Regarding diseases like diabetes, I think a big part of it is subcutaneous fat vs visceral fat.
Subcutaneous fat doesn’t really contribute to diabetes, it just looks unappealing. Visceral fat that collects in and around the organs in the torso is what contributes to diabetes.
Some groups like east asians cannot store as much subcutaneous fat as other groups like polynesians. When a person can’t store any more subcutaneous fat, the body starts storing extra body fat as visceral fat.
Because of this, there are attempts to reclassify the BMI for obesity in east asians to a BMI of 23 for overweight and 27.5 for obesity, compared to the typical 25 and 30 respectively. They have less ability to store subcutaneous fat, so the fat ends up being visceral at a lower BMI.
Generally, normal BMI is anything below 25. Researchers assessed Asian Americans using that traditional standard as well as an “Asian-specific cut point for ideal weight” that reduced the normal BMI threshold to less than 23.
Previous studies have shown Asian populations are at higher risk for diabetes, high blood pressure and high cholesterol at lower BMI thresholds. Using standard BMI definitions for overweight and obesity among Asian Americans may fail to identify people at increased cardiovascular risk, according to the study.
Even when compared to white people of similar age, sex and body fat, Asian Americans tend to have consistently lower BMI because of their “different body build,” said Dr. Jing Fang, the study’s lead author and an epidemiologist in the heart disease and stroke prevention division of the Centers for Disease Control and Prevention.
Specifically, Asians are more likely to develop fat around their abdomen, which is linked to a higher risk for cardiovascular disease. It’s partly why the World Health Organization proposed lowering the BMI cutoff for Asian populations to consider anything 23 or higher as overweight, Fang said.
By the same token, I wonder if there are also groups that have fewer health risks from obesity since they store more of their fat as subcutaneous fat.
Like do polynesians not start to develop the health risks of obesity until their BMI reaches 35+, because due to their environmental history polynesians who were better at storing subcutaneous fat had higher survival rates? Meaning, can polynesians store more fat as (relatively harmless) subcutaneous fat before their body starts storing fat as dangerous visceral fat? No idea.