Academic journal article American Journal of Health Education

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

Academic journal article American Journal of Health Education

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

Article excerpt

ABSTRACT

Background: The World Health Organization released lower Body Mass Index (BMI) cutoff points for Asian individuals to account for increased body fat percentage (BF%) and risk of obesity-related conditions at a lower body mass index. Purpose: This preliminary study: (1) explores the impact of utilizing Asian BMI standards (compared to universal standards) on the overweight/obese categorization of Asian females and males; and (2) determines whether age, gender, acculturation, and living arrangements are associated with BMI and BF%. Methods: Data on demographic variables, height and weight, BF%, living situation, and language spoken at home were collected from 170 Asian students enrolled in a health course at a public university in California. Results: When Asian BMI cutoffs were applied, categorization of Asian males and females as normal weight decreased significantly. Language spoken at home was not significantly associated with BMI; however, acculturated females tended to have higher BMIs than non- acculturated females, while acculturated males tended to have lower BMIs than non-acculturated males. Discussion: Utilization of Asian-specific BMI cutoffs will significantly increase the reported prevalence of overweight and obesity among Asians. Acculturation to the United States may be a risk factor for overweight/obesity especially among Asian females. Translation to Health Education Practice: Asian-specific BMI cutoffs may be appropriate in clinical settings, given that overweight-obesity related conditions occur at relatively lower rates of BMI and BF% among Asians.

BACKGROUND

The battle against obesity has become one of the greatest public health challenges of the twenty-first century. (1) Prevalence of obesity in the Asia-Pacific regions of the world have typically been lower than that in Europe or the United States. (1) However, increases in urbanization and westernization of many developing countries are now resulting in increased prevalence of overweight and obesity with trends towards more sedentary lifestyles and energy-dense diets with increased fat content. (2)

Overweight and obesity are major contributing factors for cardiovascular diseases in America; the first and second leading cause of death among Asian American and Pacific Islander men and women, respectively. (3,4) Asian American and Pacific Islander (AAPI) populations are among the fastest growing minority populations in the United States. (5) California has the highest percentage (12.1%) of Asian individuals in the United States (6) as well as the highest annual national medical costs related to overweight and obesity in the nation. (7) The impact of overweight and obesity, both physically and economically, is tremendous.

Changing BMI classifications for Asians

Confounding the increase in obesity and its related conditions in the Asia-Pacific regions is the fact that Asians tend to exhibit higher risk for metabolic diseases at lower body mass indices (BMI) than do Europeans, as well as higher body fat percentages (BF%) at the same age, sex, and BMI. (1) These reasons led the World Health Organization and the International Obesity Task Force to suggest lower BMI standards to classify overweight and obese Asians in the year 2000. (1) The universal standards are normal (18.6-24.9), overweight (25-29.9), and obese (> 30). (1) The lowered cutoff points for those of Asian-Pacific descent are normal (18.6 - 22.9), overweight (23-27.4), and obese (> 27.5). (1) The lowered cutoff points were found clinically relevant among many Asian populations in Asia, including Taiwanese, (8) Korean, (9) Japanese, (10) Chinese, Malays, and Asian Indians; (11) however, few studies have been conducted with Asian populations in the United States. If lowered BMI standards are applied to Asian American populations, prevalence of overweight and obesity among Asian Americans may be much higher than currently published levels. …

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