{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T12:08:46Z","timestamp":1779797326696,"version":"3.53.1"},"reference-count":28,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Weight-for-height (WHZ) and body mass index (BMI)-for-age (BAZ) are commonly used to assess child overnutrition but have limitations: they conflate skeletal growth with body weight, correlate with height, and inadequately distinguish fat from lean mass, particularly during puberty. This study proposes an India-specific generalised body mass index (gBMI), an age- and sex-specific power-type index adapted from Benn\u2019s concept, to better capture adiposity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Exponent parameters for gBMI were estimated using healthy-child data, selected by WHO selection criteria, from the National Family Health Survey (NFHS-3,4,5) and the Comprehensive National Nutrition Survey (CNNS), comprising 12,466 children under 5 years and 6,487 aged 5\u201319 years. Polynomial regression to model age- and sex-specific variation in the weight\u2013height relationship was used to estimate the exponents of height, and growth curves were generated using generalised additive models for location, scale, and shape (GAMLSS) with location scale and shape (LMS) methods. Validation employed independent data from 457 urban schoolchildren aged 5\u201316 years in Bengaluru, including fat and lean mass measured by dual-energy X-ray absorptiometry (DXA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The exponent varied with age (1.3 in infancy, \u223c2.9 in pubertal boys, 2.7 in girls, stabilising at \u223c2 in late adolescence). Unlike BMI, gBMI residuals showed near-zero correlation with height. gBMI-for-age Z-scores (gBAZ) showed lower wasting in children under 5 years (10.7%\n                      <jats:bold>\n                        <jats:italic>vs<\/jats:italic>\n                      <\/jats:bold>\n                      . 19.2% using WHZ) and higher adolescent overnutrition (8.7%\n                      <jats:italic>vs.<\/jats:italic>\n                      &lt;1% using BAZ). Validation showed stronger association of gBAZ with body fat (r=0.70) than BAZ (r=0.65).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation and conclusions<\/jats:title>\n                    <jats:p>The gBMI provides an adaptable, height-independent, and adiposity-sensitive index for assessing malnutrition and obesity in children and adolescents. Its use could refine nutritional surveillance and interventions, with potential wider applicability with longitudinal evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijmr_2555_2025","type":"journal-article","created":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T12:14:31Z","timestamp":1779020071000},"page":"655-663","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Untangling weight from height: A generalised body mass index (gBMI) approach to evaluating child and adolescent nutritional status in India"],"prefix":"10.25259","volume":"163","author":[{"given":"Rajesh","family":"Majumder","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Manipal Academy of Higher Education, Manipal, Karnataka, India"},{"name":"Division of Biostatistics and Epidemiology, St John\u2019s Research Institute, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anura Viswanath","family":"Kurpad","sequence":"additional","affiliation":[{"name":"Department of Physiology, St John\u2019s Medical College, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshpal Singh","family":"Sachdev","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Kuriyan","sequence":"additional","affiliation":[{"name":"Division of Nutrition, St John\u2019s Research Institute, Bengaluru, Karnataka, India"},{"name":"Department of Physiology, St John\u2019s Medical College, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tinku","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, St John\u2019s Medical College, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santu","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, St John\u2019s Medical College, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"10.25259\/IJMR_2555_2025\/ref-1","doi-asserted-by":"publisher","first-page":"660","DOI":"10.2471\/blt.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"de Onis","year":"2007","journal-title":"Bull World Health Organ."},{"key":"10.25259\/IJMR_2555_2025\/ref-2","first-page":"45","article-title":"The LMS method for constructing normalized growth standards","volume":"44","author":"Cole","year":"1990","journal-title":"Eur J Clin Nutr."