Sivasubramanian Ramya, Malhotra Sonali, Fitch Angela K, Singhal Vibha
Division of Pediatric Endocrinology, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA 02114, USA.
MGH Weight Center, Harvard Medical School, Boston, MA 02114, USA.
Children (Basel). 2021 May 25;8(6):447. doi: 10.3390/children8060447.
South Asians constitute one-fourth of the world's population and are distributed significantly in western countries. With exponentially growing numbers, childhood obesity is of global concern. Children of South Asian ancestry have a higher likelihood of developing obesity and associated metabolic risks. The validity of commonly used measures for quantifying adiposity and its impact on metabolic outcomes differ by race and ethnicity. In this review we aim to discuss the validity of body mass index (BMI) and other tools in screening for adiposity in South Asian children. We also discuss the prevalence of overweight and obesity amongst South Asian children in western countries and the differences in body fat percentage, adiposity distribution, and metabolic risks specific to these children compared to Caucasian children. South Asian children have a characteristic phenotype: lower lean mass and higher body fat percentage favoring central fat accumulation. Hence, BMI is a less reliable predictor of metabolic status in these children than it is for Caucasian children. Furthermore, the relatively lower birth weight and rapid growth acceleration in early childhood of South Asian children increase the risk of their developing cardiometabolic disorders at a younger age than that of Caucasians. We emphasize the need to use modified tools for assessment of adiposity, which take into consideration the ethnic differences and provide early and appropriate intervention to prevent obesity and its complications.
南亚人占世界人口的四分之一，并且大量分布在西方国家。随着数量呈指数级增长，儿童肥胖已成为全球关注的问题。南亚裔儿童患肥胖症及相关代谢风险的可能性更高。常用的量化肥胖及其对代谢结果影响的指标的有效性因种族和民族而异。在本综述中，我们旨在讨论体重指数（BMI）和其他工具在筛查南亚儿童肥胖方面的有效性。我们还将讨论西方国家南亚儿童中超重和肥胖的患病率，以及与白人儿童相比，这些儿童在体脂百分比、肥胖分布和代谢风险方面的差异。南亚儿童具有独特的表型：较低的瘦体重和较高的体脂百分比有利于中心性脂肪堆积。因此，与白人儿童相比，BMI对这些儿童代谢状态的预测可靠性较低。此外，南亚儿童相对较低的出生体重和幼儿期快速的生长加速，使他们比白人儿童在更年轻时患心脏代谢疾病的风险增加。我们强调需要使用经过改进的工具来评估肥胖，这些工具要考虑到种族差异，并提供早期和适当的干预措施以预防肥胖及其并发症。
