Body Mass Index and Cardiovascular Disease Risk Factors in Seven Asian and Five Latin American Centers: Data from the International Clinical Epidemiology Network (INCLEN)

We have tested the hypothesis that the relationship between body mass index (BMI) and other cardiovascular disease (CVD) risk factors as well as socioeconomic status is different in five Latin American populations (where BMI is high) and seven Asian populations (where BMI is low). Random samples of approximately 200 males aged between 35 and 65 years were selected from 12 general or industrial populations in Latin America and Asia. Standardized measures of height, weight, blood pressure, blood cholesterol, cigarette smoking, highest level of completed education, occupation and income were made. The mean BMI (kg/m₂) was 253 (SD 3.74) in the five Latin American populations (which were all urban), 22.2 (SD 3.24) in the four Asian urban populations and 21.4 (SD 3.33) in the three Asian rural populations. Despite the differences in mean BMI levels, statistically significant positive relationships of a similar magnitude were seen between BMI and blood pressure levels in Latin America and Asia. Similarly, there was a statistically significant positive relationship found between BMI and total cholesterol in both Latin American and Asian urban samples, but of a higher magnitude in Asian rural samples. Current cigarette smokers had significantly lower BMI than ex-smokers or never smokers in Latin America and Asia. In Asia, there were statistically significant positive associations between BMI and levels of education and income as well as with occupation — these relationships were stronger for education and occupation in rural than in urban samples. There were no statistically significant associations between BMI and these measures of socioeconomic status in Latin America. The similarities of the associations between BMI and blood pressure and cholesterol levels in the two groups suggest that efforts to reduce BMI in all populations is likely to be important in reducing risk of CVD. Preventing the future rise of BMI in populations tions where BMI is still relatively low is a high priority. The difference in association between BMI and socioeconomic status in the different population groups requires study of the way sociocultural factors influence behavior that determines BMI levels.