To compare the different correlations of body mass index (BMI) and percent body fat (BF%) with other ethnic groups and to evaluate the appropriateness of Asia-Pacific redefining obesity criteria in the Taiwanese population. The corresponding BF% to BMI cutoffs of overweight and obesity will also be studied.

A cross-sectional epidemiological survey.

SUBJECTS: A total of 509 male and 570 female Taiwanese subjects aged greater than or equal to20 y sampled by the systematic stratified clustering sampling method were analyzed.

MEASUREMENTS: BMI was obtained by body weight (kg) divided by squared body height (m2). The estimated BMI (BMIe) was deduced from the Caucasian-based four-compartment equation (4C). BF% measured by the methods of dual-energy X-ray absorptiometry (DXA) or Caucasian-based 4C were used and abbreviated as DXA-BF and 4C-BF, respectively.

RESULTS: The curvilinear relationship between age and BMI or DXA-BF was established. When compared by age-stratified groups, Taiwanese subjects had a higher BF% (4C-BF) in any given BMI than Caucasians. That is, the level of 4C-BF for BMIgreater than or equal to25 kg/m2 in Taiwanese subjects was similar to BMIgreater than or equal to30 kg/m2 in Caucasians. The BMIe values of 25 and 30 kg/m2 were nearly equal to the BMIs of 23.6 and 25.3 kg/m2 in males, and 22.7 and 24.8 kg/m2 in females, respectively. The 4C-BF of 25% was nearly equal to a BMI of 26.2 kg/m2 in males, and 35% was equal to a BMI of 24.4 kg/m2 in females. Consequently, the DXA-BF cutoffs for BMIs of 23 and 25 kg/m2 were compatible to 23 and 25% in males, and 35 and 38% in females, respectively.

CONCLUSION: It was demonstrated that Taiwanese subjects had a relatively lower BMI but a higher BF% than Caucasians. In general, the newly proposed Asia-Pacific BMI cutoffs for overweight (greater than or equal to23 kg/m2) and obesity (greater than or equal to25 kg/m2) may be acceptable to both male and female Taiwanese subjects. The corresponding BF% (DXA-BF) cutoffs for obesity would be 25% in male and 38% in female Taiwanese subjects, respectively.
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Weight loss has advantages in reducing cardiovascular risk factors and other obesity associated diseases.

Benefits of weight loss on health risks in obesity (Evidence Level B) Health Risk Benefits of 10 kg weight loss in a 100 kg subject
1. Blood Pressure
  • 10 mmHg reduction systolic BP
  • 20 mmHg reduction diastolic BP
  • Weight loss also reduces the need for medication in hypertensive patients
2. Lipids
  • 10% reduction in Total Cholesterol
  • 15% reduction in LDL-cholesterol
  • 30% reduction in Triglycerides
  • 8% increase in HDL-cholesterol
3. Diabetes
  • >50% reduction in risk of developing DM (Weight loss of 6.8 kg is associated with 58% reduction in incidence of diabetes, at 3 years in the Diabetes Prevention Programme)
  • 30-50% reduction in Fasting plasma glucose
  • 15% reduction in HbA1c
4. Osteoarthritis
  • Decrease BMI > 2kg/m2 associated with more than 50% decreased risk for developing osteoarthritis
5. Mortality
  • 20 –25% reduction all – cause mortality
  • 30 – 40% reduction diabetes related death
  • 40 – 50% reduction in obesity-related cancer death
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