Heterogeneity in BMI Percentile and Weight Status Among Asian American Youth.

Introduction: There are important and understudied health differences among subgroups of Asian Americans. The authors examined differences in BMI percentile and body weight status among Asian American youth. Methods: The authors conducted a retrospective cohort study using electronic health records in 2011-2020 from 2 integrated healthcare systems in California. Single-race, non-Latino White, and Asian American youth aged 2-19 years during the study period were included. Asian American subgroups included East, South, Southeast, and unidentified. Whites were the reference group. Study outcomes included age- and sex-specific BMI percentile and body weight status category (underweight, overweight or obesity, obesity). Series of 1-sample estimates for study outcomes were calculated by calendar year and biological ages. Results: A total of 395,134 youth were included in the study (mean [SD] age at baseline of 8.26 [5.61] years; mean [SD] BMI percentile of 53.8 [30.3]), including 23,183 East Asians; 34,783 South Asians; and 34,738 Southeast Asians. Southeast Asians had the highest age-adjusted prevalence of obesity (2019 estimate: 13.3%) than East Asians (5.2%), South Asians (7.8%), and Whites (11.8%). South Asians had the highest prevalence of underweight (2019 estimate: 11.8%) than East Asians (5.5%), Southeast Asians (3.9%), and White (3.6%). Conclusions: Substantial heterogeneity among Asian American youth was found in the study cohort. Asian American youth face distinct challenges of unhealthy weight statuses unique to their subgroups.