Distribution of Body Weight, Height and Body Mass Index.in a National Sample of Malaysian Adults

Transcription

1 Distribution of Body Weight, Height and Body Mass Index.in a National Sample of Malaysian Adults T 0 lim, MRCP*, L M Ding, MHA*, M Zaki, FRCP**, A B Suleiman, FRACP**, S Fatimah, ***S Siti ***, A Tahir, MPH***, A H Maimunah, MPH***, *Clinical Research Centre, **Department of Nephrology, Jalan Pahang, 50586, Kuala Lumpur, ***Institut Kesihatan Umum, Kuala Lumpur Introduction The distributions of body weight, height and body mass index (BMI) in' a representative national sample of Malaysian adults have not previously been described. Such information is of epidemiological interest, and is also useful in public health practice. The relationship between BMI and mortality is U shaped l -4. Both low and high BMI are associated with increase risk of all-cause mortality. High body mass index in particular is associated with increase risk of hypertension, diabetes and hyperlipidaemia 5 Height is negatively associated with mortality, with shorter individuals having higher mortality risk'. This is not due to the biological effect of height per se but is a reflection of nutritional and health deficit earlier in life with resulting failure to attain growth potential. Countries that have undergone rapid socio-economic development, for example Japan, have witnessed marked secular increase in height among younger cohorts as well as improvement in health status 5 Thus, information on population distribution ofanthropometric indicators are useful for predicting health burden in a population as well as for describing changes in physical status associated the rapid socio-economic development in the last 4 decades. We present here the distribution ofbody weight, height and body mass index by age, sex and ethnicity using the data from the National Health and Morbidity survey (NHMS) completed in Med J Malaysia Vol 55 No 1 March 2000

2 Materials and Methods Sampling design and sample The NHMS was a multi-purpose health survey designed to describe the health status, health related behaviour and health services utilisation for a representative sample ofthe population ofmalaysia. An up to date and representative sampling frame for this population was provided by the frame used by the annual Labour Force survey conducted by the Department of Statistics 6 The sampling frame was stratified by state and urban/rural residence. A stratified two stage cluster sampling design with self-weighting sample was used to draw a sample of private dwellings. However, only (87%) of dwellings were contactable or responded. All residents of sampled dwellings were included yielding a sample size of individuals. For NHMS component on body weight and height, individuals aged 20 or older were eligible (91 %) ofthem agreed to have their measurements taken or had evaluable responses. Table I and II show the composition of the sample. Body weight and height measurement Body weight and height were measured by trained observer. Body weight was measured in light indoor clothing without shoes to the nearest tenth of a kilogram using a bathroom spring balance. Height was measured without shoes to the nearest tenth of a centimetre using a measuring tape attached to a rigid wall. Measurements were not taken on respondents who were bedridden, pregnant, or who had spinal deformities and other major physical impairment. All observers attended centralised training on standardised protocol Table I Characteristics of Respondents Compared with Total Population of Malaysia Aged 20 or Older in 1996 % Respondents (unweighted) %Malaysia Population Aged 20 or Older n=28737 n= million No. (%) % Sex Male (47%) 51% Female (53%) 49% Age (13%) 17% (14%) 15% (15%) 14% (14%) 13% (12%) 10% (9%) 8% (7%) 6% (6%) 5% (5%) 4% (3%) 3% >= (4%) 4% Ethnic Malay (44%) 43% Chinese 7619 (27%) 28% Indian 1941 (7%) 7% Other indigenous 4458 (16%) 9% Others 1982 (7%) 12% Mad J Malaysia Vol 55 No 1 March

