A Comparative Study of International and Asian Criteria for Overweight or Obesity at Workplaces in Singapore

To compare the prevalence of and risk factors associated with overweight or obesity between the international (body mass index [BMI] ≥25 kg/m2) and Asian (BMI ≥23 kg/m2) criteria in a working population in Singapore. This was a cross-sectional analysis of a cohort study of 464 employees (aged ≥21 years) conducted at 4 workplaces in Singapore. The prevalence of overweight or obesity was 47.4% and 67.0% with the international and Asian criteria, respectively. With both the criteria, higher age, male sex, Malay ethnicity (vs Chinese), lower white rice intake, and consumption of sugar-sweetened beverages were positively associated with overweight or obesity. Participants with poorer mental health and higher levels of thermal comfort in the workplace were positively associated with overweight or obesity only with the Asian criteria. The use of international criteria alone in this population could have overlooked these risk factors that are highly relevant to the Singapore context.

Effect of Asian BMI on risk of chronic disease progression: A Singapore perspective

Objectives: High body mass index (BMI) has been associated with increased mortality, healthcare utilization and costs. This study investigates the one-year chronic disease progression and risk of developing diabetes with varying cardiovascular disease (CVD) risks based on the Asian BMI categories. Methods: Patients with BMI information from 2008 to 2014 were included in the analysis ( N=23,508). Patients were stratified into low, moderate, high and very high CVD risk categories. To study disease progression for patients with varying CVD risks, patients were further segmented into seven mutually exclusive disease states based on prevalence of chronic diseases and their complications. The categories were no known chronic disease, at-risk of developing chronic disease, one chronic condition, more than two chronic conditions, chronic conditions with complications, patients with cancer and death. Logistic regression was used to determine the association of CVD risk categories and risk of having diabetes. Results: High CVD risk patients had more chronic diseases in the following year as compared with low CVD risk patients. With reference to low CVD risk patients, patients in the moderate, high and very high risk categories had an odds ratio of 1.78 (95% confidence interval (CI): 1.60 to 1.98), 2.84 (95% CI: 2.51 to 3.21) and 3.99 (95% CI: 3.30 to 4.82) for having diabetes after adjusting for age, gender and ethnicity. Conclusions: Higher BMI is associated with greater chronic disease progression in the following year. Diet control and lifestyle modifications should be encouraged to prevent people from shifting to higher BMI strata as this can be detrimental in the long run.