Use of ethnic specific BMI and waist cut-offs for prevention of diabetes and cardiovascular disease

Abstract

The terms overweight and obesity are used to identifystates in which abnormal or excessive fat accumulationhas occurred in the body leading to adverse effects onhealth of an individual (1). According to the World HealthOrganization (WHO) estimates, nearly 2 billion adultsare suffering from overweight and 600 million from obesityin the world (1). Each year nearly 3 million adults die dueto being overweight and obese and it is estimated that35.8 million (2.3%) of global DALYs can be accounted tobe due to overweight or obesity (1). Obesity is stronglyassociated with diabetes, dyslipidaemia, hypertension,cardiovascular disease, non-alcoholic fatty liver diseaseand mechanical problems like obstructive sleep apnoea,osteoarthritis and even psychological issues such asdepression and anxiety (2).Sri Lanka is not an exception; obesity associatedmetabolic diseases have reached epidemic proportions.One-fifth Sri Lankan adults are suffering from dysglycemiaand 10% from diabetes (3). Moreover, 25% of adults havehypertension (4) and a similar percentage of adults arehaving metabolic syndrome (5). Deaths due to cardio-vascular diseases in Sri Lanka are more prevalent thanmany developed countries (6). However, according to theinternational BMI cut-offs, derived based on data fromWhite Caucasians obesity prevalence is very low. SriLanka Diabetes and Cardiovascular Study reported only4% of obesity in 2005-2006 (7). This level has not changedsignificantly in our second data collection carried out in2011 (8). Hence there seems to be a paradox between obesitydata according to the international cut-offs and obesityrelated co-morbidities based on prevalence data.