3 Table II Sample Size by Age, Sex and Ethnicity in the Survey Malay Chinese Indian Other indigenous Men, age in years >= Women, age in years >= for body weight and height measurement. During field survey, supervisors conducted weekly check on compliance with measurement protocol. The spring balance for weight measurement was calibrated daily. Definitions Body mass index (BMI) is defined as ratio of weight in kilogram to square of height in metre. For purpose of analysis, BMI was categorised as grade 3 thinness (BMI<16Kg/M'), grade 2 thinness (BMI Kg/M'), grade 1 thinness (BMI Kg/M'), normal (BMI KglM'), grade 1 overweight (EM! KgIM'), grade 2 overweight (BMI Kg/M'), grade 3 overweight (BMI > =40Kg/M') according to the classification system recommended by the WHO Expert Committee on Physical status'. Statistical methods Probability weighted estimation was used to obtain all estimates as appropriate for the sampling design 709 The sampling weights were adjusted for household nonresponse using adjustment cells formed by state and urban/rural residence lo Post stratification was used to adjust the weighted sample totals to known population totals for age, gender and ethnicity based on 1996 census population projection. Anthropometric measures are expected to vary smoothly and continuously by age. We therefore used polynomial smoothing method of Healyll to construct centile curves. Overall, ethnic and sex specific means and percentages were standardised by the direct method to the age distribution of the 1996 adult Malaysian 110 Med J Malaysia Vol 55 No 1 March 2000

4 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX population. S_Plus l2 and STATA13 software packages were used for analysis. Results distribution The percentiles of body weight, height and BMI by age, gender an.d ethnicity are shown in Tables III to XXVI. In all ethnic-gender groups, BMI rose with increasing age till fifth or sixth decade, thereafter it declined. The rise in BMI with age was steeper for women than men. In contrast there was an obvious decrease in height with age in both sexes and all ethnic groups. Mean 8MI Tables XXVII and XXVIII show the mean height, weight and BMI by gender, ethnicity and age. Women have higher mean BMI than men except for Chinese. Among women, Indian had the highest BMI, followed by Malay, Other indigenous and then Chinese. Among men, Chinese had the highest BMI followed by Indian, Malay and other indigenous. Among Indian, Malay and other indigenous ethnic group, women had higher BMI than men in all age groups till the seventh decade onwards when the mean BMI of the two sexes converged. In contrast, young Chinese men had higher BMI than their female counterparts until the fifth decade. Thereafter, the reverse was true. Percentage distribution of 8MI Tables XXIX to XXXI show the percentage distribution of BMI according to WHO classification'. Overall, 26.5% of the adult population had BMI in the overweight range but only about 6% had grade 2 or higher overweight, 61 % had normal BMI and 13% had grade 1 or higher thinness. Both overweight and thinness were more common among women than men. Indian had the highest prevalence of overweight, followed by Malay, Chinese and other indigenous group the lowest prevalence. Discussion We advise caution m interpreting the results. The stability ofthe centile estimates is assured only ifbased on large sample sizes. This was clearly the case for Malay, Chinese and other indigenous ethnic group's estimates. However sample sizes for Indian in the older age groups (age ) were small. The smoothing method employed to construct the centile curves had masked the underlying sampling variability. One should also be cautious in interpreting cross sectional data longitudinally. The rise in BMI with age may be interpreted as due to sedentary lifestyle associated with ageing. However, the tendency of the rise to flatten or even reverses beyond age should not be interpreted as due to ageing effect. One alternative explanation is selective survival. People with lower BMI tend to survive with increasing age thus shifting the BMI distribution of survivors downwards. On the other hand, the decrease in height with age is more reasonably interpreted as due to cohort effect. Younger cohorts attain better growth potential because of better nutrition than older cohorts. Cross sectional data as presented here cannot differentiate the individual contribution ofageing, selective survival and cohort effect. Characteristics of the BMI distribution of the Malaysian population, as shown here, largely resemble those observed in other substantial population surveys,, The right skewed distribution, the age trend in BMI, differences between the 2 sexes and variation among the ethnic groups are all well described characteristics of population BMI distribution. The most notable findings are the remarkably low BMI prevailing in all ethnic groups in our population. This is in sharp contrast to Western populations I4-16, and is comparable to other non-western populations'. The other notable finding is the marked secular increase in height among younger cohorts. Younger Malaysians from all ethnic groups had attained better growth potential as a result of better nutrition and heath brought on by the socio-economic development this country has witnessed in the last 4 decades. Countries that have similarly undergone rapid socio-economic development, for example Japan, have experienced similar changes in population height'. The distributions of anthropometric measurements of Malaysian adults described here are not merely of epidemiological interest. They are useful in their own Med J Malaysia Vol 55 No 1 March

