title: Using appropriate body mass index cut points for overweight and obesity among Asian Americans.
abstract: OBJECTIVE
  Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California.
  
  
  METHODS
  Secondary analysis of the 2009 adult California Health Interview Survey (n=45,946) of non-Hispanic Whites (NHW), African Americans, Hispanics and Asians (Vietnamese, Chinese, Korean, Filipino, South Asian and Japanese). WHO Asian BMI cut points (overweight=23-27.5kg/m(2); obese≥27.5kg/m(2)) were used for Asian subgroups. Standard BMI cut points (overweight=25-29.9kg/m(2); obese≥30kg/m(2)) were applied for other groups.
  
  
  RESULTS
  Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p<0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI=23-24.9kg/m(2) and Koreans, Filipinos and Japanese with BMI=27.5-29.9kg/m(2), the ranges WHO recommends as overweight or obese for Asians but not for other groups.
  
  
  CONCLUSIONS
  Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, San Francisco, CA, USA. Electronic address: jane.jih@ucsf.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Jih
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, San Francisco, CA, USA; Department of Health Sciences, College of Science, California State University, East Bay, Hayward, CA, USA.
authors.forename: Arnab
authors.initials: A
authors.lastname: Mukherjea
authors.affiliation: Division of Biostatistics, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, San Francisco, CA, USA.
authors.forename: Tung T
authors.initials: TT
authors.lastname: Nguyen
authors.affiliation: Asian American Research Center on Health, San Francisco, CA, USA; Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Janice Y
authors.initials: JY
authors.lastname: Tsoh
authors.affiliation: Asian American Research Center on Health, San Francisco, CA, USA; Institute for Health & Aging/Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, CA, USA.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Fukuoka
authors.affiliation: Asian American Research Center on Health, San Francisco, CA, USA; Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Melinda S
authors.initials: MS
authors.lastname: Bender
authors.affiliation: Asian American Research Center on Health, San Francisco, CA, USA; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
authors.forename: Winston
authors.initials: W
authors.lastname: Tseng
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Asian American Research Center on Health, San Francisco, CA, USA.
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
mesh_terms: D000328:Adult; D001741:Black or African American; D001213:Asian / Q000208:ethnology / Q000706:statistics & numerical data*; D044466:Asian People / Q000208:ethnology / Q000706:statistics & numerical data; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000208:ethnology*; D050177:Overweight / Q000145:classification / Q000208:ethnology; D015995:Prevalence; D012016:Reference Values; D013997:Time Factors; D044465:White People / Q000706:statistics & numerical data; D014944:World Health Organization
keywords: Asian Americans; Minority health; Obesity; Overweight; Type 2 diabetes mellitus
references.citation: Diabetes Care. 2011 Aug;34(8):1741-8
references.pmid: 21680722
references.citation: Am J Public Health. 2008 Jan;98(1):70-7
references.pmid: 18048787
references.citation: World Health Organ Tech Rep Ser. 1995;854:1-452
references.pmid: 8594834
references.citation: J Intern Med. 2003 Dec;254(6):555-63
references.pmid: 14641796
references.citation: J Phys Act Health. 2012 Jul;9(5):634-41
references.pmid: 21946117
references.citation: Prev Chronic Dis. 2009 Oct;6(4):A121
