Obesity and Abdominal Obesity among Indian Americans
- For the same body mass index (BMI), percentage body fat is 4% to 5% lower for blacks and Pacific Islanders but 7-8% higher for Asian Indians compared to Europids.1, 2
- The prevalence of obesity among Asian Indians depends on the criteria used. A BMI >25 is classified as obese for Asian Indians and all Asians by the Asia Pacific and/or Indian criteria whereas, a BMI > 30 is classified as obese for all Europids regardless of nationality.3-5
- Significant underestimation of overweight and obesity occurs when standard criteria is used.6, 7 Two cross sectional studies of Asian Indians in the US showed a mean BMI of 25 to 26.6, 7 Using the standard criteria (BMI >30) only 11% to 17% were obese, which increased to 50 -70% when Asia pacific and/or Indian criteria (BMI >25) was used.6, 7 Thus Asian Indians in the US have the highest prevalence of obesity. Another 25% were overweight (BMI 23-25).6, 7
- A similar underestimation of abdominal obesity occurs when the standard (Europid) waist circumference criteria is used (>102 cm for men and >88cm for women) instead of Asia pacific and/or Indian criteria (>90 cm for men and >80cm for women).3-5
- Using standard criteria, the prevalence of abdominal obesity among Asian Indians in the US was 23% which increased to 60% when using Asia Pacific and/or Indian criteria, compared to 58% in whites, 75% in Hispanics, and 76% in blacks.8 This prevalence is slightly higher than the 49% reported from India.9
- Both obesity and abdominal obesity confer greater risk of metabolic syndrome, diabetes, and heart disease among Asian Indians than whites.7, 10, 11
- For the same BMI, Asian American women have higher visceral fat accumulation than whites and are even higher among Asian Indian women.2, 12
1. Jackson A. S., Ellis KJ, McFarlin BK, Sailors MH, Bray MS. Body mass index bias in defining obesity of diverse young adults: the Training Intervention and Genetics of Exercise Response (TIGER) study. The British journal of nutrition. Oct 2009;102(7):1084-1090.
2. Rush E, Plank L, Chandu V, et al. Body size, body composition, and fat distribution: a comparison of young New Zealand men of European, Pacific Island, and Asian Indian ethnicities. N Z Med J. Dec 17 2004;117(1207):U1203.
3. 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.
4. Asia Pacific Perspective:Redefing obesity and its treatment World Health Organization, Western Pacific Region;2000.
5. 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.
6. Misra R, Patel T, Kotha P, et al. Prevalence of diabetes, metabolic syndrome, and cardiovascular risk factors in US Asian Indians: results from a national study. Journal of diabetes and its complications. Mar 18 2009.
7. Palaniappan L P, Wong EC, Shin JJ, Fortmann SP, Lauderdale DS. Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. International journal of obesity (2005). Aug 3 2010.
8. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006. Natl Health Stat Report. May 5 2009(13):1-7.
9. Deepa M, Farooq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34). Diabetes/metabolism research and reviews. Feb 2007;23(2):127-134.
10. Kanaya AM, Wassel CL, Mathur D, et al. Prevalence and correlates of diabetes in South asian indians in the United States: findings from the metabolic syndrome and atherosclerosis in South asians living in america study and the multi-ethnic study of atherosclerosis. Metabolic syndrome and related disorders. Apr 2010;8(2):157-164.
11. Enas EA, Garg A, Davidson MA, Nair VM, Huet BA, Yusuf S. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian heart journal. Jul-Aug 1996;48(4):343-353.
12. Park YW, Allison DB, Heymsfield SB, Gallagher D. Larger amounts of visceral adipose tissue in Asian Americans. Obesity research. Jul 2001;9(7):381-387.