BMI does not accurately predict overweight in Asian Indians in northern India

V. Dudeja, A. Misra, R. M. Pandey, G. Devina, G. Kumar, N. K. Vikram

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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/m2 and for females was 23.3 (SD 5.5) kg/m2. 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 characteristics (ROC) curve analysis showed a low sensitivity and negative predictive value of the conventional cut-off value of the BMI (25 kg/m2) 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/m2 for males and 19.0 kg/m2 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.

Original languageEnglish (US)
Pages (from-to)105-112
Number of pages8
JournalBritish Journal of Nutrition
Issue number1
StatePublished - 2001


  • Asian Indians
  • BMI
  • Body fat
  • Obesity
  • Skinfolds


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