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BMI, mortality linked in Asians
Zheng W. N Engl J Med. 2011;364:719-729.
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A study involving more than 800,000 East Asians has shown that being both underwent and overweight increased the likelihood of death.
When the researchers investigated outcomes in approximately 300,000 Indians and Bangladeshis, however, only low BMI elevated the risk for death.
The more than 1.14 million participants that comprised the study were recruited from 19 Asian cohorts. Investigators defined 10 BMI levels ranging from lowest (≤15) to highest (>35) and carried out pooled analyses of individuals to determine the association between BMI (mean 22.9) and mortality risk.
During a mean follow-up of 9.2 years, approximately 120,700 cohort members died, with cardiovascular diseases reported as the main cause of death (35.7%) followed by cancer (29.9%). For East Asians, or those from China, Japan or Korea, the lowest risk for death was among those with a BMI of 22.6 to 27.5. The risk was elevated for those with a BMI of 15 or less by a factor of 2.8 and for those with a BMI greater than 35 by a factor of 1.5.
For the cohorts comprised of Indians and Bangladeshis, the risk for death from any cause was increased among those with a BMI of 20 or lower when compared with those with a BMI of 22.6 to 25, but not for those with a higher BMI.
“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,” the researchers concluded. “Given the limitations of the current study, in which the risk of death was used as the outcome, additional studies are needed to quantify the association between BMI and the incidence of disease, in order to better define BMI criteria for overweight and obesity in Asians.”
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