Skip to main content
×
Home
    • Aa
    • Aa
  • Access
  • Cited by 105
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Chang, Yoosoo Jung, Hyun-Suk Cho, Juhee Zhang, Yiyi Yun, Kyung Eun Lazo, Mariana Pastor-Barriuso, Roberto Ahn, Jiin Kim, Chan-Won Rampal, Sanjay Cainzos-Achirica, Miguel Zhao, Di Chung, Eun Cheol Shin, Hocheol Guallar, Eliseo and Ryu, Seungho 2016. Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease. The American Journal of Gastroenterology, Vol. 111, Issue. 8, p. 1133.


    Chun, Sohyun Choi, Yuni Chang, Yoosoo Cho, Juhee Zhang, Yiyi Rampal, Sanjay Zhao, Di Ahn, Jiin Suh, Byung-Seong Pastor-Barriuso, Roberto Lima, Joao A.C. Chung, Eun Chul Shin, Hocheol Guallar, Eliseo and Ryu, Seungho 2016. Sugar-sweetened carbonated beverage consumption and coronary artery calcification in asymptomatic men and women. American Heart Journal, Vol. 177, p. 17.


    Hruschka, D. J. and Hadley, C. 2016. How much do universal anthropometric standards bias the global monitoring of obesity and undernutrition?. Obesity Reviews,


    Huang, Chih-Chien Yabiku, Scott T. Ayers, Stephanie L. and Kronenfeld, Jennie J. 2016. The obesity pay gap: gender, body size, and wage inequalities—a longitudinal study of Chinese adults, 1991–2011. Journal of Population Research,


    Johansson, Elin Mei, Hong Xiu, Lijuan Svensson, Viktoria Xiong, Yueling Marcus, Claude Zhang, Jianduan and Hagströmer, Maria 2016. Physical activity in young children and their parents–An Early STOPP Sweden–China comparison study. Scientific Reports, Vol. 6, p. 29595.


    Jung, Yoon Suk Park, Dong Il Kim, Won Hee Eun, Chang Soo Park, Soo-Kyung Ko, Bong Min Seo, Geom Seog Cha, Jae Myung Park, Jae Jun Kim, Kyeong Ok Moon, Chang Mo Jung, Yunho Kim, Eun Soo Jeon, Seong Ran and Lee, Chang Kyun 2016. Risk of Advanced Colorectal Neoplasia According to the Number of High-Risk Findings at Index Colonoscopy: A Korean Association for the Study of Intestinal Disease (KASID) Study. Digestive Diseases and Sciences, Vol. 61, Issue. 6, p. 1661.


    Jung, Yoon Suk Yun, Kyung Eun Chang, Yoosoo Ryu, Seungho and Park, Dong Il 2016. Risk Factors Such as Male Sex, Smoking, Metabolic Syndrome, Obesity, and Fatty Liver Do Not Justify Screening Colonoscopies Before Age 45. Digestive Diseases and Sciences, Vol. 61, Issue. 4, p. 1021.


    Kim, Nam Hee Kwon, Min-Jung Kim, Hyun-young Lee, Taeheon Jeong, Seok Hyeon Park, Dong Il Choi, Kyuyong and Jung, Yoon Suk 2016. Fecal hemoglobin concentration is useful for risk stratification of advanced colorectal neoplasia. Digestive and Liver Disease, Vol. 48, Issue. 6, p. 667.


    Kim, Yeonjung Jeong, Seong Min Yoo, Bora Oh, Bitna and Kang, Hee-Cheol 2016. Associations of smoking with overall obesity, and central obesity: a cross-sectional study from the Korea National Health and Nutrition Examination Survey (2010-2013). Epidemiology and Health, Vol. 38, p. e2016020.


    Lee, Taeyoung Yun, Kyung Eun Chang, Yoosoo Ryu, Seungho Park, Dong Il Choi, Kyuyong and Jung, Yoon Suk 2016. Risk of Colorectal Neoplasia According to Fatty Liver Severity and Presence of Gall Bladder Polyps. Digestive Diseases and Sciences, Vol. 61, Issue. 1, p. 317.


