Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: Implications for definitions of overweight and obesity for Asians
Journal
American Journal of Clinical Nutrition
Journal Volume
79
Journal Issue
1
Pages
31-39
Date Issued
2004
Author(s)
Abstract
Background: Recommendations based on scanty data have been made to lower the body mass index (BMI; in kg/m2) cutoff for obesity in Asians. Objective: The goal was to compare relations between BMI and metabolic comorbidity among Asians and US whites and blacks. Methods: We compared the prevalence rate, sensitivity, specificity, predictive values, and impact fraction of comorbidities at each BMI level and the BMI-comorbidity relations across ethnic groups by using data from the third National Health and Nutrition Examination Survey and the Nutrition and Health Survey in Taiwan (1993-1996). Results: For most BMI values, the prevalences of hypertension, diabetes, and hyperuricemia were higher for Taiwanese than for US whites. In addition, increments of BMI corresponded to higher odds ratios in Taiwanese than in US whites for hypertriglyceridemia (P = 0.01) and hypertension (P = 0.075). BMI-comorbidity relations were stronger in Taiwanese than in US blacks for all comorbidities studied. BMIs of 22.5, 26, and 27.5 were the cutoffs with the highest sum of positive and negative predictive value for Taiwanese, US white, and US black men, respectively. The same order was observed for women. For BMIs >27, >85% of Taiwanese, 66% of whites, and 55% of blacks had at least one of the studied comorbidities. However, a cutoff close to the median of the studied population was often found by maximizing sensitivity and specificity. Reducing BMI from >25 to <25 in persons in the United States could eliminate 13% of the obesity comorbidity studied. The corresponding cutoff in Taiwan is slightly <24. Conclusion: These data suggest a possible need to set lower BMI cutoffs for Asians, but where to draw the line is a complex issue. ? 2004 American Society for Clinical Nutrition.
Subjects
Asians; BMI; Definitions; Diabetes mellitus; Dyslipidemia; Ethnicity; Hypertension; Hyperuricemia; Obesity; Overweight
SDGs
Other Subjects
article; Asian; body mass; Caucasian; comorbidity; comparative study; correlation analysis; data analysis; diabetes mellitus; ethnic difference; health survey; human; hypertension; hypertriglyceridemia; hyperuricemia; metabolic disorder; Negro; nutritional health; obesity; prediction; prevalence; race difference; sensitivity and specificity; Taiwan; United States; weight reduction
Publisher
American Society for Nutrition
Type
journal article
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