},{"key":"10.25259\/IJMR_2555_2025\/ref-3","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1002\/sim.4780111005","article-title":"Smoothing reference centile curves: The lms method and penalized likelihood","volume":"11","author":"Cole","year":"1992","journal-title":"Stat Med."},{"key":"10.25259\/IJMR_2555_2025\/ref-4","doi-asserted-by":"publisher","first-page":"e56078","DOI":"10.1371\/journal.pone.0056078","article-title":"Testing a capacity-load model for hypertension: Disentangling early and late growth effects on childhood blood pressure in a prospective birth cohort","volume":"8","author":"Grijalva-Eternod","year":"2013","journal-title":"PLoS One."},{"key":"10.25259\/IJMR_2555_2025\/ref-5","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1093\/ije\/dyu060","article-title":"Commentary: The paradox of body mass index in obesity assessment: Not a good index of adiposity, but not a bad index of cardio-metabolic risk","volume":"43","author":"Wells","year":"2014","journal-title":"Int J Epidemiol."},{"key":"10.25259\/IJMR_2555_2025\/ref-6","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1038\/pr.2016.253","article-title":"Pubertal height gain is inversely related to peak BMI in childhood","volume":"81","author":"Holmgren","year":"2017","journal-title":"Pediatr Res."},{"key":"10.25259\/IJMR_2555_2025\/ref-7","doi-asserted-by":"publisher","first-page":"e0307238","DOI":"10.1371\/journal.pone.0307238","article-title":"Allometric multi-scaling of weight-for-height relation in children and adolescents: Revisiting the theoretical basis of body mass index of thinness and obesity assessment","volume":"19","author":"Ogata","year":"2024","journal-title":"PLoS"},{"key":"10.25259\/IJMR_2555_2025\/ref-8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1203\/00006450-200102000-00019","article-title":"BMI in childhood and its association with height gain, timing of puberty, and final height","volume":"49","author":"He","year":"2001","journal-title":"Pediatr Res."},{"key":"10.25259\/IJMR_2555_2025\/ref-9","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1046\/j.1467-789x.2001.00031.x","article-title":"Beyond body mass index","volume":"2","author":"Prentice","year":"2001","journal-title":"Obes Rev."},{"key":"10.25259\/IJMR_2555_2025\/ref-10","doi-asserted-by":"publisher","first-page":"S56","DOI":"10.1038\/ijo.2008.87","article-title":"BMI-related errors in the measurement of obesity","volume":"32","author":"Rothman","year":"2008","journal-title":"Int J Obes (Lond)."},{"key":"10.25259\/IJMR_2555_2025\/ref-11","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1038\/ijo.2008.11","article-title":"Accuracy of body mass index in diagnosing obesity in the adult general population","volume":"32","author":"Romero-Corral","year":"2008","journal-title":"Int J Obes (Lond)."},{"key":"10.25259\/IJMR_2555_2025\/ref-12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1111\/ijpo.12100","article-title":"Is infant body mass index associated with adulthood body composition trajectories? An exploratory analysis","volume":"12","author":"Johnson","year":"2017","journal-title":"Pediatr Obes."},{"key":"10.25259\/IJMR_2555_2025\/ref-13","first-page":"580","article-title":"Der Index der K\u00f6rperf\u00fclle als Ma\u00df des Ern\u00e4hrungszustandes [The index of corpulence as a measure of nutritional state]","volume":"68","author":"Rohrer","year":"1921","journal-title":"M\u00fcnchener Medizinische Wochenschrift."},{"key":"10.25259\/IJMR_2555_2025\/ref-14","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1136\/jech.25.1.42","article-title":"Some mathematical properties of weight-for-height indices used as measures of adiposity","volume":"25","author":"Benn","year":"1971","journal-title":"Br J Prev Soc Med."},{"key":"10.25259\/IJMR_2555_2025\/ref-15","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1080\/03014460.2020.1737731","article-title":"Differences in the relationship of weight to height, and thus the meaning of BMI, according to age, sex, and birth year cohort","volume":"47","author":"Johnson","year":"2020","journal-title":"Ann Hum Biol."},{"key":"10.25259\/IJMR_2555_2025\/ref-16","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1136\/jech.28.2.116","article-title":"Weight-height indices Choice of the most suitable index and its association with selected variables among 10,000 adult males of heterogeneous origin","volume":"28","author":"Goldbourt","year":"1974","journal-title":"Br J Prev Soc Med."},{"key":"10.25259\/IJMR_2555_2025\/ref-17","doi-asserted-by":"publisher","first-page":"2521","DOI":"10.1093\/ajcn\/34.11.2521","article-title":"Relative merits of the weight-corrected-for-height indices","volume":"34","author":"Lee","year":"1981","journal-title":"Am J Clin Nutr."