Cut‐off Point of BMI and Obesity‐Related Comorbidities and Mortality in Middle‐Aged Koreans

Abstract

OH, SANG WOO, SOON-AE SHIN, YOUNG HO YUN, TAIWOO YOO, AND BONG-YUL HUH. Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans. Obes Res. 2004;12:2031-2040. 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. Research Methods and Procedures: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 Ն 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 Ն 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. Discussion: 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 Ն 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.

Comparison between bioelectrical impedance analysis and body mass index methods in determination of obesity prevalence in Ahvazi women

“…On the other hand, the appropriateness of the BMI cutoffs in Asian populations, in spite of wide accepted application, has been questioned in recent years (Oh et al, 2004;WHO, 2004). Hence, it is prudent to make the diagnosis of obesity based on the measure of percentage body fat.…”

“…On the other hand, the BMI classification of overweight and obesity in Asian populations has been controversial, and investigating whether the accepted BMI cutoff points are appropriate for identifying increased health risks is an important challenge for Asian countries health systems (Oh et al, 2004). A WHO (World Health Organization) expert consultation reviewed scientific evidence, which suggests that Asian populations have different associations between BMI, percentage of body fat and health risks than do European populations, and they concluded that the proportion of Asians with a high risk of type II diabetes and CVD is substantial at BMIs lower than existing WHO cutoff point for overweight (i.e., BMIX25 kg/m 2 ) (WHO, 2004).…”

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis

“…11 Some studies showed that Asians have lower BMI but higher PBF than Caucasians, and that some Asian population's morbidity and mortality of obesity-related diseases are relatively high at a relatively low BMI level. [12][13][14] From those perspectives, the WHO expert consultation recently reported that the universal BMI criteria for adult obesity are not suitable for Asian populations, although no recommendation for new, clear, BMI cutoff points was given for any Asian population. 15 From this perspective, variations in criteria among various ethnic populations should be considered in evaluating obesity in children.…”

Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC Study

“…1 In Japan, the prevalence of obesity has been consistently increasing in men, whereas it has been stable over the last 10 years in women, according to the annual reports of the National Nutrition Survey, Japan (NNS-J); currently, the prevalence of overweight is 30.9% in men and 22.7% in women aged 20 years or older. 2 As persons with overweight and obesity are at an increased risk of type 2 diabetes, hypertension and dyslipidemia, [3][4][5] there is an urgent need to establish strategies to prevent overweight and obesity. In Japan, the Ministry of Health and Welfare has initiated a project of Healthy Japan 21 to encourage changes in lifestyle, 6 and weight reduction is one of the major challenges of this project.…”