BMI has been the benchmark in evaluating health and fitness for many years. The formula is quite simple: weight in kilograms divided by the square of height in meters. This would easily tell if one is underweight, within the healthy weight range, overweight, or obese. But with new research findings, scientists are now questioning its accuracy and usefulness as a total measure of body composition.

The report, published in The Lancet Diabetes & Endocrinology, has sparked a global conversation on rethinking BMI. Supported by more than 50 international medical experts, the report suggests classifying obesity into "clinical" and "pre-clinical" types for better diagnosis and treatment. The shift underscores a growing consensus: BMI alone may not tell the full story of your health.

While BMI is simple to calculate and universally accessible, it is far from perfect. It does not consider muscle mass, bone density, or fat distribution, leading to misleading conclusions in some cases. For example, athletes with a high muscle mass may be considered overweight, whereas individuals with normal BMI might carry unhealthy amounts of visceral fat.

A landmark study in JAMA Network Open studied more than 155,000 postmenopausal women and found that women with a normal BMI but a waist size over 35 inches were more likely to die from heart disease or cancer compared with their counterparts whose waists are smaller. That makes a great case for how BMI can be insufficient and fat distribution must be factored into account.

Not all body fat is equal. Subcutaneous fat, which lies just beneath the skin, is relatively harmless. The real health danger lies in visceral fat—fat that surrounds internal organs. Unlike subcutaneous fat, visceral fat is metabolically active, releasing stress hormones like cortisol and inflammatory substances that raise blood pressure, blood sugar, and cholesterol levels. These effects significantly increase the risk of conditions such as heart disease, type 2 diabetes, and certain cancers.

BMI Isn't Always the Best Measure of Body Composition — Here's What to Use Instead

Since BMI is not the most reliable measure, scientists and doctors have sought other means to measure body composition more accurately.

1. Waist Circumference

A simple tape measure can provide valuable insight into your health. Measure your waist at the level of your belly button, ensuring the tape is parallel to the ground. For women, a waist measurement under 35 inches is considered healthy, while for men, the goal is under 40 inches.

2. Waist-to-Hip Ratio

This is the ratio of your waist circumference to that of your hips. To calculate it, divide your waist measurement by your hip measurement. According to the National Center for Biotechnology Information, a ratio under 0.8 for women and 0.9 for men is considered healthy.

3. Body Roundness Index (BRI)

A newer method that seems to be receiving more attention involves the Body Roundness Index or BRI: height, weight, and girth are placed together to represent a more advanced view of what body composition says. Research presented in JAMA Network Open offers evidence that this BRI predicts mortality risk greater than BMI in some cases- a promising weapon for public health.

Also Read: Using BMI To Classify People As Obese Is Flawed Say Experts

Ways To Cut Off Unhealthy Fat

The good news is that visceral fat responds well to lifestyle changes. Here are three evidence-based strategies:

Time-Restricted Eating

Adopting an eating window of 12 hours—such as from 7 a.m. to 7 p.m.—can significantly reduce visceral fat, according to a study published in Nutrition Research Reviews. This approach not only helps control caloric intake but also reduces late-night snacking, a known risk factor for abdominal obesity.

Limit Alcohol Intake

Excessive alcohol consumption is associated with increased belly fat. A 2017 study published in Public Health Nutrition revealed that alcohol increases the levels of insulin and encourages the storage of fat in the abdominal area. Limiting alcohol to occasional indulgence helps avoid weight gain in this region.

High-Intensity Interval Training (HIIT)

HIIT involves repeated episodes of high-intensity exercise separated by periods of rest. A review in *Sports Medicine* concluded that HIIT is very effective in reducing visceral and total body fat. It can be noted that adding just 20 minutes of HIIT two times a week can make all the difference.

The reliance on BMI as a sole indicator of health is increasingly being challenged. While it remains a convenient screening tool, its limitations necessitate a broader approach that considers factors like fat distribution, waist circumference, and new metrics such as BRI.

