A new study finds that Japanese-American adults who are not obese have a much higher prevalence of diabetes than non-obese non-Hispanic white Americans (8.0% vs. 4.5%).
The study was conducted by the University of Victoria, University of Toronto, and University at Albany, SUNY.
Researchers looked at a representative sample of community-dwelling Californians aged 18 and older from seven combined waves of the California Health Interview Survey (CHIS) conducted between 2007 and 2016.
The study sample was restricted to Japanese Americans (n = 2,295) and non-Hispanic whites (n = 119,651) who were non-obese, defined as having a body mass index (BMI) of less than 30.
“N” represents the sample sizes for non-obese (BMI < 29.99) Japanese Americans and Non-Hispanic Whites.
“In this study of non-obese adults, Japanese Americans had twice the odds of diabetes compared to non-Hispanic whites, and this difference remained even after adjustments were made for known risk factors of diabetes including age, sex, income, education, and health behaviors,” stated lead author Karen Kobayashi, associate dean and professor at the Institute on Aging and Lifelong Health at the University of Victoria in Canada.
Among non-obese Japanese Americans, younger respondents, who never smoked and those with a post-secondary degree were less likely to have diabetes, according to Kobayashi.
Those born abroad had a comparable prevalence of diabetes to Japanese-Americans born in the United States.
As far as why Japanese Americans have a higher prevalence of diabetes even if they are not overweight, Kobayashi told dLife in an e-mail she believes that the Japanese, overall, may have a genetic predisposition to Type 2 diabetes.
She points to previous research for evidence to support this idea.
“In contrast to our expectations, gender, poverty status and exercise were not associated with the prevalence of diabetes, once age was taken into account,” reported co-author Keith Tsz-Kit Chan, assistant professor at University at Albany, SUNY.
The researchers found that older age was a particularly strong risk factor for diabetes. One-quarter of non-obese Japanese Americans aged 80 and older had diabetes, according to the researchers.
“Although Japanese-Americans and white Americans with diabetes were equally likely to receive foot exams and hemoglobin A1C checks, both groups would benefit from targeted outreach because more than one-quarter of respondents had not received these treatments at an optimal frequency in the preceding year,” stated co-author Mushira Mohsin Khan, a doctoral student at the Institute on Aging and Lifelong Health at the University of Victoria.
Since two-thirds of Japanese-Americans with diabetes were not obese, it is clearly important that family doctors and other health-care professionals regularly screen their Japanese-American patients for diabetes, even if they are not overweight and they have no known risk factors for diabetes, said co-author Esme Fuller-Thomson, the Sandra Rotman Endowed Chair at the University of Toronto’s Factor-Inwentash Faculty of Social Work and Director of the Institute for Life Course & Aging.
“Given the above, we believe that lowering the BMI threshold for diabetes screening among Japanese-Americans has great potential to improve the rates of primary prevention for Japanese-Americans with pre-diabetic status through lifestyle modifications to prevent or delay the development of diabetes,” Kobayashi concluded.
The study is published in Advances in Preventive Medicine.
The University of Toronto.
- The University of Toronto. (2019, September 10). Diabetes nearly doubles for Japanese-Americans. EurekAlert! Retrieved September 11, 2019, from https://www.eurekalert.org/pub_releases/2019-09/uot-dnd090919.php