According to the body mass index chart I have been using for the last few decades, I have been safely in the normal range at only 24.95 BMI. Although this was on the borderline of being overweight, I was always very comforted by the fact that I was in the NORMAL range. It was always very easy for me to stay outside of the overweight category by staying at just under 25 BMI. As long as I was barely under 25 BMI, I had this wonderful chart that told me that I was normal.
This affirming and reassuring CDC chart was from 2005.
An Australian BMI chart used the same numbers and told me I'm not just normal, but healthy! There's even picture of a healthy guy in the green zone and he's smiling too. That used to be me.
Being smugly complacent with my healthy normality for my entire life, I never thought that there could be different charts for different races of people.
Yes, there are and I was using the wrong chart. The charts that I had been using were not made for Asian Americans, but rather for Caucasians. Evidently, Asians are supposed to be genetically thinner and will get diabetes more easily at the same BMI. Ergo, the idea of Asians being genetically thin is not just some kind of cultural stereotype, or a cultural difference more related to food choices like less dairy and meat in favor of soy and veggies. As far as type 2 diabetes is concerned, race is not a social construct, but rather basic biology.
The Joslin Diabetes Center has an Asian American Diabetes Initiative that came out with a new chart. It's a shocking new chart, just shocking. It shifted me from the 'good' zone into the 'bad' zone.
The Joslin Diabetes Center: Asian American Diabetes Initiative that explains that I'm overweight for an Asian, and thus at elevated risk, even though I would be normal weight for a Caucasian. I'm being held to a different standard. This reminds me of when I got top 2% percentile in math and top 2% percentile in English on my SAT back in High School, and then all my Asian friends said that was actually kind of a weak score since I'm Asian after all, and besides they did much better. Even though I had a Mensa qualifying score, it was only good in the context of being compared with non-Asian high school students, which my peers didn't feel was a valid comparison. This was way before Ward Connelly's prop 209, so fortunately I still got into UCLA engineering school.
The Center for Disease Control, Department of Health and Human Services has an Office of Minority Health in the National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation that explains:
"Asian Americans are 10 percent less likely than non-Hispanic Whites to die from diabetes, however they have additional risk factors.
- Asian Americans are 20 percent more likely to be diagnosed with diabetes as compared to non-Hispanic Whites.
- Asians are 10% less likely than non-Hispanic whites to die from diabetes.
At a glance – Diagnosed Cases of Diabetes:National Health Interview Survey, NHIS
- In 2009, Asian Americans were 20 percent less likely than non-Hispanic Whites to have an annual foot examination.
Source: CDC 2012. Summary Health Statistics for U.S. Adults: 2011. Table 8.
Age-adjusted percentages of persons 18 years of age and over with diabetes, 2011
http://www.cdc.gov/nchs/data/series/sr_10/sr10_256.pdf [PDF | 3.1MB]"
So the CDC is basically saying that non-Hispanic Whites are 20% genetically better suited for surviving a couch potato lifestyle eating lots of fried foods, sugary snacks, soft drinks and starchy carbohydrates. The CDC makes the hypothesis that certain races have, "a 'thrifty gene' which helped their ancestors store food energy better during times when food was plentiful, to survive during times when food was scarce." That certainly could be a likely hypothesis given that some of my ancestors starved or almost starved, for many thousands of years living on the Malthusian edge of existence. Certainly none of my ancestors got an annual foot examination or worried about losing a foot to diabetes.
Moreover, it's is not just type II diabetes. Asians become susceptible to all kinds of diabetes, even GDM "gestational diabetes" at much lower BMIs. It appears that Non-Hispanic Blacks have a high resistance to GDM so maybe someone will develop an African-American BMI chart that tells previously overweight blacks that they are actually at a healthy and normal weight.
Kim SY, England L, Sappenfield W, Wilson HG, Bish CL, Salihu HM, Sharma AJ. Racial/ethnic differences in the percentage of gestational diabetes mellitus cases attributable to overweight and obesity, Florida, 2004-2007. Prev Chronic Dis 2012;9:110249. DOI: http://dx.doi.org/10.5888/pcd9.110249
This means that God made Asians skinny and I'm supposed to be skinny. For an Asian guy, I'm suddenly now fat, porky, overweight, chubby. Thus, I am currently opposing the will of God by being normal weight for a Caucasian, which means eventually God will punish my sinfulness with diabetes, and who knows what else, if I don't shape up.
The Asian Diabetes Prevention Initiative (a joint initiative between the Harvard School of Public Health, Department of Nutrition and the National University of Singapore, Saw Swee Hock School of Public Health) says I also have to have ripped abs, not just an overall toned body.
"Even if you [Asian person] have a normal BMI, an 'apple-shaped body' (with excess fat around the waist) increases your diabetes risk. Your target measurement for waist circumference should be less than or equal to 90 cm (35.5 in) for men and 80 cm (31.5 in) for women."This by default makes New Year's resolution = losing 10 pounds to marginally get back in the green healthy zone on the BMI chart. It's only 1 BMI away. Time to hit the gym hard.
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