BMI in Asians

Posted by Graham McMahon • February 25th, 2011

In the Original Article, Association between Body-Mass Index and Risk of Death in More Than 1 Million Asians, Zheng et al. present pooled analyses of the associations between BMI and risk of death in more than 1.1 million people from 19 cohorts in Asia after a mean follow-up of 9.2 years. Underweight was associated with a substantially increased risk of death in all Asian populations.

Over the past few decades, there has been a dramatic increase in the prevalence of obesity in many countries. The World Health Organization estimates that more than 1 billion adults worldwide are overweight; of these, at least 300 million are obese.

Clinical Pearls

What risks are associated with an increased BMI?

Obesity is associated with multiple chronic diseases, including type 2 diabetes, hypertension, coronary heart disease, stroke, and several cancers.

How does BMI differentially affect risk in Europe and Asia?

Studies have shown that for a given BMI, Asians generally have a higher percentage of body fat than do Europeans. Asian populations have also been shown to have an elevated risk of type 2 diabetes, hypertension, and hyperlipidemia at a relatively low level of BMI.

Morning Report Questions

Q: What BMI cutoff points for overweight and obesity have been suggested for Asian patients?

A: The suggested cutoff points for Asians are greater than/equal to 23.0 for overweight and greater than/equal to 25.0 for obesity.

Q: What did this study conclude?

A: Underweight was associated with a substantially increased risk of death in all Asian populations. The excess risk of death associated with a high BMI, however, was seen among East Asians but not among Indians and Bangladeshis.

2 Responses to “BMI in Asians”

  1. Hao Xie says:

    Regarding the morning report question #1, the BMI cutoff points recommendation for Asian patient is not supported by this article. In fact, this article concluded patients with BMI 24-27 has the lowest mortality rate. Considering the potential confounding in this study, the recommendation of a different BMI cutoff for Asian patients compared to Caucasian patients is still controversial. Reference 3 of this article (Lancet 2004) also supported the controversy in this field.

  2. Ken T says:

    This is an old, but, according to Google, still popular article, so it should be noted that it covers Asians *living in Asia*, which is very different from Asians living in Western countries.