    Lim, Nam-Kyoo Lee, Joung-Won and Park, Hyun-Young 2016. Validation of the Korean Genome Epidemiology Study Risk Score to Predict Incident Hypertension in a Large Nationwide Korean Cohort. Circulation Journal, Vol. 80, Issue. 7, p. 1578.


    Lin, Sophia Tukana, Isimeli Linhart, Christine Morrell, Stephen Taylor, Richard Vatucawaqa, Penina Magliano, Dianna J. and Zimmet, Paul 2016. Diabetes and obesity trends in Fiji over 30 years. Journal of Diabetes, Vol. 8, Issue. 4, p. 533.


    Park, Miyeon and Park, Pilsook 2016. Factors Related to Eating Habits and Nutrition Status of Mother Affecting on Body Mass Index of Children aged 1-5years: Data from the Fifth Korea National Health and Nutrition Examination Survey, 2010-2011. Korean Journal of Community Nutrition, Vol. 21, Issue. 1, p. 102.


    Ryoo, Jae-Hong Park, Sung Keun Hong, Hyun Pyo Kim, Min-Gi and Ha, Chul Soo 2016. Clinical significance of serum apolipoproteins as a predictor of coronary heart disease risk in Korean men. Clinical Endocrinology, Vol. 84, Issue. 1, p. 63.


    Serafica, Reimund and Angosta, Alona D. 2016. Acculturation and changes in body mass index, waist circumference, and waist–hip ratio among Filipino Americans with hypertension. Journal of the American Society of Hypertension,


    Chiu, Maria Maclagan, Laura C Tu, Jack V and Shah, Baiju R 2015. Temporal trends in cardiovascular disease risk factors among white, South Asian, Chinese and black groups in Ontario, Canada, 2001 to 2012: a population-based study. BMJ Open, Vol. 5, Issue. 8, p. e007232.


    Deng, Wuquan Li, Changyan Zhang, Yuping Zhao, Jie Yang, Mengliu Tian, Mingyuan Li, Ling Zheng, Yanling Chen, Bing and Yang, Gangyi 2015. Serum C1q/TNF-related protein-3 (CTRP3) levels are decreased in obesity and hypertension and are negatively correlated with parameters of insulin resistance. Diabetology & Metabolic Syndrome, Vol. 7, Issue. 1,


    Haldar, Sumanto Chia, Siok Ching and Henry, Christiani Jeyakumar 2015.


    Huang, Rong Zheng, Jun Li, Shengxian Tao, Tao Ma, Jing and Liu, Wei 2015. Characteristics and contributions of hyperandrogenism to insulin resistance and other metabolic profiles in polycystic ovary syndrome. Acta Obstetricia et Gynecologica Scandinavica, Vol. 94, Issue. 5, p. 494.


    Indumathy, J. Pal, G.K. Pal, Pravati Ananthanarayanan, P.H. Parija, S.C. Balachander, J. and Dutta, T.K. 2015. Association of sympathovagal imbalance with obesity indices, and abnormal metabolic biomarkers and cardiovascular parameters. Obesity Research & Clinical Practice, Vol. 9, Issue. 1, p. 55.


    ×

Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians

  • Chi Pang Wen (a1), Ting Yuan David Cheng (a2), Shan Pou Tsai (a3), Hui Ting Chan (a1), Hui Ling Hsu (a1), Chih Cheng Hsu (a1) and Michael P Eriksen (a4)
  • DOI: http://dx.doi.org/10.1017/S1368980008002802
  • Published online: 01 April 2009
Abstract
AbstractObjectives

To assess whether overweight Asians, assessed on the basis of WHO criteria, are at greater mortality risk than overweight Caucasians, and to determine whether alternative cut-off points (BMI = 23·0–24·9 kg/m2 for overweight and BMI ≥ 25·0 kg/m2 for obesity) suggested by the WHO Western Pacific Regional Office are appropriate.

