Low Indices of Overweight and Obesity are Associated with Cardiometabolic Diseases among Adult Filipinos in a Rural Community*
Keywords:
overweight, obesity, metabolic diseases, FilipinosAbstract
*Visual Abstracts prepared by Dr. Francis Xavier Mislang
Objectives. To determine cut-off levels of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) for overweight/obesity associated with cardiometabolic diseases (CMDs) among adult Filipinos in a rural community.
Methodology. This community-based cross-sectional observational study utilized data from our Phase II of Diabetes Self-Management Education Program in San Juan, Batangas, Philippines. It included 332 Filipino adults with no known illnesses and residing for at least 6 months in the rural communities. Optimal cut-offs were determined by the intersection of sensitivity and specificity curves of having at least 1 or 2 CMDs.
Results. The study population included 332 participants (72.3% females). Mean BMI, WC and WHR were 23.5 kg/m2, 79.5 cm and 0.87 respectively. Twenty eight percent, 11.1%, 78.3% and 85.8% of the participants have hypertension, diabetes, dyslipidemia, and at least 1 CMD respectively. The optimal cut-off for overweight/obesity and central obesity in males and females are BMI of 24 and 23 kg/m2, WC of 84 and 77 cm, and WHR 0.91 and 0.85 respectively.
Conclusion. Similar to other Asian countries, cut-off levels for overweight, obesity, and central obesity associated with CMDs are lower than the currently recommended cut-offs among Filipino adults in rural communities, particularly for WC in both sexes.
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References
World Health Organization. Fact sheet: Obesity and overweight. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/.
World Health Organization, eds. Chapter 1: Burden: Morbidity, mortality and risk factors. Global status report on noncommunicable diseases 2010. Available from: http://www.who.int/nmh/publications/ncd_report_chapter1.pdf.
Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Suppl 1):S9-30. https://doi.org/10.1210/jc.2008-1595.
Dans AL, Morales DD, Velandria FV, Abola TB, Roxas A Jr, Punzalan FE, et al. National Nutrition and Health Survey (NNHeS): Atherosclerosis – related diseases and risk factors. Philipp J Intern Med. 2005;43:103-115.
Sy RG, Morales DD, Dans AL, Paz-Pacheco E, Punzalan FE, Abelardo NS, et al. Prevalence of atherosclerosis-related risk factors and diseases in the Philippines. J Epidemiol. 2012;22(5):440-447. http://doi.org/10.2188/jea.JE20110095.
Jasul GV, Sy RA, for the Philippine Association for the Study of Overweight and Obesity (PASOO). Obesity treatment recommendations in the Philippines: Perspective on their utility and implementation in clinical practice. J ASEAN Fed Endocr Soc. 2011;26(2):122-8. https://doi.org/10.15605/jafes.026.02.07.
World Health Organization. Physical status: The use and interpretation of anthropometry. Geneva. 1995. Available from: http://www.who.int/childgrowth/publications/physical_status/en/.
Wildman RP, Gu D, Reynolds K, Duan X, He J. Appropriate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults. Am J Clin Nutr. 2004;80(5):1129-36. PMID: 15531658.
Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr 2002;11(Suppl s8):S681-4. https://doi.org/10.1046/j.1440-6047.11.s8.5.x.
Tee ES. Obesity in Asia: Prevalence and issues in assessment methodologies. Asia Pac J Clin Nutr. 2002;11(Suppl s8):S694-701. https://doi.org/ 10.1046/j.1440-6047.11.s8.12.x.
The World Health Organization Western Pacific Region. The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney: Health Communications Australia Pty Limited. 2000. Available from: http://www.wpro.who.int/nutrition/documents/Redefining_obesity/en/.
Low S, Chin MC, Ma S, Heng D, Deurenberg-Yap. Rationale for redefining obesity in Asians. Ann Acad Med Singapore. 2009;38(1):66-9. PMID: 19221673.
Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S. Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr. 2002;11(Suppl s8):S732-7. https://doi.org/10.1046/j.1440-6047.11.s8.19.x.
