Lupine Publishers | Scholarly Journal of Food And Nutrition
Abstract
BMI
provides the most useful population-level measure of overweight and obesity as
it is the same for both sexes and for all ages of adults. However, it should be
considered a rough guide because it may not correspond to the same degree of
fatness in different individuals. There is a difference in BMI values for the
Asians as compared to the WHO criteria. Our study focused on the BMI of the
Kaani tribes in Kanyakumari District of Tamil Nadu, India. We categorized them
as two groups, viz. those who lived in the forest area and those who had moved
out of the forest into neighbouring villages. We found that among the forest
dwellers there was a greater percentage in the underweight category, indicating
energy deficiency, while those in the rural areas were moving to a greater BMI.
This is of concern as the sequel of thinness and overweight represent major
public health problems.
Keywords: BMI, Kaani tribes, Public health,
Lifestyle, Chronic energy deficiency, Obesity
Abbreviations: BMI: Body Mass Index, WHO: World Health
Organization, CED: Chronic Energy Deficiency
Introduction
Body mass index is considered as an index
for assessing the nutritional status. The 1993 WHO Expert Committee WHO [1]
reported that weight gain in adult life was associated with increased morbidity
and mortality at higher BMI range. Therefore, BMI cutoff for overweight should
be interpreted based on risk factors of morbidity and mortality. Smalley et al.
[2] reported that type 2 diabetes mellitus, cardiovascular disease and increased
mortality are the most important sequels of obesity and abdominal fatness, but
other associations like musculoskeletal disorders, limitations of respiratory
function and reduced physical functioning and quality of life were also
observed.
Methodology
The study area Kanyakumari is located in
Tamil Nadu in South India, about 700 Kms. from Chennai the capital city of
Tamil Nadu. The nearest major city is Trivandrum in the neighbouring state of
Kerala. Kerala border is very near to Kanyakumari, which is why a mixed culture
of Kerala and Tamil Nadu is seen in the area. A crosssectional study was
carried out as it provides a clear ‘snapshot’ of the outcome and the
characteristics associated with it, at a specific point in time. The
investigator collected quantitative data; the Auxiliary Nurse Midwife
accompanied her from the Primary Health Centre to establish a rapport with the
local leaders and Kaani heads. Anthropometric measurements were collected using
standard instruments and protocol. Measurements were recorded for adult’s males
and females in the age group of 25 to 55 years from the forest and rural areas.
The sample size was calculated based on the 2011 census population size of
Kaanis in Kanyakumari district.
Result and Discussion
A BMI< 18.5 kg/m² is widely used as a
practical measure of chronic energy or hunger deficiency (CED), i.e., a
“steady” underweight in which an individual is in energy balance irrespective
of a loss in body weight or body energy stores Khongsdier [3]. Thus, the use of
BMI as an anthropometric indicator of nutritional status can be more
appropriate in a country with diverse ethnic groups, such as India Khongsdier
[4] (Table 1). Majority of the male and female in forest area (52.8 % and
52.7%) and in rural area (51.65% and 59.7%) belonged to normal weight with a
BMI of 18.5 - 22.9, followed by (45.9%) percent of the female in forest areas
being underweight with a BMI of < 18.5. Alarmingly about 41.5 percent of the
male in forest area were underweight with a BMI of < 18.5. 5.3 percent of
male in rural were obese. Body mass index is used as an index to assess the
extent of chronic energy deficiency (CEO) in adults. In adult males, the mean
BMI was 20.38kg/m2, 19.53kg/m2, 20.25kg/m2 for the age
groups 30-35 years, 36-55 years and above 55 years respectively.
Adult under nutrition very simply happens, due to hunger and lack of food. Body Mass Index (BMI) can measure adult malnutrition and a BMI below 18.5 indicates chronic under nutrition. Statistics have shown how 37% of adult Indians, 50% of adults belonging to the Scheduled Tribes and 60% of adult Indians belonging to the Scheduled Castes have a BMI below 18.5, which makes them chronically undernourished. The overall CED was highest in Madhya Pradesh (76.0%) followed by Maharastra (71.9%), Jharkhand (58.5%), Tamil Nadu (55.0%), Andhra Pradesh (50.1%), Odisha (49.5%), West Bengal (45.9%), Kerala (37.8%), Andaman & Nicobar Island (29.5%), Assam (21.5%), while Meghalaya shows the least (14.3%) prevalence of under nutrition among the tribes in all the studied states of India Das and Bose [5] . Asian Indians have a characteristic obesity phenotype, consisting of relatively lower BMI, excess body fat percentage, abdominal and truncal adiposity and less lean tissue Banerji et al. [6]; Dudeja et al. [7]. WHO [8] Expert Consultation proposed a new BMI cut-off of 23.0 kg/m2 for public health action in Asia. There has been limited data on the anthropometric and nutritional status of various tribal populations of India Bose et al. [9] to plan intervention strategies.
Conclusion
Many researchers report the relationship between BMI and diabetes mellitus. Misra and Vikram [10] reported that 67% diabetics were found as either over weight (or) obese subjects. We have found that under-weight is predominant in the Kaanis of the forest area, while those who have moved to rural areas outside the forest have a greater percentage who are over-weight. We would like to conclude that life-style in the forest is not conducive to maintaining healthy body weight; while those who have moved out of the forest are heading towards problems of over-weight. One is a consequence of insufficient food intake, the other is leading to overnutrition and consequently to lifestyle diseases in the future.
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