Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index
Metabolic syndrome prevalence is significantly higher in Asians compared with NHWs for every BMI category. For women at the mean age of 55 and BMI of 25 kg m–2, the predicted prevalence of metabolic syndrome is 12% for NHW women compared with 30% for Asians; similarly for men, the predicted prevalence of metabolic syndrome is 22% for NHWs compared with 43% of Asians. Compared with NHW women and men with a BMI of 25 kg m–2, comparable prevalence of metabolic syndrome was observed at BMI of 19.6 kg m–2 for Asian women and 19.9 kg m–2 for Asian men. A similar pattern was observed in disaggregated Asian subgroups.
https://www.nature.com/articles/ijo2010152
Lean Yet Unhealthy: Asian American Adults Had Higher Risks for Metabolic Syndrome than Non-Hispanic White Adults with the Same Body Mass Index: Evidence from NHANES 2011–2016
(1) Background: Despite having consistently lower rates of obesity than other ethnic groups, Asian Americans (AAs) are more likely to be identified as metabolically obese, suggesting an ethnic-specific association between BMI and cardiometabolic outcomes. The goal of this study was to provide an estimate of metabolic syndrome (MetS) prevalence among AAs using national survey data and to compare this rate to that of non-Hispanic Whites (NHWs) over the BMI continuum. (2) Methods: Using the NHANES 2011–2016 data, we computed age-adjusted, gender-specific prevalence of MetS and its individual components for three BMI categories. Furthermore, we conducted multivariate binary logistic regression to examine the risk of MetS in AAs compared to NHWs, controlling for sociodemographic and lifestyle factors. The analysis sample consisted of 2121 AAs and 6318 NHWs. (3) Results: Among AAs, the prevalence of MetS and its components increased with higher BMI levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23–27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23–27.4, and 67.73% for BMI ≥ 27.5 in women. We also found that for those with a BMI > 23, AAs had a higher predicted risk of MetS than their NHW counterparts of the same BMI level, in both men and women. (4) Conclusions: Our findings support the use of lower BMI ranges for defining overweight and obesity in Asian populations, which would allow for earlier and more appropriate screening for MetS and may better facilitate prevention efforts.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618667
Acculturation, Physical Activity, and Metabolic Syndrome in Asian-American Adults
Asian Americans (AsAm) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship.
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Increasing MVPA is associated with lower MetS risk among AsAms. More acculturated AsAms may receive more potent benefits by increasing time spent in MVPA. Acculturation seems to play an important role in PA and MetS, but whether or how it impacts PA, MetS, and the relationship between them remains uncertain due to the lack of consistency of acculturation measurement in the literature and paucity of research among AsAms. Further research may be needed to determine a better measurement of acculturation and to consider disaggregating AsAm subgroups in acculturation studies. Meanwhile, it will be necessary for healthcare professionals to increase awareness and knowledge of health outcomes that may differ among AsAms across acculturation levels. Given that only a quarter of AsAms spoke English at home, it is of utmost importance to expand ongoing culturally and linguistically appropriate programs focused on PA promotion and health education.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9620782
Metabolic Syndrome and Chronic Disease Risk in South Asian Immigrants: A Review of Prevalence, Factors, and Interventions
South Asians (SAs) are among the fastest-growing ethnic groups in the U.S. Metabolic syndrome (MetS) is a condition that is characterized by multiple health factors that increase the risk for chronic diseases, such as cardiovascular disease (CVD) and diabetes. MetS prevalence among SA immigrants ranges from 27–47% in multiple cross-sectional studies using different diagnostic criteria, which is generally higher compared to other populations in the receiving country. Both genetic and environmental factors are attributed to this increased prevalence. Limited intervention studies have shown effective management of MetS conditions within the SA population. This review reports MetS prevalence in SAs residing in non-native countries, identifies contributing factors, and discusses ways to develop effective community-based strategies for health promotion targeting MetS among SA immigrants. There is a need for more consistently evaluated longitudinal studies to facilitate the development of directed public health policy and education to address chronic diseases in the SA immigrant community.
