| BRI interpretation | BRI reference values | Health risk |
|---|---|---|
| Low BRI | < 3,41 | possibly increased health risk |
| Normal BRI | 3,41 - 5,46 | no risk |
| High BRI | 5,46 - 6,91 | increased health risk |
| Very high BRI | > 6,91 | significantly increased health risk |
| Table reference values: Zhang et al. | ||
BRI or Body roundness index measures the roundness of the body and is an alternative to BMI or body mass index. The BRI calculation formula takes body shape into account better.
BRI or Body roundness index has been developed to predict body fat percentage and visceral fat content. BRI is an alternative tool for assessing an individual's health status and has been shown to estimate fat percentage and visceral fat content slightly better than the traditional BMI. The widely used BMI or body mass index is calculated based on weight and height, but it does not take into account the person's body structure at all. This can lead to, for example, very muscular people getting higher BMI values and then the assessment of health status can be distorted. (Thomas et al. 2013.)
BRI is calculated using height and waist circumference as follows:
How do you measure your waist circumference?
General health classifications like BMI reference values have not been developed for BRI values because there has not yet been enough research data to develop them.
Zhou, et al. (2022) studied the effect of BRI value on the risk of total mortality and cardiovascular disease mortality. The study showed a U-shaped relationship with BRI values for both of these mortality rates. In other words, the risk of mortality decreased as the BRI value increased up to a certain point, and after a certain value was exceeded, mortality the risk began to increase.
For all-cause mortality, the risk decreased as the BRI increased when the BRI was less than 4.99 (HR = 0.67 (95% CI: 0.60-0.75, P < 0.001)). The risk increased as the BRI value increased when the value was above 4.99 (HR = 1.11 (95% CI: 1.05-1.16, P < 0.001)). In light of this study, a BRI value of 4.99 would therefore be the so-called optimal value for reducing the risk of all-cause mortality.
Zhang, et al. (2024) also found that the relationship between the BRI value and all-cause mortality was U-shaped. The study found that the risk of mortality increased by approximately 25% for a BRI value of 1.05-<3.41 (HR = 1.25 (95% CI: 1.05-1.47 P < 0.05)) and for a value of 5.46-<6.91 (HR = 1.25 (95% CI: 1.09-1.43 P < 0.01)). For a BRI value above 6.91, the risk of mortality increased by approximately 49% (HR = 1.49 (95% CI: 1.31-1.70 P < 0.001)).
For cardiovascular disease mortality, Zhou, et al. (2022) defined a lower risk value of 3.60. Do Prado, et al (2025) found in their study that values of 3.965 (in men) and 3.757 (in women) serve as so-called cut-off values for the prevalence of metabolic syndrome in the Brazilian adult population. In a study examining hypertension in a southwestern Chinese population, it was found that individuals with BRI values between 3.02 and 3.83 had an approximately 31% higher risk of developing hypertension (HR = 1.31 95% CI: 1.10–1.56 p < 0.002) compared to those with a BRI value of ≤ 2.38 (Zhan et al., 2024).
Further research is therefore needed to establish general reference values for assessing health status. In addition, it is possible that a healthy BRI value in older people is different from that in the general population. In the BRI table the values are from the study of Zhang. Remember that the BRI value only provides one estimate of your health status. You should discuss your health-related issues with a healthcare professional.
Lassi Honkanen
physiotherapist
Thomas, D. M., Bredlau, C., Bosy-Westphal, A., Mueller, M., Shen, W., Gallagher, D., Maeda, Y., McDougall, A., Peterson, C. M., Ravussin, E., & Heymsfield, S. B. (2013). Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring, Md.), 21(11), 2264–2271. https://doi.org/10.1002/oby.20408
Zhou D, Liu X, Huang Y, Feng Y. A nonlinear association between body roundness index and all-cause mortality and cardiovascular mortality in general population. Public Health Nutrition. 2022;25(11):3008-3015. doi:10.1017/S1368980022001768 https://pubmed.ncbi.nlm.nih.gov/35983642/
Zhang et al. (2024). Body Roundness Index and All-Cause Mortality Among US Adults. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819558
Do Prado et al. (2025). The cutoff points of body roundness index for predicting metabolic syndrome in the Brazilian population among 18–59 years. https://www.nature.com/articles/s41598-025-97212-y