Premature morbidity and mortality in Asians occur at lower levels of body mass index (BMI) compared to Europids. We aimed to compare the prevalence of and risk factors associated with overweight and obesity, defined by the World Health Organization (WHO) and Asia-Pacific criteria, at workplace settings in a Southeast Asian country.
We used baseline data from a cohort study of 464 full-time employees (aged ≥21 years) conducted at four workplaces in Singapore. Data on socio-demographic characteristics, lifestyle behaviours, medical history, psychosocial factors, health-related quality of life (HRQoL) and occupational factors were collected through self-administered questionnaires. Overweight and obesity was defined as BMI ≥25 kg/m2 (WHO criteria) and as BMI ≥23 kg/m2 (Asia-Pacific criteria).
The mean age of participants was 39.0 (SD 11.4) years, and 79.5% were men. The prevalence of overweight and obesity was 47.4% and 67.0% based on the WHO and Asia-Pacific criteria, respectively. With the use of WHO criteria, age, males, Malays (versus Chinese), higher fruit and vegetable intake (tertile 3 vs. tertile 1), lower white rice consumption (tertile 1 vs. tertile 2), intake of sugar-sweetened beverages and lower physical component summary score of HRQoL scale were independently associated with a greater risk for overweight and obesity. With the use of Asia-Pacific criteria, similar risk factors as the WHO criteria showed associations, along with some context-specific factors namely, lesser sleep hours (<6 hours vs. >7 hours), poorer mental health and higher thermal comfort at the workplace.
Although, there was a 19.6% absolute increase in the overweight and obesity prevalence with the use of Asia-Pacific criteria, risk factors that are highly relevant to Singapore could have been overlooked with the WHO criteria. This supports the call for redefining BMI cut-off points for different ethnic groups by several national and international organizations.