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 Almost one in three people with a healthy weight for their height
based on a measurement known as body mass index (BMI) still had at
least one risk factor for heart disease such as elevated blood
pressure or high levels of sugars, fats or cholesterol in the blood,
the study found.
Among white people in the study, only 21 percent normal weight
individuals based on BMI, or about one in five, had risk factors for
heart disease and diabetes. But a much higher proportion of healthy
weight people in other racial and ethnic groups had heart or
diabetes risk factors: 31 percent of black people, 32 percent of
participants of Chinese descent, 39 percent of Hispanics and 44
percent of South Asians.
“These results show that having a normal BMI does not necessarily
protect an individual from cardiometabolic risk,” said lead study
author Unjali Gujral, a public health researcher at Emory University
in Atlanta.
“We advocate a heart healthy diet and lots of exercise in all
individuals, regardless of race/ethnicity and body weight, but
especially in those who are members of racial/ethnic minority
populations,” Gujral said by email. “It is also important for
patients, particularly those who are Asian American, Hispanic
American and African American to have conversations with their
physicians/healthcare providers regarding their increased risk for
heart disease even at normal weight.”
For the study, researchers examined data on adults aged 44 to 84
living in seven U.S. cities. Within this group, 2,622 were white,
803 were Chinese, 1,893 were black, 1,496 were Hispanic and 803 were
South Asian.
They used data on participants’ height and weight to calculate BMI
and then see how often a healthy BMI was associated with common risk
factors for heart disease that are typically seen in obese people.
For most adults, including white, black and Hispanic individuals, a
BMI between 18.5 and 24.9 is considered a healthy weight, 25 to 29.9
is overweight and 30 or above is obese, according to the World
Health Organization.
Because Asian people are known to have a higher risk of heart
disease and diabetes at a lower BMI than other populations, WHO
created a different scale for Chinese and South Asian people. In
this scale, a BMI of 18.5 to 22.9 is considered a healthy weight, a
BMI of 23 to 27.4 is overweight and 27.5 or above is obese.
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Even with these different BMI scales applied to the participants,
researchers found that BMI alone didn’t explain heart or diabetes
risk. Neither did age, education, gender, exercise, whether people
smoked or where their body tended to store fat.
Researchers calculated that the ethnic and racial differences in
risk mean a white person with a BMI of 25.5, which is in the
overweight range, has about the same likelihood of heart disease or
diabetes as an African American with a BMI of 22.9, a Hispanic
person with a BMI of 21.5, a Chinese person with a 20.9 BMI and a
South Asian person with a 19.6 BMI – all of whom would be considered
in the “healthy” BMI range.
Current U.S. screening recommendations that emphasize testing for
risk factors for heart disease and diabetes in people who are
overweight or obese, may lead the risk to be overlooked in some
normal weight people, especially if they aren’t white, the
researchers conclude.
In particular, even normal weight people should pay close attention
to their waistline and make lifestyle changes if they start to get
thicker around the middle, said Jean-Pierre Despres of the Quebec
Heart and Lung Institute Research Center and the Laval University in
Canada.
“Your waistline, irrespective of your BMI, is an important vital
sign,” Despres, who wasn’t involved in the study, said by email.
“You do not want it to go up if you are healthy, and you want it to
go down if you have risk factors for cardiovascular disease and
diabetes.”
SOURCE: http://bit.ly/2nYKBmT and http://bit.ly/2nFZQhR Annals of
Internal Medicine, online April 3, 2017
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