Body mass index and mortality in India

Abstract

The paper reviews the current nutritional situation of India. The country is still facing childhood and adult under-nutrition, 28% of adult men and 33% of adult women have a body mass index (BMI) lower than 18.5 kg/m 2. Recently, due to demographic, epidemiological and nutritional transitions, going along with economic changes, the country is also facing a dramatic increase in the prevalence of overweight and obesity. Consequently, India is currently suffering from the coexistence of both chronic energy deficiency and obesity. Disparities in terms of nutritional status are observed: populations from East and Central states suffering more frequently from malnutrition, while people living in urban areas, highly educated, or from a high socio-economic level suffering more often from overweight and obesity. Although the association between mortality and body mass index in India has been scarcely addressed, studies on morbidity related to overweight and obesity report a growing prevalence of type 2 diabetes mellitus (31 million patients in 2005) and cardiovascular diseases (36 million patients in 2004). It is estimated that within a decade, the number of cases of these two diseases will double. The body composition of Indians has specific features such as excess body fat and great abdominal fat. Persons may be classified as "normal" by BMI criteria are actually "metabolically-obese" when body fat or abdominal obesity are considered. Attempts have been made for lowering BMI cut-off points for Asian ethnic groups; increased risk of diabetes and cardiovascular diseases is likely to start from a BMI of 23 kg/m2, and high risk of these diseases at 25 kg/m2.