Excessive adiposity at low BMI levels among women in rural Bangladesh

Saijuddin Shaikh, Jessica Jones-Smith, Kerry Schulze, Hasmot Ali, Parul Christian, Abu Ahmed Shamim, Sucheta Mehra, Alain Labrique, Rolf Klemm, Lee Wu, Mahbubur Rashid, Keith P. West

Research output: Contribution to journalArticlepeer-review


Asian populations have a higher percentage body fat (%BF) and are at higher risk for CVD and related complications at a given BMI compared with those of European descent. We explored whether %BF was disproportionately elevated in rural Bangladeshi women with low BMI. Height, weight, mid-upper arm circumference, triceps and subscapular skinfolds and bioelectrical impedance analysis (BIA) were measured in 1555 women at 3 months postpartum. %BF was assessed by skinfolds and by BIA. BMI was calculated in adults and BMI Z-scores were calculated for females <20 years old. Receiver operating characteristic (ROC) curves found the BMI and BMI Z-score cut-offs that optimally classified women as having moderately excessive adipose tissue (defined as >30 % body fat). Linear regressions estimated the association between BMI and BMI Z-score (among adolescents) and %BF. Mean BMI was 19·2 (SD 2·2) kg/m2, and mean %BF was calculated as 23·7 (SD 4·8) % by skinfolds and 23·3 (SD 4·9) % by BIA. ROC analyses indicated that a BMI value of approximately 21 kg/m2 optimised sensitivity (83·6 %) and specificity (84·2 %) for classifying subjects with >30 % body fat according to BIA among adults. This BMI level is substantially lower than the WHO recommended standard cut-off point of BMI ≥ 25 kg/m2. The equivalent cut-off among adolescents was a BMI Z-score of –0·36, with a sensitivity of 81·3 % and specificity of 80·9 %. These findings suggest that Bangladeshi women exhibit excess adipose tissue at substantially lower BMI compared with non-South Asian populations. This is important for the identification and prevention of obesity-related metabolic diseases.

Original languageEnglish (US)
Article numbere11
JournalJournal of Nutritional Science
StatePublished - Feb 17 2016


  • BMI
  • Bangladeshi women
  • Bioelectrical impedance analysis
  • Obesity
  • Overweight
  • Percentage body fat
  • Skinfolds

ASJC Scopus subject areas

  • Food Science
  • Endocrinology, Diabetes and Metabolism


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