Obesity and visceral fat in Indonesia: An unseen epidemic? A study using iDXA and surrogate anthropometric measures

Objective: Indonesia's dramatic rise in chronic disease belies their relatively low obesity prevalence. This study provides normative iDXA and anthropometry measures in an Indonesian cohort. We also compare obesity prevalence determined by traditional measures. Methods: 2623 Indonesian adults were measured by an iDXA and had waist and hip circumferences collected. Normative data were stratified by sex and age. Obesity prevalence was compared using body mass index (BMI) and body fat percentage (BF%). Specificity, sensitivity, and Youden's Index evaluated the ability of cut-off values to identify individuals with high visceral adipose tissue (VAT). Results: Overweight and obese prevalence by BF% was 72 % for males and 63 % for females. BMI incorrectly categorized 40 % of obese individuals as normal/overweight. Waist circumference provided the highest Youden's Index (0.69–0.73), identifying 91 % of Indonesians with high VAT mass. Conclusions: Normative BF% and VAT mass are higher among Indonesians when compared with Caucasian populations. This highlights the rise of chronic disease is potentially due to high BF% and VAT mass. Compared with criterion iDXA BF%, obesity prevalence is severely underestimated by BMI. Measuring waist circumference is recommended in clinical settings due to its ability to identify participants with high VAT mass.