex difference occurred irrespective of disease severity or origin. The prevalence of protein depletion increased significantly (P < 0.0001) with disease severity. Protein depletion was associated with decreased muscle function but not with lower energy and protein intake. Energy intake was significantly (P = 0.002) higher in men than in women, whereas protein intakes did not differ significantly (P = 0.12). Hypermetabolism, seen in 15% of patients, was not associated with sex, origin or severity of disease, protein depletion, ascites, or presence of tumor. Conclusions: Poor nutritional status with protein depletion and reduced muscle function was a common finding, particularly in men, and was not related to the presence of hypermetabolism or reduced energy and protein intakes. The greater conservation of protein stores in women than in men warrants further investigation.