BMI Percentile Cutoffs for Overweight and Obesity Are Set Too High in Terms of Adiposity and Metabolic Markers for Asian Children and Adolescents

IF 2.5 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2025-12-10 DOI:10.1111/ijpo.70075

Suk-Jin Hong, Xinlian Zhang, Phillipp Hartmann

{"title":"BMI Percentile Cutoffs for Overweight and Obesity Are Set Too High in Terms of Adiposity and Metabolic Markers for Asian Children and Adolescents","authors":"Suk-Jin Hong, Xinlian Zhang, Phillipp Hartmann","doi":"10.1111/ijpo.70075","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Asian adults develop metabolic complications at lower body mass indices (BMIs) compared with other ethnic groups, leading to lower BMI cutoffs for overweight and obesity. However, it remains unclear whether such adjustments are warranted in Asian children and adolescents. We aimed to determine whether lower BMI percentile cutoffs should be considered for overweight and obesity among Asian children and adolescents in the United States.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We analysed nationally representative data from U.S. children and adolescents from NHANES, 2012–2020. Metabolic parameters—including truncal fat percentage, glycemic markers, lipid profiles and liver disease markers—were compared between Asian and non-Asian participants within the 85–95th percentile and ≥ 95th percentile ranges. Metabolic parameter-based matching analyses identified corresponding BMI percentiles between groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Asian children had more pronounced metabolic abnormalities than non-Asians in the overweight and obesity groups. After matching for metabolic parameters, Asians had the same levels of metabolic dysfunction at lower BMI percentiles than non-Asians, with averaged differences of approximately 3–9 BMI percentiles across various BMI percentile ranges.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Asian children and adolescents experience elevated metabolic risks at currently defined BMI percentiles. Lower BMI cutoffs targeting the 80th percentile for overweight and 90th percentile for obesity may improve early detection of metabolic risks in the Asian paediatric population.</p>\n </section>\n </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"21 1","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70075","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Obesity","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ijpo.70075","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Asian adults develop metabolic complications at lower body mass indices (BMIs) compared with other ethnic groups, leading to lower BMI cutoffs for overweight and obesity. However, it remains unclear whether such adjustments are warranted in Asian children and adolescents. We aimed to determine whether lower BMI percentile cutoffs should be considered for overweight and obesity among Asian children and adolescents in the United States.

Methods

We analysed nationally representative data from U.S. children and adolescents from NHANES, 2012–2020. Metabolic parameters—including truncal fat percentage, glycemic markers, lipid profiles and liver disease markers—were compared between Asian and non-Asian participants within the 85–95th percentile and ≥ 95th percentile ranges. Metabolic parameter-based matching analyses identified corresponding BMI percentiles between groups.

Results

Asian children had more pronounced metabolic abnormalities than non-Asians in the overweight and obesity groups. After matching for metabolic parameters, Asians had the same levels of metabolic dysfunction at lower BMI percentiles than non-Asians, with averaged differences of approximately 3–9 BMI percentiles across various BMI percentile ranges.

Conclusions

Asian children and adolescents experience elevated metabolic risks at currently defined BMI percentiles. Lower BMI cutoffs targeting the 80th percentile for overweight and 90th percentile for obesity may improve early detection of metabolic risks in the Asian paediatric population.

Abstract Image

查看原文本刊更多论文

就亚洲儿童和青少年的肥胖和代谢指标而言，超重和肥胖的BMI百分位数临界值设定得过高

与其他种族相比，亚洲成年人在较低的身体质量指数（BMI）下发生代谢并发症，导致超重和肥胖的BMI临界值较低。然而，目前尚不清楚这种调整是否适用于亚洲儿童和青少年。我们的目的是确定在美国的亚洲儿童和青少年中是否应该考虑较低的BMI百分位数临界值来治疗超重和肥胖。方法分析2012-2020年NHANES中具有全国代表性的美国儿童和青少年数据。在85 - 95百分位和≥95百分位范围内比较亚洲和非亚洲参与者的代谢参数，包括躯干脂肪百分比、血糖标志物、脂质谱和肝脏疾病标志物。基于代谢参数的匹配分析确定了组间相应的BMI百分位数。结果在超重和肥胖组中，亚洲儿童比非亚洲儿童有更明显的代谢异常。在对代谢参数进行匹配后，亚洲人在较低BMI百分位数与非亚洲人的代谢功能障碍水平相同，在不同BMI百分位数范围内的平均差异约为3-9个BMI百分位数。结论：根据目前定义的BMI百分位数，亚洲儿童和青少年的代谢风险较高。较低的BMI临界值，针对超重的第80百分位和肥胖的第90百分位，可以改善亚洲儿科人群代谢风险的早期检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.