5 Table III of Body Mass Index for Malay Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table IV of Body Mass Index for Malay Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

6 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table V of Body Mass Index for Chinese Males l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd' skew" 'sd means standard deviation, "skew means skewness Table VI of Body Mass Index for Chinese Females l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd' skew" , sd means standard deviation, "skew means skewness Med J Malaysia Vol 55 No 1 March

7 right. In public health practice, the planning of any prevention strategy must take into account the burden of illness due to any risk factor in the community. Population BMI distribution can help in estimating the burden of illness due to obesity related morbidity in the population. In the planning of screening programme to control overweight, information on BMI distribution in the population is required for resource planning. The available resources must match the number of individuals in the population targeted for intervention, the number in turn depends on the population BMI distribution. To our knowledge, this is the first detailed description of BMI and height distributions in a representative national sample of Malaysian adults. The distributions can serve as baseline for comparison with future repeat survey to determine the effectiveness of intervention programme in shifting the population BMI distribution in a favourable direction as well in monitoring population nutritional status. The distributions described here can also serve as a yardstick for assessing the representativeness of sample in small scale survey. The BMI and height distributions of a representative sample should closely match that described here. In conclusion, we found the distribution of BMI of Malaysian adults was shifted downwards compared with those in Western populations. The height distribution was typical of that in countries that have undergone rapid socio-economic development. Detailed description ofdistributions ofbmi and height in our population are useful for public health practice. Acknowledgement We are grateful to the investigators of the Second National Health and Morbidity survey (NHMS2), and in particular its principal investigator, Dr. Maimunah A. Hamid for agreeing to release NHMS2 sample survey data for secondary analysis that made this research possible. Table VII of Body Mass Index for Indian Males l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

8 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table VIII of Body Mass Index for Indian Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** * sd means standard deviation, ** skew means skewness Table IX of Body Mass Index for Other Indigenous Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March

9 Table X of Body Mass Index for Other Indigenous Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XI of Body Weight for Malay Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

10 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX

11 Table XIV of Body Weight for Chinese Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XV of Body Weight for Indian Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

12 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table XVI of Body Weight for Indian Females l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XVII of Body Weight for Other Indigenous Males l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March

13 Table XVIII of Body Weight for Other Indigenous Females, by Age Age Group, >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XIX of Height for Malay males, by age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

14 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table XX of Height for Malay Females l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd' skew" 'sd means standard deviation, "skew means skewness Table XXI of Height for Chinese Males l by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd' skew" , sd means standard deviation, " skew means skewness Med J Malaysia Vol 55 No 1 March

15 Table XXII of Height for Chinese Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XXIII of Height for Indian Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Med J Malaysia Vol 55 No 1 March 2000

16 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table XXIV of Height for Indian Females, by Age Age Group >=70 n th th th th th th ' th th th th th th th th th th th th th th th mean sd* skew** Table XXV of Height for Other Indigenous Males, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** * sd means standard deviation, ** skew means skewness Med J Malaysia Vol 55 No 1 March

