Cutoff values for normal anthropometric variables in Asian Indian adults. Snehalatha C, Viswanathan V, Ramachandran A.Demographic Information ( South Asian Americans Leading Together website).Lancet Diabetes Endocrinol 2021 9:419-26. Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study. Caleyachetty R, Barber TM, Mohammed NI, et al.It is one step forward to attain the 'dream-goal' of universal personalized medicine, using traditional clinical tools. Sharpening and refining this common clinical tool by identifying different cutoff values of BMI for different ethnic groups would make it more effective to predict diabetes in a much wider population, with improved accuracy. Despite availability of various simple methods ranging from measurement of waist circumference or WHR to more sophisticated bioelectric impedance, dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI), BMI remains as one of the most common clinical models in predicting emergence of future diabetes. Many explanations, including a larger pool of fat accounting for resilience to infections (a common morbidity among the South Asian population) is offered, but there is no concrete evidence.Įstimation of body fat in predicting cardiometabolic derangement has always been challenging. 4Ī larger BMI thus translates to more diabetes and hypertension but surprisingly, no increase in mortality in this population. 5 While a BMI of more than 30 kg/m 2 (compared to BMI < 25 kg/m 2) had a hazard ratio (HR) of mortality at 1.08 in the South Asian persons, the HR in White persons of similar BMI levels is substantially higher at 1.99. The Global Burden of Disease data published in Lancet in 2010 shows that despite being correlated with hypertension and diabetes, a high BMI was at best a weak predictor of mortality among the South Asian persons. The issue of BMI as a predictor of morbidity and mortality is more than skin deep. Moreover, estimation of body fat by measurement of waist circumference and waist-to-hip-ratio (WHR) have shown to be a stronger predictor of cardiometabolic dysregulation and diabetes than BMI among South Asians. Studies from India 4 have consistently focused on a lower BMI predicting diabetes in this population. South Asian people have a smaller body frame, with variations of distribution of body fat (compared to White persons) with more of visceral adiposity, while a higher propensity to develop diabetes mellitus despite BMI values considered 'normal' for White persons. 3 So, it is important to focus on this large group and define their anthropometric criteria, like BMI, more accurately. There are 5.4 million South Asians in the US while United Kingdom is home to 3.2 million South Asian persons. The 1.9 billion South Asia population (India, Bangladesh, Pakistan, Nepal, Bhutan, Sri Lanka, Maldives) accounts for 24.89% of the total world population. The results show that to predict development of diabetes, the cutoff BMI of 30 kg/m 2 (obesity) for the White population was at par with 28.1 kg/m 2 for Black population, 26.9 kg/m 2 for the Chinese, 26.6 kg/m 2 for Arab and 23.9 kg/m 2 for South Asian adults.Ī lower cutoff BMI of 25 kg/m 2 (overweight) in White adults, translated to a BMI of 23.4 kg/m 2 for Black, 22.2 kg/m 2 for Chinese, 22.1 kg/m 2 for Arab, and a much lower BMI of 19.2 kg/m 2 for South Asian adults is noted.īMI, Diabetes and South Asians – More than Skin Color The data comprised of 1.3 million White adults of whom 97,827 people (6.6%) developed diabetes. The incidence of diabetes was predicted in the White population and then the BMI cutoff reverse calculated by a binomial regression model. The risk of developing diabetes was compared with that of Whites who had a BMI of 30 kg/m 2 and 25 kg/m 2. The first recorded BMI was defined as an index BMI with a 1 year 'blanking' period to prevent reverse casualty (diagnosis of diabetes improves weight watching behavior). A CALIBER phenotyping algorithm was used to identify diabetes. A value of 25-50 kg/m 2 were excluded, as were those with mixed race or missing ethnic data. Body mass index (BMI) is an easy to acquire anthropometric measurement.National Heart Lung, and Blood Institute. Retrieved 1 June 2021 from Īssessing Your Weight and Health Risk. What is the Body Mass Index (BMI)? National Health Service UK. Retrieved from -resources/body-mass-index-(bmi)-calculatorīody-Mass Index (BMI) in Children. Retrieved from īody Mass Index Calculator. Centers for Disease Control and Prevention. Retrieved from īMI Calculator Child and Teen. The Health Effects of Overweight and Obesity.
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