In the simplest of words, health is multi-dimensional, and shifting perspectives from considering weight solely to broader measures of body composition will get people a much clearer understanding of where their health risks are so that they can take the action required for a better quality of life. Through adjustment to diet, exercise, or perhaps through innovative metrics like BRI, health is well within reach of the individual.

This dynamic conversation raises the point about personalized health screenings, which helps everyone get more relevant tools fitting their unique lives and circumstances. As body composition research is enhanced, so do the futures look brighter and brighter for the times of measurement when it comes to health.

Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology.

Association of Normal-Weight Central Obesity With All-Cause and Cause-Specific Mortality Among Postmenopausal Women. JAMA Netw Open. 2019

Waist-Hip Ratio. NIH.

Physiological responses to food intake throughout the day. Nutr Res Rev. 2014

Association between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults. Public Health Nutr. 2017

At 90, Japanese bodybuilder Toshisuke Kanazawa has built an age-defying physique that is a testament to his rigorous training of two hours a day for six days a week. Kanazawa is still able to compete against athletes decades younger than him.

The 19-time national champion recently appeared at the International Fitness and Bodybuilding Federation (IFBB) World Fitness and Bodybuilding Championships in Santa Susanna, Spain, on October 30, 2026.

Although he did not finish on the podium, Kanazawa remains committed to bodybuilding and hopes to compete once more at 93.

“I like to try doing things that nobody else has done, and more than anything I want to pursue bodybuilding for the rest of my life,” he told Reuters.

In interviews with Reuters and The Guardian, Kanazawa has described how he has modified his exercise routine, diet and prioritised recovery to maintain muscle strength as he grows older.

Toshisuke Kanazawa Still Strength Trains For Two Hours A Day

Also read: Whey Protein For Muscle Gain: Do You Really Need 1.6 Grams Of Protein Per Kg?

Kanazawa trains for approximately two hours a day, six days a week, at his gym in Hiroshima, Japan. However, his routine has changed with age. He no longer performs heavy exercises, including squats and bench presses, and prefers using weight-training machines instead of free weights.

He said machines allow him to control movements and adjust resistance according to his physical capabilities. “I do what’s best for me and my body at this age,” he told The Guardian.

His approach speaks about the importance of recovery when it comes to strength training in older adults. It also reinforces that exercise needs to be adapted to changing strength, mobility and recovery capacity rather than maintaining the same intensity throughout life.

Kanazawa Prioritises Muscle Recovery

Kanazawa says recovery takes longer than it did when he was younger. “It takes longer to recover from weights sessions than it used to, so I make sure I rest properly between sets and get around seven hours’ sleep a night,” he told The Guardian.

Adequate recovery is important because resistance exercise creates stress on muscles, which need time to repair and adapt. Older adults may also experience age related stress when it comes to muscle recovery and the ability to build muscle.

Also read: Why Is Excess Belly Fat A Health Concern, Even In People Who Appear To Have A Normal Body Weight?

Kanazawa's Diet For Muscle Building

Kanazawa attributes his physical conditioning to a traditional Japanese diet that he has followed since turning 50. His regular meals include:

• Brown rice: A source of carbohydrates and dietary fibre.
• Natto: Fermented soybeans that provide plant-based protein.
• Miso soup: A traditional fermented soybean-based soup.
• Raw eggs: He has also described adding a couple of raw eggs to his miso soup.

“This is something I’ve been researching and want to learn more about. But ever since I turned 50, I’ve been building muscle by eating a purely Japanese diet which includes brown rice, natto, and miso soup,” he said.

He also revealed that he has reduced his protein shake intake with age. “I used to have six protein shakes a day but now I have three. As I get older, it’s harder to stomach that much liquid,” he said.

Kanazawa has also given up meat and fish and says he has never smoked or consumed alcohol.

Also read: Leading Gastroenterologist Padma Bhushan Dr S K Sarin Shares Dos & Don’ts For Healthy Liver At Times Health Summit 2026

He Adjusted His Training Instead Of Stopping

Kanazawa’s return to competitive bodybuilding at 50 came after he had retired from the sport in his mid-30s. He said he wanted to encourage his wife, who had a chronic illness, and realised that he had lost some of his own strength after retiring.

