BMI Percentile Cutoffs for Overweight and Obesity Are Set Too High in Terms of Adiposity and Metabolic Markers for Asian Children and Adolescents.

Asian children and adolescents had more pronounced metabolic abnormalities than non-Asian children within the same BMI percentile categories for overweight and obesity.

• Metabolic parameters compared included truncal fat percentage, glycemic markers, lipid profiles, and liver disease markers.
• Comparisons were made within the 85th–95th percentile (overweight) and ≥95th percentile (obesity) BMI ranges.
• Data were drawn from NHANES 2012–2020, a nationally representative sample of U.S. children and adolescents.
• Asian participants showed elevated metabolic dysfunction relative to non-Asian participants at the same BMI percentile thresholds.

After matching for metabolic parameters, Asian children and adolescents reached equivalent levels of metabolic dysfunction at lower BMI percentiles than non-Asian children.

• Metabolic parameter-based matching analyses were used to identify corresponding BMI percentiles between Asian and non-Asian groups.
• The averaged differences were approximately 3–9 BMI percentiles across various BMI percentile ranges.
• This pattern was consistent across multiple metabolic markers including truncal fat percentage, glycemic markers, lipid profiles, and liver disease markers.

The study used nationally representative NHANES data from 2012 to 2020 to compare metabolic parameters between Asian and non-Asian U.S. children and adolescents.

• Data source was the National Health and Nutrition Examination Survey (NHANES), cycles 2012–2020.
• The sample was described as nationally representative of U.S. children and adolescents.
• Metabolic parameters assessed included truncal fat percentage, glycemic markers, lipid profiles, and liver disease markers.
• Participants were stratified into BMI percentile ranges of 85th–95th and ≥95th percentiles for primary comparisons.

The authors propose that lower BMI cutoffs—80th percentile for overweight and 90th percentile for obesity—should be considered for Asian children and adolescents.

• Current U.S. cutoffs define overweight as BMI at the 85th–95th percentile and obesity as BMI ≥95th percentile for children and adolescents.
• The proposed adjusted thresholds (80th percentile for overweight, 90th percentile for obesity) are intended to improve early detection of metabolic risks.
• This recommendation is consistent with the precedent set for Asian adults, who have lower BMI cutoffs for overweight and obesity due to metabolic complications at lower BMIs.
• The averaged BMI percentile differences of approximately 3–9 percentiles between groups support a downward adjustment of these thresholds.

Asian adults are already recognized to develop metabolic complications at lower BMIs compared with other ethnic groups, but equivalent adjustments had not been established for Asian children and adolescents.

• Lower BMI cutoffs for overweight and obesity have been established for Asian adults based on metabolic risk data.
• The paper states 'it remains unclear whether such adjustments are warranted in Asian children and adolescents,' motivating the current study.
• The study aimed to determine whether lower BMI percentile cutoffs should be considered specifically for Asian children and adolescents in the United States.