Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population

Abstract

Research D eveloping countries are increasingly vulnerable to the worldwide epidemic of obesity, which affects all segments of the population, including men, women and now children.1,2 Compared with populations in industrialized countries, those in the developing world appear to be at greater risk of the diseases associated with overweight, and cardiovascular disease has become the leading cause of disability and death in many developing countries. 3-5Worldwide, Indo-Asian people are among the populations at highest risk for cardiovascular disease.6 Evidence also suggests that associations between body mass index (BMI), percentage of body fat and chronic disease may differ between Indo-Asian and European populations.7,8 One proposed explanation for these observations is the effect of poverty and resultant malnutrition during intrauterine and early childhood years, coupled with relative overnutrition in later years.9 There may, however, be other factors at work. Because of the observed differences between populations, the International Association for the Study of Obesity and the International Obesity Task Force have suggested lower BMI cutoff values for the definitions of overweight (23.0-24.9 kg/m 2 ) and obesity (25.0 kg/m 2 or greater) in Asian populations.10,11 Estimates of the prevalence of overweight in IndoAsian countries (India, Pakistan, Bangladesh and Sri Lanka) based on these cutoff values have not been reported. Further, it is not known whether the revised definition of overweight would be valid at a population level in terms of being better associated with the consequences of obesity.We therefore sought to determine the prevalence of overweight and obesity using the Asian-specific BMI definition in a Pakistani population. We also studied factors and conditions (hypertension, diabetes mellitus and raised serum cholesterol concentration) associated with being overweight or obese in the Pakistani population, as well as the sensitivity and specificity of various BMI cutoff values for their association with hypertension and diabetes mellitus.

Associations among physical activity, comorbidities, depressive symptoms and health-related quality of life in type 2 diabetes

“…D iabetes is a chronic disease that affects millions of people and its complications have increasing effects on quality of life and mortality (1,2). The number of people with type 2 diabetes (T2DM) will rise from 135 million in 1995 to 300 million in the year of 2025 (3).…”

Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population

“…The optimal cut-off values for men were lower than those for women regardless of ethnicity for all of the risk factors investigated. This implies that men are at greater risk for CVD than women at a given BMI value (4)(5)(6)12) . Optimal cut-off values for predicting a disease outcome increase with mean BMI when other factors (age, ethnicity, sex, socio-economic status, lifestyle) remain constant.…”

Elevated cardiovascular risk factors in a young, asymptomatic and physically active population within a normal body mass index

“…1 However, BMI cut points for South Asian and Chinese populations have been revised downwards; a BMI of 23.0 -27.4 kg/m² already represents increased cardiovascular risk and that ≥27.5 kg/m² represents high cardiovascular risk. 7 The revision was necessitated by the strong evidence pointing to an increased risk of developing type 2 diabetes, hypertension and dyslipidemia amongst South Asian [8][9][10][11] and Chinese 12 subjects even at BMI levels of <25.0 kg/m², possibly due to a relative excess of adipose tissue or defi cit of lean body mass compared with Europeans for a given BMI. 8,13,14 Studies on Singaporean subjects have demonstrated similar fi ndings; 15,16 in particular, a 70% and 104% increased risk of diabetes was noted for deciles with a mean BMI of only 19.6 and 20.7 kg/m² respectively.…”