{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:17:34Z","timestamp":1788470254118,"version":"build-2803163510"},"reference-count":60,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cooperative Translational Research Program (KTKP) of the Faculty of Medicine, Semmelweis University"},{"id":[{"id":"https:\/\/ror.org\/01g9ty582","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Body mass index (BMI) is widely used as a proxy of nutritional status and related lifestyle risk patterns in public health, yet it does not capture body composition\u2013related heterogeneity in cardiometabolic risk. Evidence on whether a more detailed body composition assessment improves population-level screening efficiency remains inconsistent, particularly in Central European populations. Methods: We conducted a cross-sectional analysis of 868 Hungarian adults participating in a nationwide mobile screening program. Locally weighted regression identified sex-specific BMI inflection points for cardiometabolic risk. Stratified receiver operating characteristic (ROC) analyses compared BMI with bioelectrical impedance-derived parameters across five outcomes. Cost- and time-effectiveness of scalable screening strategies were modeled at the population level. Results: Cardiometabolic risk increased at BMI levels below current WHO thresholds (females: 21.8\u201322.3 kg\/m2; males: 23.8\u201324.3 kg\/m2). Overall, body composition parameters did not outperform BMI in the full population. Subgroup-specific differences were observed, particularly among men with BMI 24\u201336 kg\/m2 for atherosclerosis risk, suggesting limited and outcome-specific added value rather than broad superiority over BMI. Together, non-linear risk patterns, stratified performance, and population-level modeling converged on mid-range BMI intervals (females: 22\u201330 kg\/m2; males: 24\u201330 kg\/m2) as likely screening windows of phenotypic heterogeneity. Within these ranges, targeted InBody assessment may help refine risk assessment for selected individuals. A mixed screening strategy covering 52% of the population would cost 178.4% of BMI-only screening, while reducing throughput by 24.3%. Conclusions: Population-specific BMI thresholds may more accurately reflect early deviations in nutritional and cardiometabolic risk than current universal cutoffs. BMI remains a useful first-line marker, and body composition assessment may add complementary information in selected BMI ranges. Overall, these findings support a potentially useful, subgroup-specific screening approach, but the modeled cost and time trade-offs should be considered hypothesis-generating and require further validation.<\/jats:p>","DOI":"10.3390\/nu18091410","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:32:22Z","timestamp":1777469542000},"page":"1410","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Public Health Screening: Population-Specific BMI Thresholds for Targeted Body Composition Assessment in Hungary"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-5292","authenticated-orcid":false,"given":"Tamas","family":"Jarecsny","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"},{"name":"Doctoral School, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadim","family":"Al-Muhanna","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Rebeka Fabian","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Kosik","sequence":"additional","affiliation":[{"name":"National Public Health and Pharmaceutical Center, 1097 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Schwab","sequence":"additional","affiliation":[{"name":"MiND Brain-Gut Center, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4126-0058","authenticated-orcid":false,"given":"Gergo Jozsef","family":"Szollosi","sequence":"additional","affiliation":[{"name":"Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laszlo","family":"Schandl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Diabetology, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyula","family":"Tomasics","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Diabetology, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0634-4002","authenticated-orcid":false,"given":"Eszter Melinda","family":"Pazmandi","sequence":"additional","affiliation":[{"name":"Doctoral School, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Andr\u00e1s Pet\u0151 Faculty, Semmelweis University, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2686-0610","authenticated-orcid":false,"given":"Andras","family":"Folyovich","sequence":"additional","affiliation":[{"name":"K\u00fatv\u00f6lgyi Outpatient Clinic, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"},{"name":"Cardiovascular Medicine Research Division, Doctoral College, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferenc","family":"Fazekas","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke, Saint John\u2019s Central Hospital of North Buda, 1125 Budapest, Hungary"},{"name":"Health Services Management Training Centre, Semmelweis University, 1125 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8632-2120","authenticated-orcid":false,"given":"Monika","family":"Fekete","sequence":"additional","affiliation":[{"name":"Institute of Preventive Medicine and Public Health Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Fodor Center for Prevention and Healthy Aging, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Health Sciences Division, Doctoral College, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/j.1467-789X.2010.00810.x","article-title":"The levelling off of the obesity epidemic since the year 1999\u2014A review of evidence and perspectives","volume":"11","author":"Rokholm","year":"2010","journal-title":"Obes. 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