Asian Americans officially have more reason to be extra-vigilant about their weight when it comes to diabetes risk.
As a group, Asian Americans are more at risk for developing type 2 diabetes at a lower body mass index (a weight-to-height ratio) when compared to the general population. In light of this fact, the American Diabetes Association now recommends screening Asian Americans for the disease at a BMI of 23, which is technically a "healthy" BMI level. The recommendation was published online Tuesday in a new position paper, and will appear in the January issue of the journal Diabetes Care.
"Clinicians have known this intuitively for quite some time," said lead author William C. Hsu, M.D., of the Joslin Diabetes Center and Harvard Medical School. "They can see that Asian Americans are being diagnosed with diabetes when they do not appear to be overweight or obese according to general standards."
The general population should be screened for diabetes at age 45 or older, with a BMI of 25 (the point at which one is classified as "overweight"). But this standard meant many at-risk Asian Americans were flying under the radar of diabetes screening, explained Hsu.
Hsu's position paper discusses a few possible explanations for Asian Americans' increased diabetes risk. For one, Asian Americans tend to store body fat in their trunk, as opposed to their hips and legs. Fat around the abdomen is more metabolically active than fat stored elsewhere and is strongly linked to insulin resistance, which can lead to diabetes.
Secondly, no matter what their weight, Asian Americans tend to carry a greater proportion of fat than lean mass when compared to other racial groups.
Finally, the "American" part of "Asian American" likely plays a role too. Japanese Americans have a higher rate of diabetes than Japanese people living in Japan, and the same goes for Chinese Americans compared to Chinese people living in rural China, notes the Joslin Diabetes Center. This suggests environmental factors like food source and exercise (or lack thereof) could be to blame.
Asian Americans include anyone with origins from these countries: China, Japan, Korea, Mongolia, Cambodia, Malaysia, the Philippines, Thailand, Vietnam, Indonesia, Singapore, Laos, India, Pakistan, Bangladesh, Bhutan, Sri Lanka and Nepal, notes Hsu's position paper.
Currently, Asian Americans make up 4.8 percent of the U.S. population (14.7 million people), according to the 2010 census, and 11 percent of this population is considered obese, according to the BMI scale. Meanwhile, 35 percent of Americans as a whole are considered obese. But as this new position paper shows, BMI can be a poor measure of health risks.