},{"key":"10.25259\/IJMR_2555_2025\/ref-18","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1093\/ajcn\/36.4.573","article-title":"Comparison of the Benn index and other body mass indices in nutritional assessment","volume":"36","author":"Garn","year":"1982","journal-title":"Am J Clin Nutr."},{"key":"10.25259\/IJMR_2555_2025\/ref-19","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1093\/ajcn\/44.6.725","article-title":"Correlations of body mass indices with weight, stature, and body composition in men and women in NHANES I and II","volume":"44","author":"Micozzi","year":"1986","journal-title":"Am J Clin Nutr."},{"key":"10.25259\/IJMR_2555_2025\/ref-20","doi-asserted-by":"publisher","first-page":"992","DOI":"10.2105\/ajph.76.8.992","article-title":"Relationship between body mass indices and measures of body adiposity","volume":"76","author":"Revicki","year":"1986","journal-title":"Am J Public Health."},{"key":"10.25259\/IJMR_2555_2025\/ref-21","doi-asserted-by":"publisher","first-page":"e0305790","DOI":"10.1371\/journal.pone.0305790","article-title":"MULT: An allometric body mass index (ABMI) reference to assess nutritional status of multiethnic children and adolescents","volume":"19","author":"de Oliveira","year":"2024","journal-title":"PLoS One."},{"key":"10.25259\/IJMR_2555_2025\/ref-26","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1111\/j.1651-2227.2006.tb02376.x","article-title":"Assessment of differences in linear growth among populations in the WHO multicentre growth reference study","volume":"450","author":"De Onis","year":"2006","journal-title":"Acta Paediatr Suppl."},{"key":"10.25259\/IJMR_2555_2025\/ref-27","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s13312-024-3128-x","article-title":"Anthropometric growth reference for Indian children and adolescents","volume":"61","author":"Majumder","year":"2024","journal-title":"Indian Pediatr."},{"key":"10.25259\/IJMR_2555_2025\/ref-29","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1007\/s13312-023-3009-8","article-title":"Customization of WHO under-five growth standards for an appropriate quantification of public health burden of growth faltering in India","volume":"60","author":"Ghosh","year":"2023","journal-title":"Indian Pediatr."},{"key":"10.25259\/IJMR_2555_2025\/ref-31","doi-asserted-by":"publisher","first-page":"7833","DOI":"10.3390\/ijerph18157833","article-title":"BMI fails to reflect the developmental changes in body fatness between boys and girls during adolescence","volume":"18","author":"Nevill","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"10.25259\/IJMR_2555_2025\/ref-32","doi-asserted-by":"publisher","first-page":"e23101","DOI":"10.1002\/ajhb.23101","article-title":"The allometric scaling of body mass and height in children and adolescents in five countries","volume":"30","author":"Medeiros da Silva Mazzeti","year":"2018","journal-title":"Am J Hum Biol."},{"key":"10.25259\/IJMR_2555_2025\/ref-33","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1038\/s41390-023-02503-7","article-title":"Influence of puberty on relationships between body composition and blood pressure: A cross-sectional study","volume":"94","author":"Kwarteng","year":"2023","journal-title":"Pediatr"},{"key":"10.25259\/IJMR_2555_2025\/ref-34","doi-asserted-by":"publisher","first-page":"521S","DOI":"10.1093\/ajcn\/72.2.521S","article-title":"Growth and pubertal development in children and adolescents: Effects of diet and physical activity","volume":"72","author":"Rogol","year":"2000","journal-title":"Am J Clin Nutr."}],"container-title":["The Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ijmr.org.in\/untangling-weight-from-height-a-generalised-body-mass-index-gbmi-approach-to-evaluating-child-and-adolescent-nutritional-status-in-india\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ijmr.org.in\/untangling-weight-from-height-a-generalised-body-mass-index-gbmi-approach-to-evaluating-child-and-adolescent-nutritional-status-in-india\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:54:13Z","timestamp":1779796453000},"score":1,"resource":{"primary":{"URL":"http:\/\/ijmr.org.in\/untangling-weight-from-height-a-generalised-body-mass-index-gbmi-approach-to-evaluating-child-and-adolescent-nutritional-status-in-india\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":28,"alternative-id":["10.25259\/IJMR_2555_2025"],"URL":"https:\/\/doi.org\/10.25259\/ijmr_2555_2025","relation":{},"ISSN":["0971-5916"],"issn-type":[{"value":"0971-5916","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,16]]},"article-number":"655"}}