He eventually returned to competition and went on to win several masters championships. He believes older people should not automatically give up activities they enjoyed when they were younger.

“I worry that too many of them give up on the things they did when they were younger,” he said. He added, “I want to be a bodybuilder until the day I die.”

Strength Training Tips For Older Adults

Muscle mass and strength naturally decline with age due to a process called sarcopenia. This can affect mobility, balance and the ability to perform everyday activities.

The World Health Organization recommends that adults aged 65 and older undertake muscle strengthening exercises involving major muscle groups at least twice a week.

Older adults should also include varied physical activity that emphasises functional balance and strength on three or more days a week. Exercise intensity and type should be adjusted to individual health, fitness and mobility.

India is facing a significant metabolic health challenge, with millions of people living with diabetes or prediabetes. The ICMR-INDIAB study estimated that 101 million Indians have diabetes and 136 million have prediabetes.

What is particularly concerning is that many people at risk may not appear overweight. They may have a normal Body Mass Index (BMI) but carry excess body fat, particularly around the abdomen, putting them at risk of metabolic disorders.

The ‘Thin-Fat Indian’ Phenotype: What Does It Mean?

This is especially relevant to Indians because of differences in body composition and a greater susceptibility to metabolic complications at relatively lower body weights. Research suggests that Asian Indians tend to have a higher body fat percentage, greater abdominal fat accumulation and relatively lower skeletal muscle mass than several other populations with a similar BMI.

This pattern is commonly described as the ‘thin-fat Indian phenotype’, also known as TOFI, or ‘Thin Outside, Fat Inside’. Genetic predisposition, early-life nutritional influences, physical inactivity and dietary habits can all contribute to this phenomenon. As a result, a person who appears slim may still have excess body fat, reduced muscle mass and an increased risk of metabolic disease.

Also read: Exercise Snacking: Short Bursts Of Squats May Build Strength As Effectively As Longer Gym Sessions, Study Finds

Why BMI Alone Cannot Reveal Excess Body Fat

BMI is a useful screening tool, but it measures weight in relation to height and cannot distinguish between fat and muscle. Body fat percentage offers additional information by indicating the proportion of body weight made up of fat. According to clinical guidelines from the Endocrine Society of India, body fat levels exceeding approximately 25% in men and 30% in women may be considered excessive in Indian adults when measured using Dual-Energy X-ray Absorptiometry (DXA).

However, these thresholds should be interpreted alongside age, fat distribution, muscle mass and other metabolic parameters. A normal BMI alone cannot rule out excess body fat or an underlying metabolic risk.

Visceral Fat: How Belly Fat Affects Metabolic Health

The location of fat accumulation is equally important. Subcutaneous fat lies beneath the skin, while visceral fat accumulates deep within the abdomen, surrounding internal organs. Excess visceral fat can release free fatty acids and inflammatory substances that contribute to insulin resistance, abnormal cholesterol metabolism and chronic low-grade inflammation.

Over time, these changes can increase the risk of type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, hypertension and cardiovascular disease. In Indian adults, a waist circumference of 90 cm or more in men and 80 cm or more in women indicates increased abdominal adiposity and warrants further metabolic risk assessment.

Also read: The Changing Obesity Treatment Landscape: Where Does Bariatric Surgery Fit in the Age of Weight-Loss Drugs?

Can Dietary Changes Help Reduce Metabolic Risk?

Addressing this risk requires a shift in how we approach everyday nutrition and physical activity. Traditional Indian meals can sometimes be disproportionately high in carbohydrates, with rice, rotis and potatoes taking up much of the plate while protein-rich foods receive less attention.

Including adequate protein through dal, pulses, dairy, paneer, soy, eggs, fish or lean meat can help preserve muscle mass and support metabolic health. Carbohydrates do not need to be eliminated; instead, the focus should be on balanced portions, fibre-rich foods and overall dietary quality.

Resistance Training For Metabolic Health

Physical activity is equally important, particularly resistance training, which helps maintain skeletal muscle and supports glucose metabolism and insulin sensitivity.

