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Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians.

Abstract

OBJECTIVES

To assess whether overweight Asians, assessed on the basis of WHO criteria, are at greater mortality risk than overweight Caucasians, and to determine whether alternative cut-off points (BMI = 23.0-24.9 kg/m2 for overweight and BMI >or= 25.0 kg/m2 for obesity) suggested by the WHO Western Pacific Regional Office are appropriate.

DESIGN

The cohort was followed prospectively until the end of 2001. All-cause and CVD mortality risks of the overweight and obese group, relative to the reference group (BMI = 18.5-24.9 or 18.5-22.9 kg/m2), were assessed using Cox regression analysis, adjusting for age, smoking and gender. Excess deaths were estimated with a method proposed by the US Centers for Disease Control and Prevention.

SETTING

National Health Interview Survey (NHIS 2001) and a middle-aged perspective cohort in Taiwan.

SUBJECTS

Subjects comprised 36 386 civil servants and school teachers, aged 40 years and older, who underwent a medical examination during 1989-1992.

RESULTS

In the WHO-defined overweight group, Asians showed a significant increase in all-cause mortality risk compared with Caucasians. Asians showed risks equivalent to Caucasians' at lower BMI (around 5 units). Every unit of BMI increase, at 25.0 kg/m2 or above, was associated with a 9 % increase in relative mortality risk from all causes. Applying a cut-off point of 25.0 kg/m2 for obesity would result a prevalence of 27.1 %, while the traditional WHO cut-off point of 30.0 kg/m2 yielded obesity prevalence of 4.1 %. Excess deaths due to obesity accounted for 8.6 % of all deaths and 21.1 % of CVD deaths, based on the alternative cut-offs.

CONCLUSIONS

In this Asian population, significant mortality risks started at BMI >or= 25.0 kg/m2, rather than at BMI >or= 30.0 kg/m2. The study supports the use of BMI >or= 25.0 kg/m2 as a new cut-off point for obesity and BMI = 23.0-24.9 kg/m2 for overweight. The magnitude of obesity-attributable deaths has been hitherto under-appreciated among Asians.

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  • Authors+Show Affiliations

    ,

    Center for Health Policy Research and Development, National Health Research Institutes, Miaoli County, Taiwan, Republic of China. cwengood@nhri.org.tw

    , , , , ,

    Source

    Public health nutrition 12:4 2009 Apr pg 497-506

    MeSH

    Adult
    Aged
    Asian Continental Ancestry Group
    Body Mass Index
    Cardiovascular Diseases
    Cohort Studies
    European Continental Ancestry Group
    Female
    Humans
    Male
    Middle Aged
    Obesity
    Overweight
    Prevalence
    Proportional Hazards Models
    Reference Values
    Risk
    Smoking
    Taiwan
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    18547457

    Citation

    Wen, Chi Pang, et al. "Are Asians at Greater Mortality Risks for Being Overweight Than Caucasians? Redefining Obesity for Asians." Public Health Nutrition, vol. 12, no. 4, 2009, pp. 497-506.
    Wen CP, David Cheng TY, Tsai SP, et al. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr. 2009;12(4):497-506.
    Wen, C. P., David Cheng, T. Y., Tsai, S. P., Chan, H. T., Hsu, H. L., Hsu, C. C., & Eriksen, M. P. (2009). Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutrition, 12(4), pp. 497-506. doi:10.1017/S1368980008002802.
    Wen CP, et al. Are Asians at Greater Mortality Risks for Being Overweight Than Caucasians? Redefining Obesity for Asians. Public Health Nutr. 2009;12(4):497-506. PubMed PMID: 18547457.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. AU - Wen,Chi Pang, AU - David Cheng,Ting Yuan, AU - Tsai,Shan Pou, AU - Chan,Hui Ting, AU - Hsu,Hui Ling, AU - Hsu,Chih Cheng, AU - Eriksen,Michael P, Y1 - 2008/06/12/ PY - 2008/6/13/pubmed PY - 2009/5/9/medline PY - 2008/6/13/entrez SP - 497 EP - 506 JF - Public health nutrition JO - Public Health Nutr VL - 12 IS - 4 N2 - OBJECTIVES: To assess whether overweight Asians, assessed on the basis of WHO criteria, are at greater mortality risk than overweight Caucasians, and to determine whether alternative cut-off points (BMI = 23.0-24.9 kg/m2 for overweight and BMI >or= 25.0 kg/m2 for obesity) suggested by the WHO Western Pacific Regional Office are appropriate. DESIGN: The cohort was followed prospectively until the end of 2001. All-cause and CVD mortality risks of the overweight and obese group, relative to the reference group (BMI = 18.5-24.9 or 18.5-22.9 kg/m2), were assessed using Cox regression analysis, adjusting for age, smoking and gender. Excess deaths were estimated with a method proposed by the US Centers for Disease Control and Prevention. SETTING: National Health Interview Survey (NHIS 2001) and a middle-aged perspective cohort in Taiwan. SUBJECTS: Subjects comprised 36 386 civil servants and school teachers, aged 40 years and older, who underwent a medical examination during 1989-1992. RESULTS: In the WHO-defined overweight group, Asians showed a significant increase in all-cause mortality risk compared with Caucasians. Asians showed risks equivalent to Caucasians' at lower BMI (around 5 units). Every unit of BMI increase, at 25.0 kg/m2 or above, was associated with a 9 % increase in relative mortality risk from all causes. Applying a cut-off point of 25.0 kg/m2 for obesity would result a prevalence of 27.1 %, while the traditional WHO cut-off point of 30.0 kg/m2 yielded obesity prevalence of 4.1 %. Excess deaths due to obesity accounted for 8.6 % of all deaths and 21.1 % of CVD deaths, based on the alternative cut-offs. CONCLUSIONS: In this Asian population, significant mortality risks started at BMI >or= 25.0 kg/m2, rather than at BMI >or= 30.0 kg/m2. The study supports the use of BMI >or= 25.0 kg/m2 as a new cut-off point for obesity and BMI = 23.0-24.9 kg/m2 for overweight. The magnitude of obesity-attributable deaths has been hitherto under-appreciated among Asians. SN - 1368-9800 UR - https://www.unboundmedicine.com/medline/citation/18547457/Are_Asians_at_greater_mortality_risks_for_being_overweight_than_Caucasians_Redefining_obesity_for_Asians_ L2 - https://www.cambridge.org/core/product/identifier/S1368980008002802/type/journal_article DB - PRIME DP - Unbound Medicine ER -