Obesity among Asian Indians
- Asian Indians are at high risk for the development of metabolic disturbances, diabetes, atherosclerosis and cardiovascular diseases (CVD) than any other populations at any given body mass index (BMI) ─ the standard measure of obesity (Table 007).1, 2 3
- Obesity is traditionally defined as a percentage body fat of >25% in men and >32% in women. Asians in general and Indians in particular have a greater amount of fat and less muscle mass than whites, for the same weight and BMI.4 Besides, BMI does not accurately predict body fat or cardiometabolic risk among Indians. Hence the use of universal BMI cut-off points is not appropriate for comparison of obesity prevalence between various ethnic groups.4, 5
- Asian Indians have more abdominal (visceral) fat deposition than Europids.4 For the same BMI, percentage body fat is 7-8% points higher for Asian Indians compared to Europids.5
- Conversely, for the same percentage body fat, BMI is 3-6 units lower for Asian Indians compared to Europids. 4-6 The exact opposite occurs in Pacific Islanders and blacks who have 4% points lower percentage body fat than whites for the same BMI.4, 5
- Lean non-diabetic Asian Indians in Singapore had significantly higher body fat percentage (27%) than Chinese (20%) and Europids (23%) matched for age, BMI and physical activity.7 This partially explains the greater adverse metabolic sequelae from obesity for Indians.3
- One Indian study showed that 26% of men had body fat >25% despite having a BMI< 25.8 Other studies from India have shown that the optimum BMI is 21·5 for males and 19·0 for females for identifying people with higher percentage body fat. 9, 10 Another study from South India showed the optimal BMI cut-off point for identifying cardiometabolic risk was 23 in both sexes.11
- Canadian studies have shown that Indians develop glucose and lipid abnormalities at 6 points lower BMI values compared to Europids.12 US studies have shown that at any BMI, Indians in the US have double the prevalence of metabolic syndrome and 3 times the prevalence of diabetes than that of whites (even after fully adjusting for age, sex, education, income, smoking , alcohol use and physical activity).13, 14
- The New Indian guidelines has been released jointly by the health ministry, the Diabetes Foundation of India, the All-India Institute of Medical Science, Indian Council of Medical Research, the National Institute of Nutrition and 20 other health organizations. This has set new, tighter standards for healthy BMI and waist measurement that are consistent with the recommendations of the Indo-US health Summit, WHO and Joint societies. 15-18
- For Asian Indians, the healthy BMI is 23 (kg/m2) for both sexes. A BMI above 23-25 is considered overweight compared to 25 and 30 for Europids. A BMI above > 25 is considered obese among Asians, compared to >30 for Europids.
- A 5’6” Indian, who weighs more than 155 lbs, would be considered obese, compared to 185 lbs, for whites ─ a difference of 30 pounds (Table 008).
- The prevalence of obesity among Asian Indians in the US is 11% using the standard criteria Of but increases to 50% using Asia pacific Indian criteria with another 25% for overweight.19 Both these figures are substantially higher than the US average.
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