BMI May Underestimate Metabolic Abnormality Risk Assessment in Minorities

Typical BMI criteria may overlook cardiometabolic risk in racial and ethnic minority groups.
Typical BMI criteria may overlook cardiometabolic risk in racial and ethnic minority groups.

HealthDay News — Racial/ethnic minority groups have a significantly higher prevalence of metabolic abnormality but normal weight (MAN) than whites, according to a study published online in the Annals of Internal Medicine.

Unjali P. Gujral, PhD, from Emory University in Atlanta, and colleagues conducted a cross-sectional analysis involving participants in the Multi-Ethnic Study of Atherosclerosis and in the Mediators of Atherosclerosis in South Asians Living in America study. They estimated the prevalence of 2 or more cardiometabolic abnormalities among normal-weight participants.

The researchers found that the prevalence of MAN was 21% in 846 whites, 32.2% in 323 Chinese-Americans, 31.1% in 334 African-Americans, 38.5% in 252 Hispanics, and 43.6% in 195 South Asians. The racial/ethnic differences were not explained by adjustment for demographic, behavioral, and ectopic body fat measures. For the equivalent MAN prevalence at a body mass index (BMI) of 25 kg/m² in whites, the corresponding BMI values were 22.9, 21.5, 20.9, and 19.6 kg/m² in African-Americans, Hispanics, Chinese-Americans, and South Asians, respectively, after adjustment for age, sex, and race/ethnicity-BMI interaction.

"Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked," the authors write.


Gujral UP, Vittinghoff E, Mongraw-Chaffin M, et al. Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States: a cross-sectional analysis of two cohort studies [published online April 4, 2017]. Ann Intern Med. doi: 10.7326/M16-1895

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