Bei-Fan Z and the Cooperative Meta-analysis Group of Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: Study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Asia Pac J Clin Nutr. 2002;11(Suppl s8);S685-93. https://doi.org/10.1046/j.1440-6047.11.s8.9.x.
Lin WY, Lee LT, Chen CY, Lo H, Hsia HH, Liu IL, et al. Optimal cut-off values for obesity: Using simple anthropometric indices to predict cardiovascular risk factors in Taiwan. Int J Obes Relat Metab Disord. 2002;26(9):1232-8.
Ko GTC, Chan JCN, Cockram CS, Woo J. Prediction of hypertension, diabetes, dyslipidaemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese. Int J Obes Relat Metab Disord. 1999;23(11):1136-42.
Deurenberg-Yap M, Chew SK, Lin VF, Tan BY, van Staveren WA, Deurenberg P. Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore. Int J Obes Relat Metab Disord. 2001;25(10):1554-62.
Zaher ZM, Zambari R, Pheng CS, Muruga V, Ng B, Appannah G, et al. Optimal cut-off levels to define obesity: Body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia. Asia Pac J of Clin Nutr. 2009;18(2):209-16. PMID: 19713180.
An Y, Yi S, Fitzpatrick A, Gupta V, Prak PR, Oum S, et al. Appropriate body mass index and waist circumference cutoff for overweight and central obesity among adults in Cambodia. PLoS One. 2013;8:e77897. https://doi.doi10.1371.
Aekplakorn W, Kosulwat V, Suriyawongpaisal P. Obesity indices and cardiovascular risk factors in Thai adults. Int J Obes. 2006;30:1782-90. https://doi.org/10.1038/sj.ijo.0803346.
Ardeña GJ, Paz-Pacheco E, Jimeno CA, Lantion-Ang FL, Paterno E, Juban N. Knowledge, attitudes and practices of persons with type 2 diabetes in a rural community: Phase I of the community-based Diabetes Slef-Management Education (DSME) program in San Juan, Batangas, Philippines. Diabetes Res Clin Pract. 2010;90(2):160-6. https://doi.org/10.1016/j.diabres.2010.08.003.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;31(Suppl 1):S81-90. https://doi.org/10.2337/dc14-S081.
National Education Program. Third report on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-3422.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al for the National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206-52. https://doi.org/ 10.1161/01.HYP.0000107251.49515.c2.
Kannel WB, Cupples LA, Ramaswami R, Stokes J III, Kreger BE, Higgins M. Regional obesity and risk of cardiovascular diseases; The Framingham Study. J Clin Epidemiol. 1991;44(2):183-190. https://doi.org/10.1016/0895-4356(91)90265-B.
Deurenberg-Yap M, Yian TB, Kai CS, Deurenberg P, van Staveren WA. Manifestation of cardiovascular risk factors at low levels of body mass index and waist-to-hip ratio in Singaporean Chinese. Asia Pac J Clin Nutri 1999;8:177-183.
Araneta MR, Kanaya AM, Hsu WC, Chang HK, Grandinetti A, Boyko EJ, et al. Optimum BMI cut points to screen Asian Americans for type 2 diabetes. Diabetes Care. 2015;38:814-820.
UNITE for Diabetes Philippines. Philippine practice guidelines on the diagnosis and management of diabetes mellitus. PPD Compendium of Philippine Medicine, 16th ed, 2014.
Araneta MRG, Barrett-Connor E. Ethnic differences in visceral adipose tissue and type 2 diabetes: Filipino, African-American, and White women. Obes Res 2005;13(8):1458-65. https://doi.org/10.1038/oby.2005.176.
Zhu S, Heymsfield SB, Toyoshima H, Wang Z, Pietrobelli A, Heshka S. Race-ethnicity-specific waist circumference cutoffs for identifying cardiovascular disease risk factors. Am J Cin Nutr. 2005;81(2):409-15. PMID: 15699228.
Li G, Chen Y, Jang J, Wang J, Xing X, Yang W, et al. Obesity, coronary heart disease risk factors and diabetes in Chinese: An approach to the criteria of obesity in Chinese population. Obes Rev. 2002;3(3):167-72. https://doi.org/ 10.1046/j.1467-789X.2002.00067.x.
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