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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/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 obesityrelated metabolic diseases in the Asian Indian population. Body fat: BMI: Asian Indians: Obesity: SkinfoldsOverweight and obesity are a rapidly escalating problem in developing countries. Excess body fat (BF), in particular abdominal fat, is a harbinger of several adverse metabolic consequences, including hyperinsulinaemia, impaired glucose tolerance, hyperlipidaemia and prothrombotic tendency (a conglomeration of features termed insulin resistance syndrome; Reaven, 1988). Insulin resistance is commonly observed in Asian Indians and it precedes the development of CHD (McKeigue et al. 1991).Overweight and obesity are commonly defined by the measurement of BMI. However, this is an imperfect measure, since both fat and fat-free mass (bone, muscles and body water) are estimated. An important limitation of the BMI as a measure of obesity is that it tends to ignore the distinction between fat and fat-free mass. Cut-off levels of the BMI for overweight and obesity are based on the 5th and 95th centiles of body weight and...

BACKGROUND AND AIMS:In this study, a prevalence survey of various atherosclerosis risk factors was carried out on hitherto poorly studied rural -urban migrants settled in urban slums in a large metropolitan city in northern India, with the aim of studying anthropometric and metabolic characteristics of this population in socio-economic transition. DESIGN: A cross-sectional epidemiological descriptive study. SUBJECTS: A total of 532 subjects (170 males and 362 females) were included in the study (response rate approximately 40%). METHODS AND RESULTS:In this study, diabetes mellitus was recorded in 11.2% (95% CI 6.8 -16.9) of males and 9.9% (95% CI 7.0 -13.5) of females, the overall prevalence being 10.3% (95% CI 7.8 -13.2). Based on body mass index (BMI), obesity was more prevalent in females (15.6%; 95% CI 10.7 -22.3) than in males (13.3%; 95% CI 8.5 -19.5). On the other hand, classifying obesity based on percentage body fat (%BF), 10.6% (95% CI 6.4 -16.2) of males and 40.2% (95% CI 34.9 -45.3) of females were obese. High waist -hip ratio (WHR) was observed in 9.4% (95% CI 5.4 -14.8) of males and 51.1% (95% CI 45.8 -56.3) of the females. All individual skinfolds and sum of skinfolds were significantly higher in females (P < 0.001). In both males and females above 30 y of age, there was a steep increase in the prevalence of high WHR, and in females, %BF was very high (particularly in %BF quartile > 30%). Furthermore, total cholesterol and low-density lipoprotein cholesterol were high in both males and females. Stepwise multiple linear regression analysis showed that for both males and females BMI, WHR and %BF were positive predictors of biochemical parameters, except for HDL-c, for which these parameters were negatively associated. CONCLUSIONS: Appreciable prevalence of obesity, dyslipidaemia, diabetes mellitus, substantial increase in body fat, generalised and regional obesity in middle age, particularly in females, need immediate attention in terms of prevention and health education in such economically deprived populations.

Objective: To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians. Design: Analysis of data from multisite cross-sectional epidemiological studies in north India. Subjects: In all, 2050 adult subjects 418 years of age (883 male and 1167 female subjects). Measurements: Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol. Results: In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI 421 kg/m 2 . WC levels of X90 and X80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of X25 kg/m 2 . The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study. Conclusion: We propose the following WC action levels for adult Asian Indians: action level 1: men, X78 cm, women, X72 cm; and action level 2: men, X90 cm, women, X80 cm.

Background and aims The impact of measures taken to contain COVID-19 on lifestyle-related behaviour is undefined in Indian population. The current study was undertaken to assess the impact of COVID-19 on lifestyle-related behaviours: eating, physical activity and sleep behaviour. Methods The study is a cross-sectional web-based survey. A validated questionnaire to assess the changes in lifestyle-related behaviour was administered on adults across India using a Google online survey platform. Results A total of 995 responses (58.5% male, mean age 33.3 years) were collected. An improvement in healthy meal consumption pattern and a restriction of unhealthy food items was observed, especially in the younger population (age <30 years). A reduction in physical activity coupled with an increase in daily screen time was found especially among men and in upper-socio-economic strata. Quarantine induced stress and anxiety showed an increase by a unit in nearly one-fourth of the participants. Conclusions COVID-19 marginally improved the eating behaviour, yet one-third of participants gained weight as physical activity declined significantly coupled with an increase in screen and sitting time. Mental health was also adversely affected. A detailed understanding of these factors can help to develop interventions to mitigate the negative lifestyle behaviours that have manifested during COVID-19.

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OBJECTIVE:The objectives were to study the relationships of insulin resistance with generalized and abdominal obesity, and body fat patterning in urban postpubertal Asian Indian children. DESIGN: Cross-sectional, population-based epidemiological study. SUBJECTS: In all, 250 (155 males and 95 females) healthy urban postpubertal children. MEASUREMENTS: Anthropometric profile, percentage of body fat (%BF), fasting serum insulin, and lipoprotein profile. RESULTS: Fasting insulin correlated significantly with body mass index (BMI), %BF, waist circumference (WC), central and peripheral skinfold thicknesses and sum of four skinfold thicknesses ( P 4SF) in both sexes, and with systolic blood pressure and waist-to hip circumference ratio (W-HR) in males only. Consistent increase in fasting insulin was noted with increasing values of central skinfold thickness at each tertile of peripheral skinfold thickness, WC, and %BF. Central skinfold thickness correlated with fasting insulin even after adjusting for WC, W-HR, and %BF. The odds ratios (OR) (95% CI) of hyperinsulinemia (fasting insulin concentrations in the highest quartile) were 4.7 (2.4-9.4) in overweight subjects, 8 (4.1-15.5) with high %BF, 6.4 (3.2-12.9) with high WC, 3.7 (1.9-7.3) with high W-HR, 6.8 (3.3-13.9) with high triceps skinfold thickness, 8 (4.1-15.7) with high subscapular skinfold thickness, and 10.1 (5-20.5) with high P 4SF. In step-wise multiple logistic regression analysis, %BF [OR (95% CI): 3.2 (1.4-7.8)] and ?4SF [OR (95% CI): 4.5 (1.8-11.3)] were independent predictors of hyperinsulinemia, similar to insulin resistance assessed by HOMA (homeostatic model of assessment) in the study. CONCLUSION: A high prevalence of insulin resistance in postpubertal urban Asian Indian children was associated with excess body fat, abdominal adiposity, and excess truncal subcutaneous fat. Primary prevention strategies for coronary heart disease and diabetes mellitus in Asian Indians should focus on the abnormal body composition profile in childhood.