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Implications: Adopting a lower BMI cut-off for SA immigrants would serve to increase opportunities for improved diagnosis and intervention. However, a cross-sectional survey of primary care physicians practicing in a major southern city in the U.S. found only 9% of physicians reported measuring waist circumference, and only 21% of physicians were aware of ethnicity-specific guidelines. Most lacked the knowledge and training to appropriately assess overweight/obesity and related chronic disease risks in SA immigrants [120]. These data highlight the need for more culturally sensitive clinical strategies to reduce the burden of MetS in SA immigrant communities across the U.S. [121,122,123].
https://www.mdpi.com/2227-9032/11/5/720
Ethnic-Specific Criteria for the Metabolic Syndrome: Evidence from China
The Chinese Multi-provincial Cohort Study was a nationwide, multicenter, prospective cohort study on cardiovascular disease in China. The detailed information of the participants has been reported elsewhere (6–8). Briefly, a total of 29,564 subjects (aged 35–64 years) free of cardiovascular disease were recruited from 11 provinces in mainland China in 1992 for the baseline examination using the World Health Organization MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) protocol of risk factor survey (9,10). Complete data of anthropometric and metabolic measurements were available for 26,972 subjects (91.2% of the participants) and were used in this analysis.
https://diabetesjournals.org/care/article/29/6/1414/24915/Ethnic-Specific-Criteria-for-the-Metabolic
Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988–2012
Since 1959, the National Center for Health Statistics of the Centers for Disease Control and Prevention has collected, analyzed, and disseminated data on the health status of US residents as part of the National Health and Nutrition Examination Survey (NHANES) (19). Each year NHANES surveys a nationally representative sample of about 5,000 US adults in which Mexican Americans and non-Hispanic blacks are oversampled, and weighted analysis is used to generate generalizable estimates. NHANES collects demographic, socioeconomic, dietary, and health-related data that include clinical measures of blood pressure, fasting blood glucose, triglycerides, and high-density lipoprotein (HDL) cholesterol in addition to self-reported medication use for health conditions. We conducted cross-sectional analysis of the NHANES data and examined trends in metabolic syndrome over time by establishing 3 periods; 1988–1994 (first period), 1999–2006 (second period), and 2007–2012 (third period). These periods were chosen to account for the lack of continuous annual data over the entire 24-year period (no data for 1996 through 1998) and variations in the NHANES sampling design over time. Comparisons between periods are appropriate as long as sampling weights and units are accounted for in statistical analyses.
Our analysis included all non-Hispanic white, non-Hispanic black, and Mexican American adults aged 18 or older represented in the NHANES data set during the study period. Adults of other race/ethnicities were excluded because of limited sample sizes and inconsistent categorizations across the survey years; pregnant women were also excluded to reduce bias associated with pregnancy-associated diabetes or weight gain. A total of 51,371 participants during the study period were included in this analysis; 18,552 participants for 1988–1994, 18,445 participants for 1999–2006, and 14,374 participants for 2007–2012. The University of Alabama at Birmingham Institutional Review Board considered this study exempt from review because of the use of publicly available, de-identified data.
https://www.cdc.gov/pcd/issues/2017/16_0287.htm
Commentary
This happens a lot, where Asian American and other ethnic groups, like Native American, Hawaiian, Pasifika, are excluded from a study due to small sample sizes. In these cases, generally, Asians get classified with whites.
This Metabolic Syndrome category shows, that grouping Asian Americans together with whites is inaccurate and harmful, when prevalence of a disease among Asian Americans doesn’t match with whites.
Moreover, for many years, the stereotype has been that Asians don’t get fat. Well, it turns out that we don’t become visibly fat as quickly as white people, but we suffer the obesity diseases sooner.