Anthropometric indices for obesity and hypertension in Indian affluent adolescents

Abstract

Childhood obesity and its health consequences have been attracting more attention in view of the increasing prevalence worldwide and the long term effects of obesity in adults. Earlier, anthropometric indices of obesity were recommended based on their correlation with body fat percent. However, in view of the fact that increasing body fatness is positively associated with blood pressure and other cardiovascular disease risk factors in adolescents, the choice of a cut off for anthropometric indicator should be based on health related criteria. Review of childhood obesity indicates that criteria used for assessing obesity in adolescents varied greatly. Nevertheless, it indicates that despite potential problems with body mass index (BMI), it still remains to be a popular indicator for estimating obesity in adolescents. One of the major limitations of BMI is however, that it does not perform well as a surrogate major of adiposity among thinner children thus affecting its validity in populations where prior undernutrition exists. The need for anthropometric indices for assessing total body fat or its distribution in large population studies is even more, in view of the fact that the existing equipment like Dual X-ray Absorptiometry (DXA) are not affordable and have limited ability outside the research setting. The chapter therefore describes benefits and limitations of different skinfolds and circumferences with the help of the data collected on urban affluent adolescents from Pune, India. It is worthwhile to mention that there is no uniform definition of assessment of overweight and obesity in adolescents and that any index will not fully characterize the impact of body fat patterning on metabolism. In fact, there are recently no guidelines for the classification of obesity related health risks among adolescents. The chapter thus highlights the need for examining the concordance between various indicators used for assessing obesity in adolescents, need for using national BMI reference data and developing cut offs anchored to metabolic risks and validating such indicators across different populations.