Kaiser Permanente study also finds rapidly increasing rates of obesity in Filipino and other Southeast Asian ethnic groups
A growing number of Asian American, Native Hawaiian, and Other Pacific Islander young adults living in northern California have obesity, a large new Kaiser Permanente study found.
“This obesity epidemic has been hiding in plain sight because all too often studies have not focused in on the distinct ethnic subgroups that make up the broader Asian community in the U.S.,” said first author Joan Lo, MD, a research scientist at the Kaiser Permanente Division of Research.
The study, published in the Journal of the American Medical Association, included more than 1.1 million Asian American, Native Hawaiian, Pacific Islander, and White adults ages 30 to 49 who were members of Kaiser Permanente Northern California (KPNC) between 2012 and 2023.
The study’s large size and the diversity of the KPNC membership made it possible for the researchers to study obesity trends in 8 Asian and Pacific Islander populations: Chinese, Filipino, Japanese, Korean, Native Hawaiian or Other Pacific Islander, South Asian, Southeast Asian, and Vietnamese.
The researchers found that, overall, the prevalence of obesity was higher in Native Hawaiian and Other Pacific Islanders than in White young adults. In contrast, White young adults had a higher prevalence of obesity than Chinese, Japanese, Korean, South Asian, and Vietnamese adults. The study also showed that the prevalence of obesity has been accelerating fastest in Filipino and Southeast Asian young adults.
At the study’s end, in 2023, the prevalence of young adults with a body mass index (BMI) of 27.5 or higher ranged from 18% in Chinese and Vietnamese women to 48% in Filipino and other Southeast Asian women. In men, rates ranged from 34% for Chinese adults to 60% in Southeast Asian adults. In comparison, using a BMI of 30 or higher, 39% of White women and 41% of White men were obese.
“Our focus on contemporary obesity trends in younger Asian and Pacific Islander adults provides an impetus for efforts to be made nationally to focus on the specific ethnic subgroups who we show are moving through adulthood at high risk of developing significant health problems,” said Lo.
New insights into obesity
The researchers used 2 methods to classify obesity. The first method used the standard definition of obesity, which is a BMI of 30 or higher. The second method used a BMI cutoff of 27.5 or higher which has been proposed for Asian adults.
“The lower BMI threshold of 27.5 has been recommended by some to support clinical decision-making on when to treat obesity because studies have found that, overall, Asian adults develop cardiometabolic disease at lower BMI levels than White adults,” explained senior author Alan Go, MD, a DOR research scientist and associate director of the DOR Cardiovascular, Kidney, and Metabolic Health section.
For decades, rates of obesity have been increasing in children and adults in the U.S. Currently, about 1 in 5 children and 2 in 5 adults in the U.S. have obesity. This is a concern because obesity is a known risk factor for diabetes, kidney disease, and high blood pressure. In adults, it also increases risk for heart attack, stroke, heart failure, metabolic disease, and some cancers.
There are several reasons why certain Asian and Pacific Islander ethnic groups may have higher rates of obesity. These include potential biologic and genetic traits associated with ancestry, lifestyle and cultural factors, and social determinants of health.
In an editorial accompanying the study, Nilay S. Shah, MD, MPH, and Sadiya S. Khan, MD, MSc, professors at the Northwestern Feinberg School of Medicine, underscored the unique and compelling aspects of the study noting, “implementation of evidence-based preventive strategies to address known environmental drivers and adverse social and behavioral exposures among Asian American and Native Hawaiian or Other Pacific Islander populations is needed now for equitable prevention of cardiometabolic diseases.”
The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health.
Co-authors include Rishi V. Parikh, MPH, Thida C. Tan, MPH, Stacey Alexeeff, PhD, and Andrew Ambrosy, MD, of the Division of Research, and Connor K. Howick, MS, and Yihe G. Daida, PhD, of the Kaiser Permanente Center for Integrated Health Research in Hawaii.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. KPDOR seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 720-plus staff, including 73 research and staff scientists, are working on nearly 630 epidemiological and health services research projects. For more information, visit divisionofresearch.kp.org or follow us @KPDOR.
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