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Background <p>Obesity is increasingly affecting military personnel, yet its accurate assessment remains challenging because body mass index (BMI) does not distinguish between fat and lean mass; percent body fat (PBF) offers a more physiologically meaningful alternative. However, data on PBF-defined obesity prevalence and its predictors among elite Indian military personnel, such as Indian federal contingency force (IFCF) commandos, remain scarce.</p> Methods <p>We conducted a cross-sectional study among 116 IFCF personnel stationed in Gujarat, western India. PBF was measured using direct segmental multi-frequency bioelectrical impedance analysis (InBody 770) and served as the reference standard, with PBF-defined obesity considered as PBF ≥ 25%. BMI-based obesity was classified using both Asian (BMI ≥ 25&#xa0;kg/m²) and WHO (BMI ≥ 30&#xa0;kg/m²) criteria, with diagnostic accuracy of BMI evaluated via receiver operating characteristic (ROC) analysis. Data on demographics, service-related factors, physical activity (Global Physical Activity Questionnaire), and eating behavior (Adult Eating Behavior Questionnaire) were additionally collected, and predictors of obesity identified using multivariable Firth-penalized logistic regression.</p> Results <p>PBF-defined obesity prevalence was 16% (95% confidence interval [CI]: 10–23%). The Asian BMI criterion overestimated obesity at 28% (95% CI: 20–36%), while the WHO criterion identified no obese individuals. BMI demonstrated good discriminative ability (AUC, 0.85; 95% CI: 0.75–0.95). The Asian BMI criterion showed sensitivity of 78% and specificity of 82%. The empirically derived optimal cut-off (25.4&#xa0;kg/m²), closely approximated the Asian threshold. Each additional year of age increased obesity odds by 15% (95% CI: 1.03–1.31), those recruited from central armed police forces had 75% lower odds compared to army (95% CI: 0.06–0.83), and every additional 1000 MET-minutes/week of physical activity reduced obesity odds by 31% (95% CI: 0.45–0.98).</p> Conclusion <p>Approximately one in six IFCF commandos were obese by PBF-based criterion. The WHO BMI criterion substantially underestimated obesity, while the Asian BMI criterion closely aligned with the PBF-derived cut-off. These findings support the Asian BMI criterion for obesity screening, while supplementary PBF assessment may be considered where feasible. Obesity prevention efforts should prioritize individuals at greater risk, such as older personnel and those in service roles involving relatively lower physical activity.</p>

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Prevalence and predictors of percent body fat-defined obesity among federal contingency force commandos in India: implications for military obesity standards

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Devika Bhat,
  • Rakshit Shah,
  • Mihir Rupani,
  • Nitishkumar Tank,
  • Ankit Sheth,
  • Ankit Viramgami,
  • Sanjay Kotadiya

摘要

Background

Obesity is increasingly affecting military personnel, yet its accurate assessment remains challenging because body mass index (BMI) does not distinguish between fat and lean mass; percent body fat (PBF) offers a more physiologically meaningful alternative. However, data on PBF-defined obesity prevalence and its predictors among elite Indian military personnel, such as Indian federal contingency force (IFCF) commandos, remain scarce.

Methods

We conducted a cross-sectional study among 116 IFCF personnel stationed in Gujarat, western India. PBF was measured using direct segmental multi-frequency bioelectrical impedance analysis (InBody 770) and served as the reference standard, with PBF-defined obesity considered as PBF ≥ 25%. BMI-based obesity was classified using both Asian (BMI ≥ 25 kg/m²) and WHO (BMI ≥ 30 kg/m²) criteria, with diagnostic accuracy of BMI evaluated via receiver operating characteristic (ROC) analysis. Data on demographics, service-related factors, physical activity (Global Physical Activity Questionnaire), and eating behavior (Adult Eating Behavior Questionnaire) were additionally collected, and predictors of obesity identified using multivariable Firth-penalized logistic regression.

Results

PBF-defined obesity prevalence was 16% (95% confidence interval [CI]: 10–23%). The Asian BMI criterion overestimated obesity at 28% (95% CI: 20–36%), while the WHO criterion identified no obese individuals. BMI demonstrated good discriminative ability (AUC, 0.85; 95% CI: 0.75–0.95). The Asian BMI criterion showed sensitivity of 78% and specificity of 82%. The empirically derived optimal cut-off (25.4 kg/m²), closely approximated the Asian threshold. Each additional year of age increased obesity odds by 15% (95% CI: 1.03–1.31), those recruited from central armed police forces had 75% lower odds compared to army (95% CI: 0.06–0.83), and every additional 1000 MET-minutes/week of physical activity reduced obesity odds by 31% (95% CI: 0.45–0.98).

Conclusion

Approximately one in six IFCF commandos were obese by PBF-based criterion. The WHO BMI criterion substantially underestimated obesity, while the Asian BMI criterion closely aligned with the PBF-derived cut-off. These findings support the Asian BMI criterion for obesity screening, while supplementary PBF assessment may be considered where feasible. Obesity prevention efforts should prioritize individuals at greater risk, such as older personnel and those in service roles involving relatively lower physical activity.