CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

February 24th, 2011

Study Probes BMI-Associated Risk in Asia

The association between BMI and the risk of death in Asia is mostly similar to that seen in people of European origin, but there may be some important differences between populations, suggesting that being underweight may be a more potent risk factor than being overweight in Asia. In a large pooled analysis including more than 1.1 million people in 19 separate Asian cohorts, Wei Zheng and colleagues found a U-shaped curve among East Asians in which the lowest risk of death was found in people with a BMI in the range of 22.6 to 27.5. Risk was elevated by as much as 1.5 times in East Asians with a BMI over 35 and by as much as 2.8 times in those with a BMI of 15 or lower.

However, among Indians and Bangladeshis, high BMI was not associated with an excess risk of death, although the association with low BMI remained significant. In the discussion section of their report in the New England Journal of Medicine, the authors note that “socioeconomic status could confound the association between BMI and the risk of death, since in less well-developed countries, people with a high BMI are more likely to have a high socioeconomic status (and thus better access to health care) than are those with a lower BMI.”

The authors concluded that “overall, the risk of death among Asians, as compared with Europeans, seems to be more strongly affected by a low BMI than by a high BMI.”

 

Categories: Prevention
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2 Responses to “Study Probes BMI-Associated Risk in Asia”

  1. Kishaloy Sur, MBBS says:
    February 25, 2011 at 12:30 am

    I am not completely convinced by the study result, especially of Bangladeshi & Indian population, where researcher found no association with High BMI with mortality. In my practice in Dhaka,Bangladesh,while treating large population of urban diabetic patients,my 18-year experience showed overweight & obesety,especially abdominal obesity,clearly associated with hypertension,dyslipidemia(low HDL,high TG),incidence of coronary heart disease(CHD) & stroke.Dhaka is now one of the largest city in the world,constituting 98%,first generation rural migrants,explosive incidence of diabetes,hypertension,dyslipidemia,CHD,stroke & cancer.
    Lower socioeconomic groups affected most.Because of rapid urbanization,adoption of free market economy & globalization created an unique situation consisting of ugly gap of wealth,lack of social justice & very poor infrastructure of primary health care.
    If research collected sample from Dhaka,I guess,BMI-mortality correlation will be same as western countries.

  2. Robin Motz, M.D., Ph.D. says:
    February 26, 2011 at 4:08 pm

    All data must be considered and evaluated on its merits. If the statistical results contradict “accepted” medical wisdom, then either the wisdom is wrong (after all, we now know that INcreasing the calcium in the diet is one way to reduce calcium nephrolithiasis) or different boundaries have to be placed on the interpretation of the data.
    A retrospective diet study on the incidence of prostate cancer showed that both tomatoes and strawberries correlated with a reduced incidence. Tomatoes contain lycopenes, so that part of the result was accepted. Since there was no APPARENT reason why strawberries should be beneficial, they were not recommended. But it is wrong to cherry-pick results in this way.