Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans.
OBJECTIVE
The need for a lower BMI to classify overweight in Asian populations has been controversial. Using both disease and mortality outcomes, we investigated whether lower BMI cut-off points are appropriate for identifying increased health risk in Koreans.


METHODS
We conducted a cohort study among 773,915 men and women from 30 to 59 years old with 8- to 10-year follow-up periods. Primary outcomes were change of obesity prevalence, obesity-related disease incidence, and all-cause mortality.


RESULTS
Prevalence of overweight (BMI of 25.0-29.9) has steadily increased (1.3% annually), whereas obesity (BMI > or = 30) showed a lower prevalence and only a slight increase (0.1%-0.2% annually). Our study revealed that dose-response relationships exist between obesity and related disease incidences (hypertension, type 2 diabetes, and hypercholesterolemia) beginning at lower BMI levels than previously reported. Compared with those in the healthy weight range, Koreans with a BMI > or = 25 were not at greater risk of hypertension, type 2 diabetes, or hypercholesterolemia than has been reported for whites in similar studies. Obesity-related all-cause mortality also did not seem so different from that of whites.


CONCLUSIONS
Our findings did not support the use of a lower BMI cut-off point for defining overweight in Koreans compared with whites for the purpose of identifying different risks. However, populations with BMI > or = 25 are rapidly increasing and have substantial risks of diseases. To preempt the rapid increases in obesity and related health problems that are occurring in Western countries, Korea should consider using a BMI of 25 as an action point for obesity prevention and control interventions.
Oh
Sang Woo
SW
Department of Family Medicine and Center for Health Promotion, Ilsan-paik Hospital, College of Medicine, Inje University, Goyang, South Korea. osw6021@yahoo.co.kr
Shin
Soon-Ae
SA
Yun
Young Ho
YH
Yoo
Taiwoo
T
Huh
Bong-Yul
BY
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012016:Reference Values