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Obesity among Indian Americans
Obesity among Indian Americans
28 Dec 2020
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A few weeks ago, I heard a talk by Dr Enas A Enas (see biography), a world expert on heart disease among Indian sub-continent populations. He is the founder of CADI Research. An interesting article: Obesity in Indian Americans caught my attention. It was an eye opener — I was stunned to realize the rates of obesity and abdominal obesity among Indian Americans.
Obesity Among Indian Americans

"Standard Criteria": WHO guidelines define obesity as BMI ≥ 30.

"Asia Pacific / Indian Criteria": India-Specific BMI Cut-Offs for Obesity developed by Indian scientists define obesity as BMI ≥ 25.

Are 50% to 70% of Indian Amerians obese? CADI Research article: Obesity in Indian Americans explains:

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

Sources:

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.

(2018) Among 1,038 Asian Indian adults in this study, 25% were overweight (BMI between 23 and 25 kg/m2) and 49.8% were obese (BMI ≥ 25 kg/m2) using the Asian criteria! Adults were chosen from 7 US cities—Houston, TX; Phoenix, AZ; Washington, DC; Boston, MA; San Diego, CA; Edison, NJ; and Parsippany, NJ. The mean BMI was 25.4 ± 3.7 kg/m2. [Source: Vegetarian Diet and Cardiometabolic Risk among Asian Indians in the United States by Misra et al, KJ Diabetes Res. 2018]

Abdominal Obesity Among Indian Americans

CADI Research article: Obesity in Indian Americans explains:

  • A similar underestimation of abdominal obesity occurs when the standard (Europid) waist circumference criteria is used (>102 cm for men and >88 cm 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

Sources:

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.

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.

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.

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