Modelling Body Shape and Size Index (BSSI) Variations: A Quantile Regression and LMS Framework for Obesity Surveillance in Pakistani Populations
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Abstract
Introduction: Obesity is a significant public health concern worldwide, characterised by excessive adiposity linked to various metabolic and cardiovascular diseases. In Pakistan, the prevalence of obesity is rising rapidly, necessitating precise tools for surveillance and early intervention. The Body Shape and Size Index (BSSI) offers a comprehensive measure of body morphology, capturing variations beyond traditional indices like BMI.
Methods: This study employed a cross-sectional, population-based design involving 9,906 participants aged 2 to 60 years from South Punjab, Pakistan. Using stratified random sampling, anthropometric measurements were collected following standardised protocols. Advanced statistical methods, including nonparametric quantile regression and semi-parametric LMS (Lambda-Mu-Sigma) modelling, were applied to develop age- and sex-specific growth charts for BSSI. Additionally, dynamic physiological models based on differential equations were formulated to examine the influence of caloric intake and physical activity on body mass trajectories.
Results: Significant gender differences were observed, with males exhibiting a higher mean BSSI than females. Nonlinear age-related trends revealed accelerated adiposity during adolescence and middle age. Socioeconomic status influenced BSSI, with lower-income groups showing higher values. Growth charts derived from both modelling techniques demonstrated high concordance, providing reliable reference standards across the age spectrum. Dynamic models indicated that increased caloric intake elevates BSSI, while physical activity mitigates adiposity gains over time.
Conclusion: The integrated application of quantile regression, LMS frameworks, and physiological modelling offers robust, population-specific growth standards for BSSI in Pakistani populations. These models facilitate early detection of abnormal body morphology, enabling targeted public health interventions to curb the rising obesity epidemic in Pakistan and comparable settings.
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