title: BMI does not accurately predict overweight in Asian Indians in northern India.
abstract: Asian Indians are at high risk for the development of atherosclerosis and related complications, possibly initiated by higher body fat (BF). The present study attempted to establish appropriate cut-off levels of the BMI for defining overweight, considering percentage BF in healthy Asian Indians in northern India as the standard. A total of 123 healthy volunteers (eighty-six males aged 18--75 years and thirty-seven females aged 20--69 years) participated in the study. Clinical examination and anthropometric measurements were performed, and percentage BF was calculated. BMI for males was 21.4 (sd 3.7) kg/m(2) and for females was 23.3 (sd 5.5) kg/m(2). Percentage BF was 21.3 (sd 7.6) in males and 35.4 (sd 5.0) in females. A comparison of BF data among Caucasians, Blacks, Polynesians and Asian ethnic groups (e.g. immigrant Chinese) revealed conspicuous differences. Receiver operating characteristic (ROC) curve analysis showed a low sensitivity and negative predictive value of the conventional cut-off value of the BMI (25 kg/m(2)) in identifying subjects with overweight as compared to the cut-off value based on percentage BF (males >25, females >30). This observation is particularly obvious in females, resulting in substantial misclassification. Based on the ROC curve, a lower cut-off value of the BMI (21.5 kg/m(2) for males and 19.0 kg/m(2) for females) displayed the optimal sensitivity and specificity, and less misclassification in identification of subjects with high percentage BF. Furthermore, a novel obesity variable, BF:BMI, was tested and should prove useful for interethnic comparison of body composition. In the northern Indian population, the conventional cut-off level of the BMI underestimates overweight and obesity when percentage BF is used as the standard to define overweight. These preliminary findings, if confirmed in a larger number of subjects and with the use of instruments having a higher accuracy of BF assessment, would be crucial for planning and the prevention and treatment of various obesity-related metabolic diseases in the Asian Indian population.
authors: Department of Medicine, All India Institute of Medical Sciences, New Delhi-110029, India.
authors: V
authors: V
authors: Dudeja
authors: A
authors: A
authors: Misra
authors: R M
authors: RM
authors: Pandey
authors: G
authors: G
authors: Devina
authors: G
authors: G
authors: Kumar
authors: N K
authors: NK
authors: Vikram
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D044466:Asian People; D044383:Black People; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D012885:Skinfold Thickness; D044465:White People