Canadian global village reality: anthropometric surrogate cutoffs and metabolic abnormalities among Canadians of East Asian, South Asian, and European descent.
OBJECTIVE
To test the appropriateness of body mass index (BMI) and waist circumference (WC) cutoff points derived in largely white populations (ie, those of European descent) for detecting obesity-related metabolic abnormalities among East Asian and South Asian Canadians.


METHODS
Cross-sectional survey.


METHODS
Primary care and community settings in Ontario.


METHODS
Canadians of East Asian (n = 130), South Asian (n = 113), and European (n = 111) descent.


METHODS
Variables for metabolic syndromes, including BMI, WC, body fat percentage, blood pressure, lipid profile, and fasting blood glucose and insulin levels, were measured. Receiver operating characteristics curve analysis was used to generate BMI and WC cutoff points based on various criteria for metabolic syndromes.


RESULTS
Adjusting for sex and age, East Asian Canadians had a significantly lower mean BMI (23.2 kg/m(2)) and mean WC (79.6 cm) than did those of South Asian (26.1 kg/m(2) and 90.3 cm) and European (26.5 kg/m(2) and 89.3 cm) descent (P < .05). The BMI cutoffs for an increased risk of metabolic abnormalities ranged from 23.1 to 24.4 kg/m(2) in East Asian Canadians; 26.6 to 26.8 kg/m(2) in South Asian Canadians; and 26.3 to 28.2 kg/m(2) in European Canadians. Waist circumference cutoffs for increased risk of metabolic abnormalities were relatively low in East Asian men (83.3 to 85.2 cm) and women (74.1 to 76.7 cm), compared with South Asian men (98.8 cm) and women (90.1 to 93.5 cm), as well as European men (91.6 to 95.2 cm) and women (82.8 to 88.3 cm).


CONCLUSIONS
The BMI and WC cutoffs used for defining risk of metabolic abnormalities should be lowered for East Asian Canadians but not for South Asian Canadians. The World Health Organization ethnic-specific BMI and WC cutoffs should be used with caution, particularly with Asian migrants who have resided in Canada for a long period of time.
He
Meizi
M
University of Texas at San Antonio, Department of Health and Kinesiology, One UTSA Circle, San Antonio, TX 78249, USA. meizi.he@utsa.edu
Li
E T S
ET
Harris
Stewart
S
Huff
Murray W
MW
Yau
Chun Y
CY
Anderson
G Harvey
GH
D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D002170:Canada; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005202:Asia, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008659:Metabolic Diseases / Q000208:ethnology*; D008875:Middle Aged; D012372:ROC Curve; D012016:Reference Values; D012737:Sex Factors; D055105:Waist Circumference; D044465:White People
Biomed Environ Sci. 2002 Mar;15(1):83-96
12046553
Int J Obes (Lond). 2005 Jun;29(6):656-67
15782225
Asia Pac J Clin Nutr. 2005;14(1):74-9
15734711
Int J Obes (Lond). 2005 Feb;29(2):228-35
15570315
Int J Obes Relat Metab Disord. 2001 May;25(5):748-52
11360160
Clin Chem. 1993 Apr;39(4):561-77
8472349
Diabetes Care. 2003 May;26(5):1380-4
12716792
Stat Med. 1997 Jul 15;16(13):1529-42
9249923
Int J Obes Relat Metab Disord. 2002 Sep;26(9):1232-8
12187401
CMAJ. 2004 Nov 23;171(11):1361-3
15557589
Diabet Med. 1998 Jul;15(7):539-53
9686693
Circulation. 2005 Oct 25;112(17):2735-52
16157765
Int J Obes Relat Metab Disord. 1998 Dec;22(12):1164-71
9877251
Diabetes Care. 2000 Jan;23(1):57-63
10857969
Lancet. 2004 Jan 10;363(9403):157-63
14726171
Lancet. 2005 Sep 24-30;366(9491):1059-62
16182882
J Am Coll Cardiol. 2007 May 29;49(21):2112-9
17531661
Diabetes Res Clin Pract. 2005 Oct;70(1):63-70
16126124
Am J Clin Nutr. 1994 Jul;60(1):23-8
8017333
Circulation. 2007 Apr 24;115(16):2111-8
17420343
Br J Nutr. 1974 Jul;32(1):77-97
4843734
Atherosclerosis. 2006 Jun;186(2):367-73
16112123
Clin Dermatol. 2004 Jul-Aug;22(4):276-80
15475226
World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
11234459
Diabetologia. 1985 Jul;28(7):412-9
3899825