A Systematic Review of Overweight, Obesity, and Type 2 Diabetes Among Asian American Subgroups

Abstract

This systematic review synthesizes data published between 1988 and 2009 on mean BMI and prevalence of overweight, obesity, and type 2 diabetes among Asian subgroups in the U.S. We conducted systematic searches in PubMed for peer-reviewed, English-language citations that reported mean BMI and percent overweight, obesity, and diabetes among South Asians/Asian Indians, Chinese, Filipinos, Koreans, and Vietnamese. We identified 647 database citations and 23 additional citations from hand-searching. After screening titles, abstracts, and full-text publications, 97 citations remained. None were published between 1988 and 1992, 28 between 1993 and 2003, and 69 between 2004 and 2009. Publications were identified for the following Asian subgroups: South Asian (n=8), Asian Indian (n=20), Chinese (n=44), Filipino (n=22), Korean (n= 8), and Vietnamese (n=3). The observed sample sizes ranged from 32 to 4245 subjects with mean ages from 24 to 78 years. Among samples of men and women, the lowest reported mean BMI was in South Asians (22.1 kg/m2), and the highest was in Filipinos (26.8 kg/m2). Estimates for overweight (12.8 - 46.7%) and obesity (2.1 – 59.0%) were variable. Among men and women, the highest rate of diabetes was reported in Asian Indians with BMI ≥ 30 kg/m2 (32.9%, age and sex standardized). This review suggests heterogeneity among U.S. Asian populations in cardiometabolic risk factors, yet comparisons are limited due to variability in study populations, methods, and definitions used in published reports. Future efforts should adopt standardized methods to understand overweight, obesity and diabetes in this growing U.S. ethnic population.

Contrasting Obesity-Related Beliefs and Behaviors among West and East Coast Chinese Americans

“…Our study also confirmed that males were more likely to be overweight or obese than females. Our percentages were not as high as California's government data, which indicated high propensity for obesity among Asians [30]. However, their data included a variety of Asian groups.…”

Diabetes among non-obese Filipino Americans: Findings from a large population-based study

“…A key issue is that Filipino Americans have a higher mean BMI in comparison to other Asian American subgroups. 12 Second, more than one third of Filipino Americans (38%) are physically inactive, which is a higher rate than that noted for Chinese Americans. 13,14 Obesity and physical inactivity do not, however, completely explain the higher prevalence of diabetes among Filipino Americans in comparison to non-Hispanic whites in the US.…”

Dietary Patterns Are Associated with Metabolic Risk Factors in South Asians Living in the United States

“…Individuals of South Asian (Bangladeshi, Indian, Nepali, Pakistani, and Sri Lankan) origins are at particular risk of severe early onset CVD and type 2 diabetes, even before the development of obesity (9)(10)(11). Metabolic risk factors such as waist circumference, dyslipidemia, and deregulation of glucose and insulin often underlie oxidative stress and atherosclerotic changes in this population (12)(13)(14).…”