Longitudinal study of acculturation and BMI change among Asian American men.

BACKGROUND: Cross-sectional studies examining the association between Western acculturation and BMI in Asians have been inconsistent, and studies on BMI change are lacking. OBJECTIVE: This study examined the associations between indicators of acculturation (generational status, length of US residence, and age at immigration) and overweight (BMI ≥25kg/m(2)) as well as 5-year BMI changes in 7,073 Chinese, Japanese, Korean, Filipino, and Vietnamese men who lived in the US and were 44-71years old at baseline of the California Men's Health Study (2002-2003). METHODS: Indicators of acculturation were reported at baseline. Repeated clinical measures of BMI were extracted from electronic health records (2005-2012). RESULTS: Using generalized estimating equations we found that lower generational status, shorter duration of US residence and older age at immigration were inversely associated with being overweight. However, analysis of BMI curves using linear mixed models showed that shorter length of US residence and older age at immigration were associated with larger 5-year increases in BMI. CONCLUSIONS: Asian immigrants who were less acculturated had larger BMI increases as they became more acculturated but had not achieved overweight status. Healthy weight interventions among Asians immigrants may be most effective when targeting weight maintenance early in the process of acculturation.

Cardiovascular disease risk by assigned treatment using the 2013 and 1998 obesity guidelines.

OBJECTIVE: The 1998 and the 2013 guidelines on management of overweight and obesity in adults provided algorithms for identification of patients to be treated with weight loss. To date, the cardiovascular disease (CVD) risk in the groups recommended or not recommended for weight loss treatment has not been estimated and compared. METHODS: Baseline data for the Atherosclerosis Risk in Communities study were collected between 1987 and 1989 from adults aged 45 to 64 years. Black and White men and women free of CVD were followed over 22.8 years (median), and 2,907 incident CVD events were recorded. RESULTS: The hazard ratios adjusted for demographic variables in adults not recommended for treatment versus adults recommended for treatment were 0.54 (95% CI: 0.50-0.59) for the 1998 algorithm and 0.63 (95% CI: 0.58-0.69) for the 2013 algorithm, respectively. No gender or race differences were detected when the 2013 algorithm was applied, but using the 1998 algorithm, CVD risk between the groups recommended or not recommended for treatment was more pronounced in Black women than in Black men. CONCLUSIONS: The 2013 algorithm performed similarly in Black and White men and women but did not improve upon the 1998 algorithm in terms of discriminating risk of CVD.