![]() Therefore, having a common BMI cut-off for obesity is not appropriate, as these cut-off points were derived from studies of the relationship between BMI, morbidity and mortality in the Western populations. In a cross-sectional study of Malaysian women aged 40–59, prevalence of obesity was 72.8% based on BF% (BF% > 33) but only 20.6% when classified using BMI ≥ 30 kg/m 2. Asians are found to have a higher body fat percentage for the same age, gender, and BMI, when compared to European white population, and have higher prevalence of type 2 diabetes (T2DM) and increased cardiovascular risk at lower BMI values compared to European white population. Furthermore, the relationship between BMI, BF%, and body fat distribution differ with ethnicity. BMI (body weight divided by height squared) is not a good indicator of body fat, as body weight comprises both fat and fat-free mass. WC have different cut-off points between Europeans (102 cm for men and 88 cm for women) and Asians (90 cm for men and 80 cm for women) due to different body sizes. Waist circumference (WC), measured at midpoint of the last palpable rib and top of iliac crest, has good correlation with abdominal adiposity, and strong association with cardiovascular mortality. Two commonly used methodology used to determine accumulation of body fat are waist circumference and BMI. Therefore, it is crucial to determine obesity or threshold of body fat that is associated with increased adverse health risk. Southeast Asia, with lower initial prevalence of obesity (2–15%), has also experienced increasing obesity over the last decade, in tandem with globalization, rapid urbanization, and increase in socio-economic status. Despite the relatively stable obesity prevalence in the US (30–34%) and UK (23–24%) between 20, the global prevalence has increased due to the rising trend in Asia (including China and India) which comprise a major portion of the world’s population. In 2016, WHO reported the global prevalence of obesity at 11% in men and 15% in women. World Health Organization (WHO) recommends an international BMI cut-off point classification for adults: overweight is BMI 25–29♹ kg/m 2 and obesity is BMI ≥30 kg/m 2. BMI has long been used to define obesity in adults. Obesity has long been associated with increased risks of mortality, cardiovascular diseases, diabetes, and cancer, and is associated with significant health and economic burden. Obesity is a complex and chronic condition, clinically defined as the accumulation of excess body fat to the extent that it may have adverse effects on health. The results confirmed that Singaporean adults have higher BF% at lower BMI compared to US and Europe white counterparts and that BF% in our population has increased over two decades. There is a large discrepancy between BF% and BMI measured obesity in Singaporean adults. However, using the BF% cut-off (> 25% for men and > 35% for women) resulted in very high prevalence of obesity of 82.0% (80.2% men 83.8% women). The overall population-adjusted prevalence of obesity according to WHO International classification (BMI ≥30 kg/m 2) was 12.9% (14.9% men 11.0% women) and 26.6% (30.7% men 22.8% women) according to the MOH classification (BMI ≥27.5 kg/m 2). The current cohort of Singaporeans when compared to Caucasians in the US and Europe as well as a Singapore cohort from 20 years age have higher BF% when matched for BMI, age, and sex. We derived a prediction model to estimate BF% based on BMI, age and sex. Prevalence of overweight and obesity were estimated using WHO and Singapore Ministry of Health (MOH) Clinical Practice Guidelines for BMI classification, and BF% cut-off points of 25 and 35% for men and women respectively. Relationship between BMI and BF% were analysed using multiple regression models. Anthropometry and body composition were assessed. ![]() This was a population-based study of 542 community-dwelling Singaporeans (21–90 years old, 43.1% men). The secondary aim was to determine the prevalence of overweight and obesity based on BF% threshold and the new risk categories for obesity in Singaporean population. The main aim of this study was to the determine relationship between Body Mass Index (BMI) and percentage body fat (BF%) in Singaporean adults, derive a prediction model to estimate BF%, and to report population BF%.
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