4 min readNew DelhiSep 15, 2024 01:52 PM IST
First published on: Sep 13, 2024 at 03:01 PM IST
The body mass index (BMI), which is a ratio of height to weight and is still used as a medical screening tool, has long been considered flawed because it ignores belly fat or abdominal obesity and lean muscle mass that might push up weight in gym-goers. Yet visceral fat is a good indication of your diabetes, hypertension and cardiovascular disease risk.
Now the body roundness index (BRI), which measures how round you are by factoring in your height and waist but not weight, is gaining traction in Western clinical practices. BRI scores range between 1 and 15 with those measuring above 7 considered at a higher risk of developing chronic diseases.
“Since BMI cannot distinguish body fat from muscle mass, a lean person with abdominal obesity may be considered fit. Yet belly fat, that surrounds important organs like the liver, stomach and intestines, contributes to insulin resistance and accelerates the development of Type 2 diabetes. Since Indians largely gain weight around the middle, the BRI would work better than BMI,” says Dr V Mohan, Chairman, Diabetes Specialities Centre, Chennai. Excerpts:
Why Indians need a BRI score more than BMI
BMI assumes that fat is the only component of weight when it includes muscle, bone, water and organs. Neither does it map where and how the body fat is stored. This leads to erroneous calculations of obesity. For example, muscle being much denser than fat, anybody with an athletic build, lean muscle mass and low body fat would still seem to be overweight by this measure. Now if you are an elderly person, who has lost a significant amount of muscle mass, the space of which has been taken over by loose body fat, BMI will still make you look normal.
That’s why the waist circumference or the waist to hip ratio (measuring the latter is more cumbersome) are more desirable indices. Whether BRI is indeed superior can be ascertained when it is tested on a South Asian population where abdominal obesity is a matter of concern.
How does abdominal obesity raise the risk of chronic illnesses?
Deep subcutaneous fat can change the body’s metabolism and release free fatty acids and glucose into the blood. This blunts the insulin sensitivity of cells and over-stresses the pancreas, which needs to produce more insulin than normal. Over time, the pancreas may no longer produce enough insulin to bring down sugar levels and cause Type 2 diabetes. Belly fat also triggers conditions for inflammation and accelerates fat deposition in heart vessels.
Currently, we need to worry about fat accumulation around the liver as it leads to non-alcoholic fatty liver disease, which in turn increases cardiovascular disease risk.
Is there an easier way to assess abdominal obesity?
The Indian Diabetes Risk Score Test is the result of 20 years of research. We measure the waistlines of patients with a tailor’s tape and ask them their age, family history of diabetes and their physical activity. Our scoring is 0 for no family history, 10 when one of the parents has a history and 20 when both come from families with diabetes. In a woman, less than 80 cm of waistline gets you a score of 0, anything between 80 to 90 cm gets you 10 and a higher measurement gets you 20. For men, less than 90 cm is 0, 90 to 100 cm is 10 and more than 100 cm is 20. A combined score above 60 means you are at a high risk of getting diabetes.
Now the body roundness index (BRI), which measures how round you are by factoring in your height and waist but not weight, is gaining traction in Western clinical practices. (Pixabay) 
Share
