1. The present study characterized the prevalence of obesity across several heterogeneous Asian American subgroups to better understand cardiometabolic risk and disease.
2. There was a wide range in age- and sex-adjusted obesity prevalence, from 6% in Vietnamese Americans to 17% in Filipino Americans.
Evidence Rating Level: 3 (Average)
Study Rundown: Obesity, often defined as a body mass index (BMI) of 30 kg/m2, is associated with various metabolic comorbidities. Previous research suggests that persons of Asian ancestry are at a higher risk of cardiometabolic complications at lower BMIs. In this study, participants were self-reported as non-Hispanic Asians (NHA) and further subcategorized into Asian Indian, Chinese, Filipino, Japanese, Vietnamese, Korean, and “other Asian”. In comparison to non-Hispanic White (NHW) and non-Hispanic Black (NHB) populations, NHA participants were younger, higher income, higher education, more frequently men, more frequently never smokers, and less likely to have cardiometabolic comorbidities. Prevalence rates of obesity based on standard categorization (BMI>=30 kg/m2) were lower in NHA participants than in NHW and NHB participants. In subgroup analyses, Filipino American adults had the highest prevalence of obesity and Vietnamese American adults had the lowest. At adjusted BMI levels (BMI >= 27.5 kg/m2), was the highest in Filipino American adults and lowest in Chinese American adults. This study is limited in that it is based on self-reported data for race/ethnicity and there are wide intra-racial/intra-ethnic variety limits in the generalizability of the study results.
In-Depth [cross-sectional study]: This cross-sectional study used Behavioural Risk Factor Surveillance System (BRFSS) data; a state-based, annual telephone survey done by health departments with the support of Centers for Disease Control and Prevention. Data from 2013 to 2020 were combined to determine the prevalence of obesity among United States adults. Some eligible participants were excluded due to missing data for BMI calculation or missing data for primary analysis of covariates. Logistic regression analyses were used to estimate the adjusted prevalence of BMI, with BMI being the dependent variable and racial or ethnic category as the independent variable. A total of 71,057 NHA participants were included. Of those, 11,815 were Asian Indian, 11,686 were Chinese, 11,815 were Filipino, 12,473 were Japanese, 3,634 were Korean, and 2,618 were Vietnamese. Overall adjusted obesity prevalence in NHA participants was 11.7% (95% Confidence interval [CI], 11.2% to 12.2%) compared to 39.7% (95% CI, 39.5% to 40.1%) among NHB participants and 29.4% (95% CI, 29.3% to 29.5%) among NHW participants. In NHA subgroups, Filipino Americans had the highest standard obesity prevalence of 16.8% (95% CI, 15.2% to 18.5%), while Vietnamese Americans had the lowest prevalence of 6.5% (95% CI, 5.1% to 7.8%). These rates were different by age, sex, education, insurance status income, history of cardiovascular disease, physical activity, hypertension, diabetes, and smoking groups. The prevalence of adjusted BMI in NHA participants was 22.4% (95% CI, 21.8% to 23.1%). In subgroup analyses, the prevalence of adjusted BMI was highest in Filipino Americans at 28.7% (95% CI, 27.6% to 30.7%) and lowest in Chinese Americans at 13.2% (95% CI, 12.0 to 14.5%). Prevalence rates for adjusted BMI were different across all characteristics in NHA overall and NHA subgroups. In summary, this study demonstrated the importance of sub-group analysis in population-wide risk stratification.
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