Body Composition of Asian Indians and New definitions of Obesity and Syndrome X


Importance of Body Fat Compartments, Cut-off Points of Body Fat Depots, for Asian Indians and Predictive Equations:

  • As a World Health Organization fellow in 1996, Dr. Misra worked at the Center of Human Nutrition, University of Texas Southwestern Medical Center at Dallas. For the first time, he showed a strong relationship of subcutaneous abdominal fat, particularly in the posterior abdominal region, using magnetic resonance imaging of abdominal fat and made assessment of insulin sensitivity, using hyperinsulinemic euglycemic clamp technique
  • In India, using the same technique, Dr. Misra reported body composition characteristics of Asian Indians residing in India. In adults, he analyzed cut-offs for subcutaneous and intra-abdominal fat for CV risk prediction. He also reported predictive equations for total fat, abdominal subcutaneous fat and intra-abdominal fat, using simple anthropometric measures. Further to that, he defined the body composition characteristics of adolescent population, especially body fat patterning.

New Waist Circumference Criteria for Indians and Correct Methodology for Measurement of Waist Circumference:

  • Dr. Misra reported a new waist circumference criteria for abdominal obesity in Indians, which are different from the current international criteria. These criteria have been considered for revised criteria for the diagnosis of abdominal obesity in Asian Indians and for revised criteria for the metabolic syndrome.
  • There are different methods for measurement of waist circumference and there is no consensus on this issue. Dr. Misra has tried to evolve a standard method for the measurement of waist circumference for worldwide use.

New Limits for Body Mass Index in Indians:

  • According to Dr. Misra and his team’s data as well as that of others, Asian Indians develop diabetes and other co-morbidities at a lower BMI than white Caucasians. Dr. Misra proposed that the current limits of body mass index are not appropriate for the diagnosis of overweight and obesity in Asian Indians, based on the estimation of body fat and prevalence of cardiovascular morbidities. These observations have been debated at the International Congress of Obesity in Sao Paulo and Sydney and published repeatedly.

New Definitions of Syndrome X in Indians and Proposal for Improving International Definitions of Syndrome X:

  • There is controversy about the correct definition of Syndrome X worldwide. Dr. Misra has proposed new definitions for syndrome X in Indians, both in adults and in children. In the definition for adults, he has included new criteria which are more appropriate for the Indian population. For children, he and his team are one of the four groups in the world who have attempted to define this syndrome.
  • In addition Dr. Misra has published a number of papers, debated at international fora and suggested new ways to improve ethnic-specific diagnostic criteria for the metabolic syndrome.

Excess Muscle Lipids in Obese Indians:

  • Using magnetic resonance spectroscopy, Dr. Misra and his team have shown high content of intra-myocellular lipids in obese and lean Asian Indians and its absence in correlation with insulin sensitivity. These findings have been reported for the first time in Asian populations and also emphasize the ethnic difference in the deposition of fat.

Adverse Profile of Nutrition and High Prevalence of Sub-clinical Inflammation in Adolescents and Young Asian Indians:

  • A high prevalence of obesity, excess body fat, sedentary activity and imbalanced nutrition in adolescents has been reported by Dr. Misra and his team. High prevalence of hyperinsulinemia and sub-clinical inflammation (marker-C-reactive protein) and their strong correlations to generalized obesity, abdominal obesity and subcutaneous fat in young Asian Indians have also been recently reported by them. They have also shown low plasma adiponectin concentration and other novel cardiovascular risk factors in children. In these series of publications, they have adequately highlighted high future metabolic and cardiovascular risk in young, and prepared a platform for intensive intervention for risk reduction.
  • Importantly, Dr. Misra and his team have reported a new cut off for intake of saturated fat and the importance of n-6 fatty acids in relation to insulin resistance in adolescent population. These findings have important implications for policies for prevention. Their public health awareness activities among children are based on these findings