Excessive adiposity at low BMI levels among women in rural Bangladesh.
Asian populations have a higher percentage body fat (%BF) and are at higher risk for CVD and related complications at a given BMI compared with those of European descent. We explored whether %BF was disproportionately elevated in rural Bangladeshi women with low BMI. Height, weight, mid-upper arm circumference, triceps and subscapular skinfolds and bioelectrical impedance analysis (BIA) were measured in 1555 women at 3 months postpartum. %BF was assessed by skinfolds and by BIA. BMI was calculated in adults and BMI Z-scores were calculated for females <20 years old. Receiver operating characteristic (ROC) curves found the BMI and BMI Z-score cut-offs that optimally classified women as having moderately excessive adipose tissue (defined as >30 % body fat). Linear regressions estimated the association between BMI and BMI Z-score (among adolescents) and %BF. Mean BMI was 19·2 (sd 2·2) kg/m(2), and mean %BF was calculated as 23·7 (sd 4·8) % by skinfolds and 23·3 (sd 4·9) % by BIA. ROC analyses indicated that a BMI value of approximately 21 kg/m(2) optimised sensitivity (83·6 %) and specificity (84·2 %) for classifying subjects with >30 % body fat according to BIA among adults. This BMI level is substantially lower than the WHO recommended standard cut-off point of BMI ≥ 25 kg/m(2). The equivalent cut-off among adolescents was a BMI Z-score of -0·36, with a sensitivity of 81·3 % and specificity of 80·9 %. These findings suggest that Bangladeshi women exhibit excess adipose tissue at substantially lower BMI compared with non-South Asian populations. This is important for the identification and prevention of obesity-related metabolic diseases.
The JiVitA Project of Johns Hopkins University , Godown Road , Paschimpara , Gaibandha , Bangladesh.
Saijuddin
S
Shaikh
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Jessica
J
Jones-Smith
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Kerry
K
Schulze
The JiVitA Project of Johns Hopkins University , Godown Road , Paschimpara , Gaibandha , Bangladesh.
Hasmot
H
Ali
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Parul
P
Christian
The JiVitA Project of Johns Hopkins University , Godown Road , Paschimpara , Gaibandha , Bangladesh.
Abu Ahmed
AA
Shamim
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Sucheta
S
Mehra
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Alain
A
Labrique
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Rolf
R
Klemm
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Lee
L
Wu
The JiVitA Project of Johns Hopkins University , Godown Road , Paschimpara , Gaibandha , Bangladesh.
Mahbubur
M
Rashid
Center for Human Nutrition , Department of International Health , Bloomberg , School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
Keith P
KP
West
BIA, bioelectrical impedance analysis; BMI; Bangladeshi women; Bioelectrical impedance analysis; Obesity; Overweight; Percentage body fat; ROC, receiver operating characteristic; Skinfolds