Research Spotlight: More Granularity in BMI Metrics for Asian Americans Could Increase Accuracy and Equity

Fatima Cody Stanford, MD, MPH, MPA, MBA, a physician investigator in the departments of Medicine and Pediatrics at Massachusetts General Hospital and an associate professor of Medicine and Pediatrics at Harvard Medical School, is senior author of a new perspective in Annals of Internal Medicine; Asian BMI: A Race Correction in Need of Correction?

What Question Were You Investigating with This Study?

This perspective sought to investigate whether body mass index (BMI) and other clinical metrics should be disaggregated in Asian populations to reflect the population's heterogeneity better.

What Are the Key Takeaways?

Due to a higher tendency towards central adiposity, Asian Americans face a substantial risk of type 2 diabetes, cardiovascular disease, and other comorbidities at lower body mass indices (BMI) than other populations.

As such, in 2004, the World Health Organization (WHO) suggested new BMI categories for many Asian populations, primarily based on data measuring body fat percentage.

Twenty years later, the U.S. still has not developed more granular BMI categories despite heterogeneity among Asian American ethnic groups.

With recent pushes toward disaggregated data and personalized medicine, we believe increasing granularity for Asian Americans can pave the way for similar efforts among all racial and ethnic groups, making BMI more accurate, tailored, and equitable.

Alternative measures for diagnosing obesity and estimating risk, including waist circumference, waist-to-hip ratio, and waist-to-height ratio, are becoming increasingly prominent.

We welcome these efforts to address BMI’s inherent limitations, but continued disaggregation is still necessary given this metric’s convenience and, thus, staying power.

What Are the Next Steps?

Ultimately, advancing equity will require funding research that engages diverse Asian communities and developing tailored interventions for all ethnicities.