The World Health Organization has proposed lower weight criteria for Asians than other individuals because Asians have more health problems at a lower body weight. The body mass index (BMI) proposed for Asians are shown in the table. However, many people even in the normal weight range can have health problems like diabetes, high blood pressure and heart disease.

We looked at the MASALA data and compared it to our sister study, the Multi-Ethnic Study of Atherosclerosis (MESA) which includes Whites, African Americans, Latinos and Chinese individuals. We found that many people in the normal BMI category still had abnormal risk factors, and this was highest for South Asians.  Almost 44% of South Asians, 38% of Latinos, 32% Chinese, 31% of African Americans, and 21% of Whites who are of normal weight have more than 2 metabolic risk factors.  This cannot be explained by differences in the age, sex, education, physical activity, dietary intake, smoking, alcohol use, and where the body fat is stored.  To have the same number of risk factors as a White person who has a BMI of 25, a South Asian person would have a BMI of 19.6!

Currently, physicians check for diabetes and other risk factors when someone is overweight (BMI of 23 for Asians). But our study results show that many people would be missed if we relied on body weight or BMI. Just being a South Asian should be reason enough to be screened for metabolic risk factors, because weight or BMI is not a helpful criterion.

For more information, please click on the links below:

New York Times: Healthy Weight? You May Still Be at Risk for Heart Disease

Newsweek: There's a Dangerous Racial Bias in the Body Mass Index

UCSF News: Race Ranks Higher than Pounds in Diabetes, Heart-Health Risks

NBC News Asians, Blacks, Hispanics Have More Heart Disease Risks at Normal Weight: Study

India West Normal-Weight S. Asians Have Higher Heart, Diabetes Risk