Design

The cohort was followed prospectively until the end of 2001. All-cause and CVD mortality risks of the overweight and obese group, relative to the reference group (BMI = 18·5–24·9 or 18·5–22·9 kg/m2), were assessed using Cox regression analysis, adjusting for age, smoking and gender. Excess deaths were estimated with a method proposed by the US Centers for Disease Control and Prevention.

Setting

National Health Interview Survey (NHIS 2001) and a middle-aged perspective cohort in Taiwan.

Subjects

Subjects comprised 36 386 civil servants and school teachers, aged 40 years and older, who underwent a medical examination during 1989–1992.

Results

In the WHO-defined overweight group, Asians showed a significant increase in all-cause mortality risk compared with Caucasians. Asians showed risks equivalent to Caucasians’ at lower BMI (around 5 units). Every unit of BMI increase, at 25·0 kg/m2 or above, was associated with a 9 % increase in relative mortality risk from all causes. Applying a cut-off point of 25·0 kg/m2 for obesity would result a prevalence of 27·1 %, while the traditional WHO cut-off point of 30·0 kg/m2 yielded obesity prevalence of 4·1 %. Excess deaths due to obesity accounted for 8·6 % of all deaths and 21·1 % of CVD deaths, based on the alternative cut-offs.

Conclusions

In this Asian population, significant mortality risks started at BMI ≥ 25·0 kg/m2, rather than at BMI ≥ 30·0 kg/m2. The study supports the use of BMI ≥ 25·0 kg/m2 as a new cut-off point for obesity and BMI = 23·0–24·9 kg/m2 for overweight. The magnitude of obesity-attributable deaths has been hitherto under-appreciated among Asians.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians
      Your Kindle email address
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians
      Available formats
      ×
Copyright
Corresponding author
Corresponding author: Email cwengood@nhri.org.tw
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.AH Mokdad , JS Marks , DF Stroup & JL Gerberding (2004) Actual causes of death in the United States, 2000. JAMA 291, 12381245.

2.CP Wen , SP Tsai , CJ Chen , TY Cheng , MC Tsai & D Levy (2005) Smoking attributable mortality for Taiwan and its projection to 2020 under different smoking scenarios. Tobacco Control 14, Suppl. 1, i76i80.

4.EE Calle , LR Teras & MJ Thun (2005) Obesity and mortality. N Engl J Med 353, 21972199.

6.KM Flegal , BI Graubard , DF Williamson & MH Gail (2005) Excess deaths associated with underweight, overweight, and obesity. JAMA 293, 18611867.

7.KM Flegal , BI Graubard , DF Williamson & MH Gail (2007) Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 298, 20282037.

8.DB Allison , KR Fontaine , JE Manson , J Stevens & TB VanItallie (1999) Annual deaths attributable to obesity in the United States. JAMA 282, 15301538.

9.KM Flegal , BI Graubard & DF Williamson (2004) Methods of calculating deaths attributable to obesity. Am J Epidemiol 160, 331338.

10.DH Mark (2005) Deaths attributable to obesity. JAMA 293, 19181919.

11.JR Banegas , E López-García , JL Gutiérrez-Fisac , P Guallar-Castillón & F Rodríguez-Artalejo (2007) A simple estimate of mortality attributable to excess weight in the European Union. Eur J Clin Nutr 57, 201208.

13.M Deurenberg-Yap , SK Chew & P Deurenberg (2002) Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Obes Rev 3, 209215.

14.S Guricci , Y Hartriyanti , JGAJ Hautvast & P Durenberg (1998) Relationship between body fat and body mass index: differences between Indonesians and Dutch Caucasians. Eur J Clin Nutr 52, 779783.

15.DW Haslam & WPT James (2005) Obesity. Lancet 366, 11971209.

17.SH Jee , JW Sull , J Park , SY Lee , H Ohrr , E Guallar & JM Samet (2006) Body-mass index and mortality in Korean men and women. N Engl J Med 355, 779787.

