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Background <p>Body mass index (BMI) is widely used to assess health risk but overlooks fat and lean mass. This limitation is particularly salient for Indigenous/Tribal South Asian populations, who exhibit distinct body composition and cardiometabolic profiles. This study explores the distributions of BMI, fat mass index (FMI), and fat-free mass Index (FFMI) among the&#xa0;Hmar tribe of Northeast India, and evaluates their predictive utility for hypertension, with sex-specific focus.</p> Methods <p>A cross-sectional study was conducted on 1207 adults (598 men, 609 women) using anthropometry, skinfolds, and bioelectrical impedance. BMI was classified using WHO (1995) and WHO Asia-Pacific (2000) criteria. Polynomial regressions generated sex-specific FFMI and FMI reference ranges. ROC analysis evaluated the predictive utility of BMI, FMI, and FFMI for hypertension.</p> Results <p>FFMI/BFMI ranged 16.3–19.2/2.2–5.8&#xa0;kg/m<sup>2</sup> (men) and 15.1–17.5/3.5–7.6&#xa0;kg/m<sup>2</sup> (women) under WHO cutoffs; narrower under Asia-Pacific: 16.3–18.5/2.2–4.5 (men), 15.1–16.7/3.5–6.3 (women), differing from other populations reflecting ethnic variability. Overweight&#xa0;and/or&#xa0;obesity prevalence increased from 32.06% (WHO, 1995) to 49.96% (WHO, 2000). Despite similar BMI and FFMI across sexes, significant differences were observed in FMI (WHO 1995: <i>χ</i><sup>2</sup> = 8.26, <i>p</i> &lt; 0.05; WHO 2000 <i>χ</i><sup>2</sup> = 9.46, <i>p</i> &lt; 0.05). Hypertension affected 21% of participants. FFMI emerged as the strongest predictor of hypertension in men (AUC = 0.704), while BMI was more predictive in women (AUC = 0.761).</p> Conclusion <p>BMI alone is insufficient for assessing cardiometabolic risk among the&#xa0;Hmars. Sex-specific differences in FMI and FFMI, and their predictive value for hypertension, highlight the need for body composition-based population-sensitive screening strategies.</p>

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Is BMI Enough? Body Composition Profiles and Cardiometabolic Risk in Hmar Tribe of Northeast India

  • 期刊论文

  • 发表日期：

    2025年10月17日

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  • Abigail Lalnuneng

摘要

Background

Body mass index (BMI) is widely used to assess health risk but overlooks fat and lean mass. This limitation is particularly salient for Indigenous/Tribal South Asian populations, who exhibit distinct body composition and cardiometabolic profiles. This study explores the distributions of BMI, fat mass index (FMI), and fat-free mass Index (FFMI) among the Hmar tribe of Northeast India, and evaluates their predictive utility for hypertension, with sex-specific focus.

Methods

A cross-sectional study was conducted on 1207 adults (598 men, 609 women) using anthropometry, skinfolds, and bioelectrical impedance. BMI was classified using WHO (1995) and WHO Asia-Pacific (2000) criteria. Polynomial regressions generated sex-specific FFMI and FMI reference ranges. ROC analysis evaluated the predictive utility of BMI, FMI, and FFMI for hypertension.

Results

FFMI/BFMI ranged 16.3–19.2/2.2–5.8 kg/m2 (men) and 15.1–17.5/3.5–7.6 kg/m2 (women) under WHO cutoffs; narrower under Asia-Pacific: 16.3–18.5/2.2–4.5 (men), 15.1–16.7/3.5–6.3 (women), differing from other populations reflecting ethnic variability. Overweight and/or obesity prevalence increased from 32.06% (WHO, 1995) to 49.96% (WHO, 2000). Despite similar BMI and FFMI across sexes, significant differences were observed in FMI (WHO 1995: χ2 = 8.26, p < 0.05; WHO 2000 χ2 = 9.46, p < 0.05). Hypertension affected 21% of participants. FFMI emerged as the strongest predictor of hypertension in men (AUC = 0.704), while BMI was more predictive in women (AUC = 0.761).

Conclusion

BMI alone is insufficient for assessing cardiometabolic risk among the Hmars. Sex-specific differences in FMI and FFMI, and their predictive value for hypertension, highlight the need for body composition-based population-sensitive screening strategies.