Evaluation of anthropometric indices for obesity prediction and classification in indian adults: A cross-sectional comparative analysis of waist-to-height ratio, body roundness index, and traditional measures.

Dr. Sundar   Gurunathan; Dr. Vidulatha  Kuppurathinam; Dr. Sangeetha   Kuthalingam

doi:10.51168/sjhrafrica.v6i12.2317

Authors

Dr. Sundar Gurunathan Associate Professor, Department of Anatomy, Government Vellore Medical College, Vellore , Tamilnadu
Dr. Vidulatha Kuppurathinam Associate professor, Department of Anatomy, Coimbatore medical college, Coimbatore, Tamilnadu
Dr. Sangeetha Kuthalingam Assistant Professor, Department of Anatomy, Coimbatore Medical College, Coimbatore, Tamilnadu

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2317

Keywords:

Obesity, Anthropometric indices, Waist-to-height ratio, Body roundness index, Predictive accuracy

Abstract

Background
Obesity is a major public health challenge worldwide and is strongly associated with cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome. Although Body Mass Index (BMI) is widely used for obesity classification, it has limitations in reflecting body fat distribution, particularly central adiposity.

Objective

To evaluate the effectiveness of selected anthropometric indices in predicting obesity among Indian adults and to determine optimal cutoff values for obesity classification.

Methods

A cross-sectional study was conducted among 241 adults (133 females and 108 males) at Coimbatore Medical College, Coimbatore, Tamil Nadu, India. Standard anthropometric measurements were obtained, and derived indices, including WHtR, BRI, WHR, and A Body Shape Index (ABSI) were calculated. Pearson correlation analysis assessed relationships between indices, independent t-tests evaluated gender differences, and Receiver Operating Characteristic (ROC) curve analysis determined predictive accuracy and optimal cutoff values.

Results

WHtR and BRI demonstrated the highest predictive accuracy for obesity classification, each with an AUC of 0.88. BRI showed the highest sensitivity (91%) with 78% specificity, followed by WHtR (sensitivity 87%, specificity 78%). Optimal cutoff values were identified as WHtR ≥ 0.55 and BRI ≥ 4.21. Hip circumference also showed strong predictive performance (AUC 0.89; cutoff 108 cm). Waist circumference exhibited high specificity (92%) with an optimal cutoff of 97 cm but moderate sensitivity (65%). WHR and ABSI were the weakest predictors. Combining indices, particularly waist circumference with BRI, improved classification accuracy (AUC 0.90).

Conclusion

WHtR and BRI are superior to BMI for obesity classification in Indian adults, offering better reflection of central adiposity and improved risk stratification.

Recommendation

Waist-to-Height Ratio and Body Roundness Index should be incorporated into routine clinical and community-based obesity screening programs to facilitate early detection and timely intervention.

Author Biographies

Dr. Sundar Gurunathan , Associate Professor, Department of Anatomy, Government Vellore Medical College, Vellore , Tamilnadu

is the First Author and serves as an Associate Professor of Anatomy at Government Vellore Medical College, affiliated with The Tamil Nadu Dr. M.G.R. Medical University. He completed his MBBS (April 2001) at IRT Perundurai Medical College and obtained his MD in Anatomy (October 2015) from Sri Manakula Vinayagar Medical College, Puducherry. With 13 years of teaching experience, Dr. Sundar is committed to simplifying anatomical concepts through clear language and illustrative line diagrams. His academic interests focus on enhancing anatomy education, integrating visual learning tools, and promoting meaningful understanding among medical students.

Dr. Vidulatha Kuppurathinam , Associate professor, Department of Anatomy, Coimbatore medical college, Coimbatore, Tamilnadu

is an Associate Professor in the Department of Anatomy, Coimbatore Medical College, affiliated with The Tamil Nadu Dr. M.G.R. Medical University. She completed her MBBS (1996–2001) at Coimbatore Medical College and later earned her MD in Anatomy (2012–2015) from Madurai Medical College. With 10 years of teaching experience, including 8 years of postgraduate teaching, she is dedicated to fostering effective learning in medical education. Her academic interests center on innovative teaching strategies and anatomical research, and she remains passionate about advancing scientific knowledge through active research and student mentorship.

Dr. Sangeetha Kuthalingam , Assistant Professor, Department of Anatomy, Coimbatore Medical College, Coimbatore, Tamilnadu

is the 3rd Author and currently serves as an Assistant Professor of Anatomy at Coimbatore Medical College, affiliated with the Tamil Nadu Dr. M.G.R. Medical University. She completed her MBBS (2008) at Fr. Muller Medical College, Mangalore, and earned her MD in Anatomy (2019) from PSG Institute of Medical Sciences & Research, Coimbatore. With 6 years of teaching experience, she is passionate about guiding students and exploring anatomical concepts that support accurate clinical diagnosis. Her academic interests include applied anatomy, medical education, and research aimed at enhancing the clinical relevance of foundational anatomical sciences.

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