PBH 101
Lab Class
Instructor:
Zeeba Zahra Sultana
MBBS (IMC), MPH (NSU), MPhil (Cantab, UK)
Lecturer
Department of Public Health
North South University
Measurement of
Body Mass Index (BMI)
Content
• What is nutrition? What is over and undernutrition?
• What are the functions of fat?
• What are the cause and consequence of obesity?
• What is BMI? How can we calculate it?
• What is the normal range of BMI?
• What are the limitations of BMI estimation?
• What are the alternatives of BMI estimation?
• Application of BMI in public health
NUTRITION AND NUTRIENTS
• Nutrition is the process by which our body takes nutrients from foods and utilizes for
growth, energy production and metabolism
• Nutrients are chemical components found in food that are used for growth, energy
production and metabolism
• Good nutritional status is very important for proper functioning. Good nutritional
status means all the necessary nutrients are present in the body in appropriate
amount
CLASSIFICATION OF MALNUTRITION
Abnormal Nutrition
Normal Nutrition
(Malnutrition)
Under-Nutrition Over-Nutrition
Overweight and Obesity
Protein Energy Micronutrient
Malnutrition Deficiency
Wasting Vitamin A deficiency
Stunting Zinc deficiency
Underweight Iodine deficiency
Iron deficiency
OVERWEIGHT AND OBESITY
• Overweight and obesity are defined as abnormal or excessive fat accumulation that
presents a risk to health
• These conditions are determined by measuring the BMI and following specific cutoffs
• When a person becomes overweight the number and/or size of his/her fat storing cells
increase
• Overweight and obesity usually occurs due to combination of a number of factors, but the
fundamental cause being imbalance between energy consumed and energy spent
DIFFERENT KIND BODY SHAPE
OF BODY FAT BASED ON BODY FAT
FUNCTION OF FAT IN THE BODY
• Energy stores à Fats are the body’s chief form of stored energy (9Kcal/gram)
• Muscle fuel à Fats provide much of the energy to fuel muscular work
• Padding à Fat pads inside the body cavity protect the internal organs from shock
• Insulation à Fats insulate against temperature extremes by forming a fat layer unde skin
• Absorption of vitamin à Fat soluble vitamins (A, D, E and K) require presence of fat for
absorption
CAUSES OF OBESITY
• Dietary choices (processed or fast food, sugary drinks, alcohol) have a large impact on development of
overweight or obesity. Additionally, eating out a lot and having larger portions can increase the risk of obesity
• Physical inactivity due to several reasons like sedentary lifestyle, changing modes of transportation and
increased urbanization can lead to obesity
• Genetics can play an important role in development of obesity. Genes can affect our appetite, satiety (the
sense of fullness), metabolism, food cravings, body-fat distribution, and the tendency to use eating to cope
with stress. More than 400 different genes have been implicated in the causes of overweight or obesity
• Lack of sleep can cause obesity by increasing appetite (ghrelin/leptin pathway), increasing opportunity to
eat and increased fatigue (leading to physical inactivity)
• Composition of gut microbiota (by dictating energy extraction from food) can influence the development of
obesity
CONSEQUENCES OF OBESITY
• Short life expectancy – Obese people have ≥50% increased risk of dying prematurely
• Hypertension and Cardiovascular diseases (Heart attack, Stroke, ,Heart failure)
• Metabolic diseases (type II diabetes, liver cirrhosis, abnormal blood lipid)
• Cancers (Breast, Colon, Kidney, Stomach, Pancreas)
• Reproductive health problems (Polycystic ovary, abnormal periods, infertility)
• Others – Asthma, Joint problems, Bone thinning (osteoporosis), Depression, Gall stones
etc.
Obesity is associated with more than 40 diseases, including all major NCDs
BODY MASS INDEX (BMI)
• BMI is a value derived from the mass and height of a person
• BMI gives us an idea about the amount of fat a person have, by determining the
ideal weight for a person’s height (based on a cutoff) and assuming that the
excess weight is attributable to fat
• To measure a person’s BMI, we have to divide a person’s weight in kilograms by
his/her height in squared meters.
CALCULATION OF BMI
Weight in kilograms
BMI = kg/m2
Height in meter squares
If a person has a height of 67 kilograms and a height of 5 feet 8 inches, what would be his/her BMI?
Height = 5 feet 8 inches Weight = 67 kilograms
= 5 x 12 + 8 inches [1 feet = 12 inches]
67 kg
= 68 inches So the BMI =
(1.7272 meters)2
= 68 x 2.54 cm [1 inch = 2.54 centimeters] 67 kg
= 172.72 cm =
2.9832 m2
= 172.72/100 meters [1 meter = 100 cm]
= 1.7272 meters = 22.4591 kg/m2
= 22.46 kg/m2
RANGE OF BMI (kg/m2)
LIMITATION OF BMI
• PROXY indicator (does not actually measure the fat mass, but
makes an idea about it)
• Cannot differentiate between visceral or subcutaneous fat
• BMI may overestimate (in athletes) or underestimate (in old
age or muscle wasting) fat
• Should not be used for pregnant women or growing children
ALTERNATIVES OF BMI MEASUREMENT
Skin fold thickness Waist circumference Waist-Hip ratio
APPLICATION IN PUBLIC HEALTH
Identifying high risk individuals:
This procedure in public health practice is called "Screening"
Normal
Underweight
Overweight
Obese
APPLICATION IN PUBLIC HEALTH
• Assessing Overweight and Obesity: Categorizing weight status for tracking and analysis.
• Policy Development: Informing policies on nutrition, activity, and obesity prevention.
• Resource Allocation: Targeting interventions to populations in need.
• Epidemiological Studies: Studying weight's impact on health outcomes.
• Health Surveillance: Monitoring changes in population health trends.
• Health Promotion Campaigns: Designing targeted awareness campaigns.
• Program Evaluation: Assessing the effectiveness of interventions.
• Educational Initiatives: Informing the public about health risks.
