Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians

Pan, Wen‐Harn; Flegal, Katherine M.; Chang, Hsing-Yi; Yeh, Wen-Ting; Yeh, Chih‐Jung; Lee, Wen‐Chung

doi:10.1093/ajcn/79.1.31

Cited by 312 publications

(249 citation statements)

References 25 publications

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“…The data collected on smoking, physical activity, and diet from the self‐administered questionnaires may be subject to recall bias. Future modifications of the LS7 metrics could make BMI specific for each racial/ethnic group because some studies have demonstrated that Asians are at a higher risk of weight‐related diseases, such as CVDs, at lower BMIs 37, 38, 39, 40…”

Section: Discussionmentioning

confidence: 99%

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Oni

Michos

et al. 2017

JAHA

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BackgroundThe American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We sought to examine the association between the LS7 metrics and incident heart failure (HF) in a multiethnic cohort.Methods and ResultsWe analyzed data from 6506 participants of the Multi‐Ethnic Study of Atherosclerosis free of cardiovascular disease at baseline. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) were graded on a scale of 0 to 2, with 2 indicating “ideal” status, 1 “intermediate” status, and 0 “poor” status. Points were summed, thus the LS7 score ranged from 0 to 14. Cox proportional hazard ratios and incidence rates of HF per 1000 person‐years were calculated. During a median follow‐up of 12.2 years, 262 (4%) participants developed HF. Incidence of HF decreased as the number of ideal LS7 metrics increased; 5.9 per 1000 person‐years for participants with 0 to 1 ideal metrics and 0.6 per 1000 person‐years for those with 6 to 7 ideal metrics. Compared with inadequate scores (0–8 points), hazard ratios for HF were 0.57 (0.43–0.76) and 0.31 (0.19–0.49) for average (9–10 points) and optimal (11–14 points) scores, respectively. A similar pattern was observed when the results were stratified by 4 racial/ethnic groups: white, Chinese American, black, and Hispanic.ConclusionsA lower risk of HF with more favorable LS7 status regardless of race/ethnicity suggests that efforts to achieve ideal cardiovascular health may reduce the burden of HF, a major source of morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Oni

Michos

et al. 2017

JAHA

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“…This can be explained on several accounts. It has been suggested that 60% of FRAP activity is contributed by uric acid and hyperuricemia as part of the metabolic syndrome [2,[42][43][44] may be responsible for higher FRAP in the NAFLD group. The increase in FRAP levels may occur as a compensatory phenomenon in NA-FLD patients to protect against OS.…”

Section: Discussionmentioning

confidence: 99%

Comparative redox status in alcoholic liver disease and nonalcoholic fatty liver disease

et al. 2008

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Purpose Altered redox status has been implicated in pathogenesis of alcoholic liver disease (ALD) as well as in nonalcoholic fatty liver disease (NAFLD). This study was planned to find the relative role of redox status in these two diseases. Methods A total of 44 patients with ALD and 32 patients with NAFLD and 25 apparently healthy controls were included in the study. Redox status was estimated by measuring oxidative stress (superoxide dismutase (SOD) and lipid peroxidation products as thiobarbituric acid reactive substances (TBARS)) and antioxidant status (ferric reducing ability of plasma (FRAP) and vitamin C). Results TBARS level was raised significantly in both ALD (3.5 (2.3-9.4) vs. 1.8 (0.5-4.1) nmol/ml; P = 0.0001) and NAFLD (5.1 (1-10.2) vs. 1.82 (0.51-4.1) nmol/ml; P = 0.0001) as compared with controls, but was not different between ALD and NAFLD. SOD was significantly higher in ALD as compared to NAFLD (2.4 (1.3-7.8) vs. 0.68 (0.05-19.1) U/ml; P = 0.0001) and controls (1.12 (0.01-3.5) U/ml; P = 0.001). FRAP was lower in ALD as compared with 3) lmol of Fe +2 liberated; P = 0.001) but similar to that of controls (340.9 (141.5-697.5) lmol of Fe +2 liberated). Conclusions ALD patients have a higher degree of redox imbalance as compared with NAFLD patients

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“…Because the metabolic risks at a given BMI value are greater in Asians than Caucasians, it is generally accepted that BMI values used for defining overweight and obesity in Asians should be lower than those used for Caucasians (33,34). Therefore, studies investigating the impact of obesity on balance and mobility outcomes in Asian patients post-TKR should use a BMI cutoff value of 27 kg/m 2 for defining obesity rather than a value of 30 kg/m 2 , which is commonly used for Caucasian patients.…”

Section: Discussionmentioning

confidence: 99%

“…The BMI can be used to distinguish between overweight and obese individuals within a single ethnic group (31). However, BMI cutoff values should be lowered when defining overweight and obesity in Asians (32)(33)(34). Thus, for the Asian patients included in the current study, we used BMI values of 18.5-23.9 kg/m 2 , 24.0-26.9 kg/m 2 , 27.0-29.9 kg/m 2 , 30-34.9 kg/m 2 , and .35 kg/m 2 to define normal weight, overweight, class I obesity, class II obesity, and class III obesity, respectively.…”

Section: Methodsmentioning

confidence: 99%

Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

Liao

Huang

et al. 2015

Arthritis Care & Research

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ObjectiveObesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post‐TKR rehabilitation outcomes. We investigated the effects of obesity on functional mobility outcomes following post‐TKR rehabilitation in Asian patients whose BMIs were not as high as those reported in similar studies performed in non‐Asian countries.MethodsA total of 113 patients were categorized as normal weight (n = 23), overweight (n = 32), class I obese (n = 31), or class II/III obese (n = 27). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2‐month and 6‐month followup assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single‐leg stance, ten‐meter walk, timed up and go, chair rise, and stair climbing.ResultsA 4 × 3 (group × time) repeated‐measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2‐month and 6‐month followup assessments (P < 0.05 for all). No significant intergroup differences at the 2‐month and 6‐month followup assessments were observed for any of the mobility measures except the functional reach and single‐leg stance (P < 0.05).ConclusionPatients with class II/III obesity benefit from early post‐TKR outpatient rehabilitation and respond as well as patients with lower BMIs.

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Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians

Abstract: These data suggest a possible need to set lower BMI cutoffs for Asians, but where to draw the line is a complex issue.

Cited by 312 publications

References 25 publications

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Comparative redox status in alcoholic liver disease and nonalcoholic fatty liver disease

Body Mass Index and Functional Mobility Outcome Following Early Rehabilitation After a Total Knee Replacement: A Retrospective Study in Taiwan

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