Abdominal Obesity and Ethnicity
- Cutoff points for abdominal obesity vary by gender, ethnicity and also country. Asians tend to have more metabolic abnormalities at lower waist circumference (WC) than whites.1
- Even among whites, substantial risk of premature coronary artery disease (CAD) occurs at WC of > 90 cm and underscores the dangers of abdominal obesity.
- Previously, several studies in Japan have found optimum waist circumference for abdominal obesity to be 85 to 90 cm in men and 80 cm in women.2, 3 The optimum WC among Chinese has been found to be 80 cm for both men and women.4
- Several expert bodies after reviewing the studies in various Asian countries have proposed lower cutpoints for all Asians including Asian Indians that are 8 cm lower for women and 12cm lower for men than Europids. The cutpoints recommended in Asians is 80cm (31.5inches) in women and 90cm (35.4 inches) in men as opposed to 88cm (34.6 inches) in Europid women and 102cm (40 inches) in Europid men.5-8
- In sharp contrast to Asians, at any given level of BMI, blacks have less visceral fat compared with whites.9 Despite a higher BMI among blacks overall, the WC among black men is 4 cm smaller than in white men but 5 cm larger in black women compared with white women.10
- Measures of adiposity in childhood and adolescence were significantly higher in white children compared to black children, when adjusted for BMI and age.11
- At a given waist size, Indians have greater dyslipidemia, diabetes, and heart disease than do Europids and other Asians. Studies in India have shown the optimum waist circumference for cardiometabolic risk was 85 – 87 cm for men and 80 – 82 cm for women.12, 13
Sources
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2. Hara K, Matsushita Y, Horikoshi M, et al. A proposal for the cutoff point of waist circumference for the diagnosis of metabolic syndrome in the Japanese population. Diabetes Care. May 2006;29(5):1123-1124.
3. Oka R, Kobayashi J, Yagi K, et al. Reassessment of the cutoff values of waist circumference and visceral fat area for identifying Japanese subjects at risk for the metabolic syndrome. Diabetes Res Clin Pract. Mar 2008;79(3):474-481.
4. Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. Aug 11 2008;168(15):1617-1624.
5. Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and international association for the Study of Obesity. Circulation. Oct 20 2009;120(16):1640-1645.
6. Enas EA, Singh V, Gupta R, Patel R, et al. Recommendations of the Second Indo-US Health Summit for the prevention and control of cardiovascular disease among Asian Indians. Indian heart journal. 2009;61:265-74.
7. Misra A , Chowbey P, Makkar B. Consensus statement for diagnosis of obesity, abdominal obesity, and metabolic syndrome, for Asian Indians and recomendations for physical activity, medical and surgical management. JAPI. 2009;57:163-170.
8. Asia Pacific Perspective:Redefing obesity and its treatment World Health Organization, Western Pacific Region;2000.
9. Conway JM, Yanovski SZ, Avila NA, Hubbard VS. Visceral adipose tissue differences in black and white women. Am J Clin Nutr. 1995;61(4):765-771.
10. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The Metabolic Syndrome: Prevalence and Associated Risk Factor Findings in the US Population From the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med. 2003;163(4):427-436.
11. Sisson SB, Katzmarzyk PT, Srinivasan SR, et al. Ethnic differences in subcutaneous adiposity and waist girth in children and adolescents. Obesity (Silver Spring, Md. Nov 2009;17(11):2075-2081.
12. Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care. 2003;26(5):1380-1384.
13. Mohan V, Deepa M, Farooq S, Narayan KM, Datta M, Deepa R. Anthropometric cut points for identification of cardiometabolic risk factors in an urban Asian Indian population. Metabolism. Jul 2007;56(7):961-968.