19.K Shiwaku , E Anuurad , B Enkhmaa , A Nogi , K Kitajima , K Shimono , Y Yamane & T Oyunsuren (2004) Overweight Japanese with body mass indexes of 23.0 to 24.9 have higher risks for obesity associated disorders: a comparison of Japanese and Mongolians. Int J Obes Relat Metab Disord 28, 152158.

20.WY Lin , LT Lee , CY Chen , H Lo , HH Hsia , IL Liu , RS Lin , WY Shau & KC Huang (2002) Optimal cut-off values for obesity: using simple anthropometric indices to predict cardiovascular risk factors in Taiwan. Int J Obes Relat Metab Disord 26, 12321238.

21.D Gu , J He , X Duan , R Reynolds , X Wu , J Chen , G Huang , CS Chen & PK Whelton (2006) Body weight and mortality among men and women in China. JAMA 295, 776783.

23.WPT James (2005) Assessing obesity: are ethnic differences in body mass index and waist classification criteria justified? Obes Rev 6, 179181.

24.SW Oh , SA Shin , YH Yun , T Yoo & BY Huh (2004) Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans. Obes Rev 12, 20312040.

26.WHO Expert Consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363, 157163.

28.DL McGee ; Diverse Populations Collaboration (2005) Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Ann Epidemiol 15, 8797.

29.JT Gronniger (2006) A semiparametric analysis of the relationship of body mass Index to mortality. Am J Public Health 96, 173178.

30.EE Calle , MJ Thun , JM Petrelli , C Rodriguez & CW Heath Jr (1999) Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med 341, 10971105.

31.JE Manson , WC Willett , MJ Stampfer , GA Colditz , DJ Hunter , SE Hankinson , CH Hennekens & FE Speizer (1995) Body weight and mortality among women. N Engl J Med 333, 677685.

32.UA Ajani , PA Lotufo , JM Gaziano , I-M Lee , A Spelsberg , JE Buring , WC Willett & JE Manson (2004) Body mass index and mortality among US male physicians. Ann Epidemiol 14, 731739.

33.SP Tsai , RP Donnelly & JK Wendt (2006) Overweight, obesity, and mortality in a prospective study of a middle-aged industrial population. J Occup Environ Med 48, 2227.

36.CP Wen , SP Tsai , CJ Chen & TY Cheng (2004) The mortality risks of smokers in Taiwan. Part I: cause-specific mortality. Prev Med 39, 528535.

37.CP Wen , TY Cheng , SP Tsai , HL Hsu & SL Wang (2005) Increased mortality risks of pre-diabetes (impaired fasting glucose) in Taiwan. Diabetes Care 28, 27562761.

38.CP Wen , SP Tsai , TY Cheng , WSI Chung , HT Jan & CJ Chen (2005) Excess injury mortality among smokers – a neglected tobacco hazard. Tobacco Control 14, i28i32.

40.KM Flegal , MD Carroll , CL Ogden & CL Johnson (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288, 17231727.

41.PT Katzmarzyk , CL Craig & C Bouchard (2001) Underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol 54, 916920.

42.J He , D Gu , X Wu (2005) Major causes of death among men and women in China. N Engl J Med 353, 11241134.

43.D Gu , K Reynolds , X Wu , J Chen , X Duan , RF Reynolds , PK Whelton & J He ; InterASIA Collaborative Group (2005) Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 365, 13981405.

45.P Deurenberg , M Deurenberg-Yap & S Guricci (2002) Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 3, 141146.

46.JM Yuan , RK Ross , YT Gao & MC Yu (1998) Body weight and mortality: a prospective evaluation in a cohort of middle-aged men in Shanghai, China. Int J Epidemiol 27, 824832.

47.GTC Ko , JCN Chan , CS Cockram & J Woo (1999) Prediction of hypertension, diabetes, dyslipidaemia or albuminuria, using simple anthropometric indexes in Hong Kong Chinese. Int J Obes Relat Metab Disord 23, 11361142.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: