Clinical outcome of individualised treatment of multidrug-resistant tuberculosis in Latvia: a retrospective cohort study

Study objective: To describe height, weight, and body mass index (BMI) of the adult urban population in Mumbai, western India and to estimate the prevalence and severity of thinness and overweight in this population. To describe the association of BMI with education, age, and tobacco habits in an urban Indian population. 

Design: Cross sectional representative survey of 99 598 adults (40 071 men and 59 527 women). 

Setting: The survey was carried out in the city of Mumbai (formerly known as Bombay) in western India. 

Participants: Men and women aged ≥35 years who were residents of the main city of Mumbai. 

Main results: The mean height, weight, and BMI were 161.0 (SD 6.7) cm, 56.7 (SD 11.0) kg, and 21.8 (SD 3.8) kg/m2 for men and 148.0 (SD 6.2) cm, 49.8 (SD 11.2) kg, and 22.7 (SD 4.7) kg/m2 for women, respectively. Some 19% of men and women were thin (BMI<18.5 kg/m2), while 19% of men and 30% of women were overweight (BMI≥25kg/m2). Multivariable logistic regression analyses showed that age, level of education, and tobacco use were independently associated with BMI. The odds ratio (OR) and 95% confidence intervals (CI) for thinness (BMI<18.5 kg/m2) were OR 6.52, 95%CI 5.38 to 7.89 for men and OR 4.83, 95%CI 3.71 to 6.28 for women, respectively, (p<0.001) for the lowest level of education (illiterate group). The OR and 95%CI for overweight were 2.25, 2.20 to 2.58 for college educated men and 1.90, 1.64 to 2.20 for college educated women, respectively, p<0.001. Both smoking (2.33, 2.09 to 2.59; 2.89, 1.77 to 4.72 for men and women, respectively, p<0.001) and smokeless tobacco use (1.65, 1.52 to 1.80; 2.26, 2.14 to 2.38 for men and women, respectively p<0.0001) were significantly associated with low BMI. 

Conclusions: Sequelae of thinness and overweight represent major public health problems. The results of this study, indicating an equal prevalence of thinness and overweight in an urban area and their association with age, level of education, and tobacco use raise concerns of an emerging public health crisis in urban India.

https://jech.bmj.com/content/jech/56/11/876.full.pdf

Descriptive epidemiology of body mass index of an urban adult population in western India

The weight of obesity on the human immune response to vaccination

The evolution of thinking about food security.

Objective: To assess the suitability of the body mass index (BMI) as an indicator of standard of living in developing countries. Design, setting and subjects: The analysis is based on data collected in the first two rounds of the Ghana Living Standards Survey, held in 1987/88 (GLSS-I) and 1988/89 (GLSS-II). The dataset provides information on a wide range of socio-economic variables, at the individual, the household and the community level, including the height and weight data of approximately 9000 adults in the 20–65 y age bracket. Method: Bivariate analysis was used to assess, at the individual level and at the level of population groups, the relationships between adult Body Mass Index and selected household characteristics such as income and expenditure, years of schooling of head of household, access to services, quality of housing, and nutritional status of children. Through multiple regression, indicative estimates have been derived of the effects of these variables on adult BMI. For comparison, the same relationships were investigated for weight and height. Results and conclusion: At the individual level, BMI shows a significantly positive relation with the various socio-economic indicators of living standard, though the correlation coefficients indicate a poor fit. However, at the level of population groups, the relationship between BMI and other characteristics of socio-economic development is strong, with a correlation coefficient of 0.86 between mean BMI and mean per capita expenditures of 12 population groups in Ghana, presumed to be at different levels of standard of living. The relationships between weight and the various socioeconomic characteristics were comparable to those for BMI, while height was poorly correlated with the selected household variables. Results suggest that in low-income countries, information on adult BMI (mean and distribution) can be used for assessing differences in standards of living between population groups or for monitoring changes over time. Sponsorship: The project is co-financed by the Netherlands' Ministry of Development Cooperation, within the context of the Reseau SADAOC-Programme (Food Security and Sustainable Development in West-Africa).

Body mass index as indicator of standard of living in developing countries

Adult malnutrition is much more widespread than is commonly recognized. Described in this article is the use of body mass index (BMI = weight in kg/(height in metres)2) as a measure of adult nutritional status, both of individuals and of communities. Concurrent assessment of the nutritional status of children and adults permits conclusions to be drawn about whether there is generalized undernutrition in a community or whether other factors (e.g., childhood infections or feeding practices) are more important in childhood malnutrition. Included is a tabular presentation that permits rapid assessment of both thinness or underweight (BMI values 25, 30 and 40). Examples of the use of BMI in both clinical and public health practice are also given.

Use of body mass index of adults in assessing individual and community nutritional status.

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Use of body mass index of adults in assessing individual and community nutritional status.