Elsevier

Maturitas

Volume 65, Issue 4, April 2010, Pages 315-319
Maturitas

Review
Ethnic differences in body composition and the associated metabolic profile: A comparative study between Asians and Caucasians

https://doi.org/10.1016/j.maturitas.2009.12.012Get rights and content

Abstract

It is estimated that Asia will be the home of more than 100 million people with type 2 diabetes by the year of 2025. This region combines a high proportion of the world's population with rapidly rising diabetes prevalence rates. The increase in diabetes in Asia differs from that reported in other parts of the world: it has developed in a shorter time, in a younger age group, and in people with lower body-mass index (BMI).

Studies reported that for the same BMI, Asians have a higher body fat percentage, a prominent abdominal obesity, a higher intramyocellular lipid and/or a higher liver fat content compared to Caucasians. These characteristics may contribute to a higher predisposition to insulin resistance at a lesser degree of obesity than Caucasians. The differences in body composition are more pronounced depending on the region. For the same BMI, among three major ethnic groups in Asia, Asian Indians have the highest body fat, followed by Malay and Chinese.

Lower insulin sensitivity is already observed in Asian Indian adolescents with a higher body fat and abdominal obesity compared to Caucasian adolescents. In general, Asian adolescents share the same feature of body composition such as higher body subcutaneous fat, lower appendicular skeletal muscle and lower gynoid fat compared to Caucasian adolescents. This unfavourable body composition may predispose to the development of insulin resistance at later age. Genetics may play a role and the interaction with environmental factors (changes in lifestyle) could increase the risk of developing the metabolic syndrome.

Introduction

By the year 2025, 300 million people will have diabetes and among them more than 100 million people live in Asia [1]. This region combines a high proportion of the world's population with rapidly rising diabetes prevalence rates [2] due to the pronounced demographic, epidemiologic and socioeconomic changes in recent decades [3]. The increase of diabetes in Asia differs from that reported in other parts of the world: it has developed in a shorter time (3–5-fold increase within 30 years), in a younger age group (45–64 years old), and in people with a lower body-mass index (BMI) compared to that in Western countries [3].

BMI is significantly correlated with adiposity [4], [5] and can predict body fat percentage adequately as long as age and gender are taken into account [6]. Excess adiposity (body fat) has been shown to be an independent risk factor for diabetes, cardiovascular disease, dyslipidaemia and hypertension [7]. The phenomenon in Asians, is most likely due to a higher percentage of body fat accumulation at a given BMI level compared to Caucasians [8], as pointed out by a series of comparative studies from Deurenberg et al. [9], [10], [11]. Hence, the relationship between body fat percentage and BMI is ethnic-specific [12]. Increased body fat percentage may affect individuals differently due to differences in genetic make-up, intra-uterine (developmental) environment, or dietary and physical activity patterns [8].

Section snippets

Body composition

Numerous comparative studies reported that for the same BMI, age and gender, Asians had a higher body fat percentage compared to Caucasians. The studies were performed among South Asian Indians/Pakistani [13], [14], [15], [16], [17], [18], East Asian Hong Kong Chinese [19], Japanese [20], Korean women [21] and Taiwanese [22] as well as Southeast Asian Indonesian [23], Singaporean [11] and Philipino [24]. Some studies reported no differences [11], [25], [26].

For the same BMI as Caucasians, the

The metabolic profile associated with the “unfavourable” body composition in Asians

The “unfavourable” body composition in Asians implicates some metabolic consequences. As Asians were found to have a higher risk to develop the metabolic syndrome at a relatively lower BMI [3], they were identified as metabolically obese but normal body weight (MONW) [35]. The existence of a subgroup of normal-weight individuals displaying an obesity-related phenotype was first proposed in 1981 by Ruderman et al. [36]. These individuals might be characterized by hyperinsulinemia and/or insulin

General discussion

Evidence showed that the high prevalence of metabolic disease in Asia was partly explained by an unfavourable body composition. However, there is a lack of understanding of the ethnic-specific nature of the association between the various components of body composition and morbidity sequelae [17]. For example, in contrast with Caucasians, the higher BMI, body fat percentage, visceral fat and intramyocellular lipid in Asian Indians did not correlate with insulin sensitivity [13], but waist to

Conclusion

The difference in body fat percentage between Asians and Caucasians is dependent on the region/ethnicity. It is most pronounced in South (Indians), followed by Southeast (Malay) and than East Asian (Chinese/Japanese). In general, Asians tend to store more fat in abdominal regions.

Genetic variation in lean body mass and fat mass may predispose individuals in different ethnicities to a different muscularity and adiposity. The interaction with other genes or the environment, both prenatal and

Contributors

As the first author, Siti Wulan is responsible for most of the writing of the manuscript.

Klaas Westerterp and Guy Plasqui, as supervisors of Ms. Siti Wulan, have contributed by discussing the content of the paper, as well as reviewing and correcting the manuscript.

Competing interests

The authors have no conflicts of interest.

Provenance and peer review

Commissioned and externally peer reviewed.

Acknowledgements

This work was supported by the Directorate General Higher Education, Ministry of National Education of Indonesia.

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