Modified BMI

Date:29/08/2004 URL:

http://www.thehindu.com/2004/08/29/stories/2004082908490300.htm

WHO asked to revise obesity scale for Indians

By Bindu Shajan Perappadan

NEW DELHI, AUG. 28. There is clearly more to an Indian belly than just regular fat. And that is exactly what the physicians are telling those at the helm of affairs. Warning that the Indian belly is an indication of far greater risk including insulin resistance, coronary heart ailments, high-density lipoprotein and hypertension, doctors are now asking the World Health Organisation (WHO) to revise its obesity measuring scale for Indians.

Simply put, the Asian ethnic groups have higher body fat than the WHO-prescribed "normal'' range of Body Mass Index (BMI) and this excess fat causes obesity-related ailments.

What doctors are asking for then is that WHO re-consider the fat measurement parameters used for Indians and lower the scale to suit the Indian BMI.

According to the WHO scale, a person with a BMI between 25 to 29.9 is fat and anyone over that is categorised as obese. But for India, a BMI of 23 to 27.5 is considered overweight and those over 27.5 come under the obese category.

"Overall what we are asking for is lowering of the BMI scale by one-two units in the Asian population which will not only bring a large number of overweight people under the medical scanner, but will also ensure that help can be provided to them before they go from fat to obese,'' explains Prof. Anoop Misra of the Department of Internal Medicine at the All-India Institute of Medical Sciences (AIIMS) here who has conducted intensive research on the subject.

He adds: "Indians are categorised as fat only after they meet the international BMI scale by which time they are ready hosts for a large number of ailments. This can be prevented if the scales are lowered to suit the Indian BMI.''

While Indians are more susceptible to obesity-related ailments, yet another fact that has come to light is that this data remains consistently uniform in the Indian population regardless of the country of residence, socio-economic strata and physical activity profile.

But sadly for the Indian population, the story does not end here. While Indians have been categorised under the high-vulnerability group, it is the women and low birth weight babies who put on body fat very fast as they grow up and who are under the maximum risk category.

WHO for its part has maintained that though there may be variations as per the ethnic group, what they can provide is a blanket cut-off BMI that can be modified according to the need of each group.

"WHO has given indicative BMI, leaving its acceptability to individual groups. But in India physicians don't often understand this 'dual BMI' scheme and this leads to further confusion. What we require is a revision of the BMI, redefinition of overweight and obesity in Indian population so that the measuring scale can be set right for Indians," explains Prof. Umesh Kapil of the Department of Gastroenterology and Human Nutrition at AIIMS.