On your health journey? You must have heard of Body Mass Index (BMI). A quick calculation based on your height and weight can give you your BMI result within seconds. But how do you make sense of this number? And what does it mean for your health?
Boss Mass Index (BMI), is a measure of body fat, used to assess health risks like cardiac disorders and diabetes. Traditionally, BMI standards are determined by a global scale. But according to recent studies, what qualifies as a normal BMI range can vary significantly across different ethnic groups. Let’s see how this applies to healthcare management across diverse populations, particularly South Asians.
What does a ‘Healthy’ BMI/ Body Weight Mean?
Standard BMI categories classify a BMI of 25 as overweight and 30 as obese. While these thresholds serve as a general guideline for health assessments and interventions, healthcare professionals acknowledge the limitations of BMI in factoring in aspects like muscle mass that are crucial to health. Thus, it has long been understood that this metric needs to be viewed alongside other parameters like blood pressure, cholesterol levels etc. But here’s something else that must be taken into account— ethnic diversity.
Studies show that South Asians have a higher percentage of body fat and increased abdominal or visceral fat compared to other ethnic groups, even at lower body weights. This distinctive physical makeup contributes to higher rates of obesity-related health issues, even when they appear to be at a "normal" weight as per the global scale. A South Asian person with a BMI deemed fit by these standards might be at a significantly increased risk of developing diabetes— in fact, research suggests that the prevalence of type 2 diabetes in South Asians can be up to 5.3 times higher than in Europeans at similar BMI levels.
This applies to heart disease, too. The risk factors associated with obesity – such as high blood pressure, elevated cholesterol levels, and insulin resistance – may manifest at lower BMI levels in South Asians as well. Research shows for any given level of cholesterol, South Asians are at twice the risk of cardiac disease, as compared to other ethnic groups. Their lipid profile shows higher LDL (low-density lipoprotein) or “bad” cholesterol and lower HDL (high-density lipoprotein) or “good” cholesterol, in relation to other ethnicities. Cardiovascular risk assessments based on standard BMI categories therefore might underestimate the actual risk for South Asian people.
A significant impact of this is on the preventive measures or early interventions, potentially leading to more advanced stages of the health conditions before diagnosis and treatment.
Changing the way we understand BMI
This knowledge of ethnic differences in body composition and health risks have led to a change in what we see as normal. Healthcare professionals now use lower BMI cutoffs for South Asians, where a BMI of 23 is categorized as overweight, while the threshold for obesity is adjusted to a BMI of 27.5. This shift isn't merely a numerical change; it reflects a deeper implication for how we manage our health. For example, a key component of keeping cardiometabolic conditions at bay has been maintaining a healthy body weight. A scale calibrated for the unique biology of a South Asians allows healthcare providers to make an accurate assessment of ideal weight for people/patients.
Similarly, more frequent lipid profile testing may be recommended to understand the risk of heart disease and take preemptive action to avoid a health episode. Dosages that are typically based on body weight or BMI might need to be adjusted to account for the differential body composition of South Asian patients. This is particularly important for medicines that are stored in fat tissue or whose metabolism is affected by body fat distribution.
Beyond BMI
As we further our knowledge about diverse bodies, a wider range of parameters must be explored, for insights into overall health that BMI alone cannot provide. These include waist circumference, which helps assess abdominal fat – a key risk factor for metabolic disorders, and waist-to-hip ratio, which provides information about body fat distribution.
Studying these factors across populations helps healthcare providers gain a more comprehensive and culturally relevant understanding of health needs. This could help personalized treatments through ethnicity-specific BMI calculators, frequent screenings for conditions that pose higher risks, and nutrition recommendations that consider cultural dietary habits and body composition differences.
The case of BMI in South Asians is just one example of how the concept of "normal" health is evolving. It serves as a reminder that our approach to wellbeing must be more nuanced and inclusive. By continuing to research, understand, and account for ethnic variations in health risks, we can ensure that personalized healthcare is accessible to everyone across the globe.
Disclaimer: The information mentioned in this document is only suggestive /for patient education and shall not be considered as a substitute for doctor’s advice or recommendations from Abbott. Please consult your doctor for more information.
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