Key result
Filipino-Canadians had significantly higher odds of having at least one cardiometabolic condition (OR 1.29) compared to South Asians, whereas Chinese (OR 0.63) and Arab-Canadians (OR 0.38) had lower odds.
Why the study?
Do WHO Asian-specific BMI cut-offs identify increased cardiometabolic risk across different Asian-Canadian sub-groups compared to normal weight?
Cross-Sectional (n=18,794)
Yes
Do WHO Asian-specific BMI cut-offs identify increased cardiometabolic risk across different Asian-Canadian sub-groups compared to normal weight?
Effect estimate: OR 1.29 (95% CI 1.04-1.62)
The use of WHO Asian-specific BMI cut-offs (≥23 and ≥27.5 kg/m2) effectively identifies obesity-related cardiometabolic risks in various Asian-Canadian sub-groups that traditional BMI categories would miss.
Ethnic variations in cardiometabolic odds among Asian-Canadians may inform targeted screening; leaves open validation of WHO BMI cut-offs in prospective studies.
OBJECTIVES: To quantify and compare the association between the World Health Organizations' Asian-specific trigger points for public health action ['increased risk': body mass index (BMI) ≥23 kg/m2, and; 'high risk': BMI ≥27.5 kg/m2] with self-reported cardiovascular-related conditions in Asian-Canadian sub-groups. METHODS: Six cycles of the Canadian Community Health Survey (2001-2009) were pooled to examine BMI and health in Asian sub-groups (South Asians, Chinese, Filipino, Southeast Asians, Arabs, West Asians, Japanese and Korean; N = 18 794 participants, ages 18-64 y). Multivariable logistic regression, adjusting for demographic, lifestyle characteristics and acculturation measures, was used to estimate the odds of cardiovascular-related health (high blood pressure, heart disease, diabetes, 'at least one cardiometabolic condition') outcomes across all eight Asian sub-groups. RESULTS: Compared to South Asians (OR = 1.00), Filipinos had higher odds of having 'at least one cardiometabolic condition' (OR = 1.29, 95% CI: 1.04-1.62), whereas Chinese (0.63, 0.474-0.9) and Arab-Canadians had lower odds (0.38, 0.28-0.51). In ethnic-specific analyses (with 'acceptable' risk weight as the referent), 'increased' and 'high' risk weight categories were the most highly associated with 'at least one cardiometabolic condition' in Chinese ('increased': 3.6, 2.34-5.63; 'high': 8.9, 3.6-22.01). Compared to normal weight South Asians, being in the 'high' risk weight category in all but the Southeast Asian, Arab, and Japanese ethnic groups was associated with approximately 3-times the likelihood of having 'at least one cardiometabolic condition'. CONCLUSION: Differences in the association between obesity and cardiometabolic health risks were seen among Asian sub-groups in Canada. The use of WHO's lowered Asian-specific BMI cut-offs identified obesity-related risks in South Asian, Filipino and Chinese sub-groups that would have been masked by traditional BMI categories. These findings have implications for public health messaging, especially for ethnic groups at higher odds of obesity-related health risks.
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Nie et al. (2014) conducted a cross-sectional in Obesity and cardiometabolic health risk (n=18,794). Asian-specific BMI trigger points ('increased risk' ≥23 kg/m2, 'high risk' ≥27.5 kg/m2) and Asian sub-group ethnicity vs. Acceptable risk BMI (18.5-<23 kg/m2) and South Asian ethnicity was evaluated on At least one cardiometabolic condition (high blood pressure, heart disease, or diabetes) (OR 1.29, 95% CI 1.04-1.62). Filipino-Canadians had significantly higher odds of having at least one cardiometabolic condition (OR 1.29) compared to South Asians, whereas Chinese (OR 0.63) and Arab-Canadians (OR 0.38) had lower odds.
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