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WHO came up with this?

4/28/2015

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Jih and colleagues report that the WHO advises lower BMI cut points for overweight/obesity in Asians. Using these cut points, the authors analyse the 2009 adult California Health Interview Survey (n = 45,946) of non-Hispanic Whites, African Americans, Hispanics and Asians.  They report that using the ethnic-specific criteria, Filipinos have the highest prevalence of overweight/obesity, and that most Asian subgroups have higher diabetes prevalence at lower BMI cut points.  


My question is: if BMI already accounts for stature, then why would there different cut-points for Asian sub-populations?  One might answer: “Because at a given BMI, Asians have a higher diabetes risk than non-Hispanic Whites.”  But if that is the justification, then shouldn't we also have a lower cut-point for poor people? 


Moreover, the WHO cut-points were recommended for Asians, not for Asian-Americans.  We know from decades of research that immigrants take on the risk profile of their adopted countries.  So how many generations would it take for Asian-Americans to get the American cut-points instead of the Asian cut-points?  Obviously the application of the Asian threshold to people born in the US turns a regional norm into a racial trait.  

The authors write "In particular, we focused on prevalence of diabetes in the category 23–24.9 kg/m2, in which Asians are considered overweight by the WHO guidelines while non-Asians are not, and in the category 27.5–29.9 kg/m2, in which Asians are considered obese but the other the groups are classified as overweight."  



Do these folks know what a BMI of 23 kg/m2 looks like?  If someone thinks that women 3 and 4 below are "overweight", I think they may have a perceptual disorder.  
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