While walking and other aerobic activities are beneficial, adults should also incorporate muscle-strengthening exercises at least twice a week. A combination of aerobic exercise and resistance training can help improve body composition and reduce metabolic risk.

Festive Eating And Metabolic Health

Festive seasons and weddings often involve frequent consumption of sweets, fried foods and calorie-dense meals. Occasional indulgence is not the primary concern; rather, repeated overeating combined with reduced physical activity can affect long-term metabolic health. Mindful portions, balanced meals and regular exercise can help people enjoy celebrations without consistently compromising their health.

Ultimately, the weighing scale tells only part of the story. BMI, waist circumference, body fat percentage, muscle mass and metabolic markers such as blood glucose and cholesterol should be considered together to obtain a more complete picture of health. India's fight against diabetes must go beyond weight loss and focus on improving body composition, preserving muscle and reducing excess fat. Looking thin does not necessarily mean being metabolically healthy, and recognising this distinction is an important step towards preventing diabetes and other metabolic disorders.

By Dr. Aparna Govil Bhasker, Consultant Bariatric and Metabolic Surgeon, Saifee Hospital, Mumbai

Finding an hour for the gym is one of the most common reasons people skip workouts. But what if short bursts of exercise at the office or home could deliver similar benefits?

A small trial from China suggests that splitting squats into short bursts throughout the day, a practice known as "exercise snacking", may build strength about as effectively as completing the same workout in one session.

How the trial worked

The study was published in the October 2026 issue of the Journal of Exercise Science & Fitness. It was led by researchers at Tongji University, including Rongxuan Zhai and Lejun Wang. The team recruited 45 male students aged 18 to 25, all with at least six months of regular weight training behind them.

Participants were randomly placed in one of three groups: fragmented resistance training, traditional continuous training, or no supervised training at all. For eight weeks, the two training groups squatted three times a week on a Smith machine under expert supervision, with the weight rising over time for each person. The fragmented group did three separate one-minute bouts of 20 weighted squats. The traditional group did one continuous session of 60. The total amount of work was the same.

What they found

Both training groups got clearly stronger than the control group. According to the study’s abstract, one-rep max squat strength beat the control group by about 20.6 kilograms in the fragmented group and about 28.9 kilograms in the traditional group. ScienceAlert reported that muscular strength, isometric squat force and relative muscular endurance improved in both training groups compared with the control group.

Also Read: Just Four Days Of High-Fat Diet May Increase Inflammation, Study Finds

The traditional group’s gains were larger on paper, but ScienceAlert reported that the difference between the two training styles was not statistically significant. “The present findings do not support the conclusion that traditional continuous resistance training is superior,” the authors concluded.

The one clear difference was enjoyment. Participants who squatted in short bursts reported having more fun than those who did one long session. The authors suggest that “dividing the same training volume into several brief sessions may reduce the perceived burden associated with prolonged exercise while allowing individuals greater flexibility to integrate exercise into their daily schedules.”

Why it matters

“Exercise snacking”, meaning short bouts of activity spread through the day, has become popular in recent years. Earlier research has mostly looked at aerobic activity such as climbing stairs or brisk walking. ScienceAlert noted that it has been linked with better cardiorespiratory fitness and blood sugar control.

This trial looked at resistance training instead. That matters because strength work usually means a dedicated gym session, which is harder to fit into a busy day. Breaking it into one-minute pieces could make it easier to start.

What the study can’t tell us

The trial was small, and the volunteers were young men who already lifted weights. They did one exercise, the squat, for eight weeks. The results may not apply to women, older adults, beginners or other exercises. Because the sessions were supervised, the study also can’t show whether people would keep up short bursts on their own.

ScienceAlert noted that the researchers had expected traditional training to build better endurance than the short bursts. That hypothesis was not supported here. The authors say longer studies in more diverse groups are needed.

The bottom line

For people short on time, this early evidence suggests that a few one-minute sets of squats spread through the day can do much of what a longer session does. It is a promising option, not yet a proven replacement for a full workout. Anyone with a health condition or injury should check with a doctor before starting a new exercise routine.