references.pmid: 19754997
references.citation: Obesity (Silver Spring). 2007 Nov;15(11):2817-24
references.pmid: 18070773
references.citation: Diabetes Care. 2004 Jan;27(1):66-9
references.pmid: 14693968
references.citation: JAMA. 2003 Jan 8;289(2):229-30
references.pmid: 12517236
references.citation: Lancet. 2004 Jan 10;363(9403):157-63
references.pmid: 14726171
references.citation: Am J Clin Nutr. 2004 Jan;79(1):31-9
references.pmid: 14684394
references.citation: Diabetes Care. 2013 Jan;36 Suppl 1:S11-66
references.pmid: 23264422
references.citation: Int J Obes Relat Metab Disord. 2000 Sep;24(9):1188-94
references.pmid: 11033989
references.citation: Diabetes Care. 2013 Feb;36(2):289-93
references.pmid: 22966093
references.citation: Obes Rev. 2007 Jul;8(4):307-26
references.pmid: 17578381
references.citation: Diabetes Care. 2011 Aug;34(8):1791-3
references.pmid: 21715521
references.citation: JAMA. 2012 Aug 8;308(6):619-20
references.pmid: 22871873
references.citation: Ann Acad Med Singap. 2009 Jan;38(1):66-9
references.pmid: 19221673
references.citation: Can J Public Health. 2008 Sep-Oct;99(5):423-7
references.pmid: 19009930
references.citation: J Am Coll Cardiol. 2002 Feb 20;39(4):578-84
references.pmid: 11849854
references.citation: BMC Public Health. 2013 Apr 15;13:348
references.pmid: 23587253
references.citation: Epidemiol Rev. 2007;29:6-28
references.pmid: 17510091
references.citation: Diabetes Care. 2012 May;35(5):1181-8
references.pmid: 22517939
references.citation: N Engl J Med. 2011 Feb 24;364(8):719-29
references.pmid: 21345101
references.citation: Nutr J. 2005 Oct 06;4:27
references.pmid: 16209706
references.citation: Diabetes Care. 2009 Sep;32(9):1644-6
references.pmid: 19509010
references.citation: BMJ. 2013 Oct 01;347:f5446
references.pmid: 24473060
references.citation: Ethn Dis. 2012 Winter;22(1):72-8
references.pmid: 22774312
references.citation: Int J Obes Relat Metab Disord. 2003 Nov;27(11):1297-9
references.pmid: 14574338
references.citation: Circulation. 2007 Apr 24;115(16):2111-8
references.pmid: 17420343
references.citation: JAMA. 1999 Oct 27;282(16):1523-9
references.pmid: 10546691
references.citation: Am J Clin Nutr. 1990 Dec;52(6):1125-33
references.pmid: 2239790
references.citation: JAMA. 2009 May 27;301(20):2129-40
references.pmid: 19470990
references.citation: Asia Pac J Clin Nutr. 2008;17(3):370-4
references.pmid: 18818155
references.citation: Diabetes Care. 2011 Feb;34(2):353-7
references.pmid: 21216863
references.citation: Obes Res. 1998 Sep;6 Suppl 2:51S-209S
references.pmid: 9813653
references.citation: Obes Rev. 2002 Aug;3(3):141-6
references.pmid: 12164465
references.citation: Asia Pac J Clin Nutr. 2009;18(2):280-4
references.pmid: 19713189
references.citation: J Am Coll Cardiol. 2008 Aug 19;52(8):605-15
references.pmid: 18702962
references.citation: JAMA. 2012 Aug 8;308(6):581-90
references.pmid: 22871870
references.citation: J Immigr Minor Health. 2012 Oct;14(5):890-4
references.pmid: 22089979
references.citation: Q J Med. 1991 Dec;81(296):1021-30
references.pmid: 1808637
references.citation: Arch Intern Med. 2006 Feb 13;166(3):350-6
references.pmid: 16476877
references.citation: Obesity (Silver Spring). 2010 Dec;18(12):2354-61
references.pmid: 20395951
references.citation: Int J Obes (Lond). 2011 Mar;35(3):393-400
references.pmid: 20680014
references.citation: Ann Intern Med. 2012 Sep 4;157(5):373-8
references.pmid: 22733087
references.citation: Diabetes Care. 2013 Mar;36(3):574-9
references.pmid: 23069837
references.citation: Int J Epidemiol. 2003 Jun;32(3):381-5
references.pmid: 12777423
references.citation: Metab Syndr Relat Disord. 2010 Apr;8(2):157-64
references.pmid: 19943798