Week 1 BMI measurement
Instructor:
Nusrat E Mozid, MD, MPH
Department of Public Health
School of Health and Life Sciences
North South University
March 3, 2025
Agenda
• Introductions
• Syllabus Overview
• Lecture 1: BMI measurement
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?
• 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
➢ 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)
Undernutrition Overnutrition
Overweight and Obesity
Protein Micronutrient
Energy Deficiency
Malnutrition Vitamin A deficiency
Wasting
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 points
➢ When a person becomes overweight the number and/or size of his/her fat
storing cells also increases
➢ 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 - Fats are the body’s chief form of stored energy (9Kcal/gram)
➢ Muscle fuel - Fats provide much of the energy to fuel muscular work
➢ Padding - Fat pads inside the body cavity protect the internal organs from
shock
➢ Insulation - Fats insulate against temperature extremes by forming a fat
layer under skin
➢ Absorption of vitamin - 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
Premature death:
Shorter life expectancy – Obese people have ≥50% increased risk of dying prematurely
Chronic diseases (Non-communicable diseases (NCDs)):
1) Hypertension and Cardiovascular diseases (Heart attack, Heart failure)
2) Metabolic diseases (type II diabetes, liver cirrhosis, abnormal blood lipid)
3) Cancers (Breast, Colon, Kidney, Stomach, Pancreas)
Reproductive health problems:
1) Polycystic ovary syndrome (PCOS)
2) Abnormal menstrual periods
3) 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 square meters.
CALCULATION OF BMI
Weight in kilograms
BMI =
Height in meter squares
If a person has a weight 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]
= 68 inches 67 kg
So, the BMI =
= 68 x 2.54 cm [1 inch = 2.54 centimeters] (1.7272 meters)2
= 172.72 cm 67 kg
=
= 172.72/100 meters [1 meter = 100 cm] 2.9832 m2
= 1.7272 meters
= 22.4591 kg/m2
= 22.46 kg/m2
RANGE OF BMI (kg/m2)
LIMITATION OF BMI
• Cannot differentiate between visceral or subcutaneous fat
• Should not be used for pregnant women or growing children
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.
Next week:
• March 10, 2025
• Lecture 2: Random Blood Sugar Measurement
Let’s measure BMI (kg/m^2)