17 Table XXVI of Height for Other Indigenous Females, by Age Age Group >=70 n th th th th th th th th th th th th th th th th th th th th th mean sd* skew** Table XXVII Crude and Age-adjusted Mean Height, Body Weight and BMI Height, em Weight, Kg BMI, Kg/m 2 Crude Age-adjusted Crude Age-adjusted Crude Age-adjusted (SE) (SE) (SE) (SE) (SE) (SE) All (0.1) «0.1) 58.3 (0.1) 58.3 «0.1) 22.9 «0.1) 22.9 «0.1) men (0.3) (0.1) 61.9 (0.4) 61.8 (0.1) 22.7 «0.1) 22.7 «0.1) women (0.3) (0.1) 54.6 (0.3) 54.7 (0.1) 23.1 (0.3) 23.1 «0.1) Malay (0.3) (0.1) 58.2 (0.4) 58.2 (0.1) 23.1 (0.3) 23.1 «0.1) men (0.3) (0.1) 61.7 (0.4) 61.6 (0.2) 22.7 (0.3) 22.7 (0.1) women (0.3) (0.1) 55.0 (0.4) 55.0 (0.2) 23.4 (0.3) 23.4 (0.1) Chinese (0.3) (0.1) 59.9 (0.4) 59.8 (0.2) 22.9 (0.3) 22.8 (0.1) men (0.4) (0.1) 64.6 (0.4) 64.6 (0.2) 23.2 (0.3) 23.2 (0.1) women (0.3) (0.1) 55.2 (0.4) 55.0 (0.2) 22.7 (0.3) 22.5 (0.1) Indian (0.5) (0.2) 60.9 (0.5) 60.7 (0.3) 23.4 (0.3) 23.4 (0.1) men (0.5) (0.3) 65.1 (0.6) 64.9 (0.4) 23.2 (0.3) 23.1 (0.1) women (0.5) (0.2) 56.7 (0.6) 56.5 (0.4) 23.7 (0.4) 23.6 (0.2) Other (0.4) (0.1) 54.9 (0.5) 54.9 (0.2) 22.4 (0.3) 22.4 (0.1) indigenous men 161.8(0.4) (0.2) 58.3 (0.5) 58.3 (0.2) 22.2 (0.3) 22.3 (0.1) Women (0.4) (0.1) 51.4 (0.5) 51.5 (0.2) 22.6 (0.3) 22.6 (0.1) *Age-adjusted to the 1996 Malaysian population 124 Med J Malaysia Vol 55 No 1 March 2000

18 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table XXVIII Age Specific Mean Height, Weight and 8MI Age group Height (SE) Weight (SE) 8MI (SE) cm Kg Kg/m 2 Malay men (0.2) 59.8 (0.3) 21.7 (0.1) (0.2) 64.1 (0.3) 23.3 (0.1) (0.2) 64.6 (0.4) 23.8 (O.ll (0.2) 60.9 (0.4) 23.0 ( ) 57.9 (0.6j 22.4 (0.2) >= ) 53.9 ( (0.3) Malay women (0.2) 52.2 (0.3) 21.9 (0.1) (0.2) 57.4 (0.3) 24.1 (0.1) (0.2) 58.7 (0.3) 25.0 (0.1) (0.3) 56.1 (0.5) 24.5 (0.2) (0.4) ) 23.0 (0.3) >= (0.6) ) 21.5 (0.3) Chinese men (0.3) ) 22.4 (0.2j (0.3) ) 23.7 ( (0.3) 66.1 (0.5) 23.9 (0.1) (0.3) 63.9 (0.5) 23.4 (0.2) (0.4) 61.2 (0.6) 23.1 (0.2) >= (0.6) 58.0 (1.0) 22.0 (0.3) Chinese women ) 51.9 (0.3) 20.9 (0.1) ) 56.0 (0.3) 22.6 (0.1) (0.2) 57.7 (0.3) 23.8 (0.2) (0.3) ) 24.1 (0.2) (0.4) ) 23.9 (0.3) >= (0.5) 51.2 (0.8) 22.3 (0.4) Indian men fo.4) 61.1 (0.7) 21.5 (0.2) ) 67.3 (0.7) 23.9 (0.2) ) 68.4 ( (0.3) ) 68.6 ( (0.5) (1.0) 62.7 (1.6) 23.1 (0.5) >= (1.1) 57.8 (2.4) 22.2 (0.8) Indian women (0.5) 52.9 (0.8) 21.7 (0.3) (0.4) 58.7 (0.7) 24.3 (0.3) ( fo.8) 25.1 (0.3) ( ) 25.4 (0.6) (0.9) 56.0 (1.3) ) >= (2.0) 46.1 (1.2) ) Other indigenous men (0.3) 57.7 (0.4) 21.7 (0.1) (0.3) 60.9 ( (0.2) (0.4) 60.9 ( (0.2) (0.5) 55.5 (0.7) 21.9 (0.2) (0.6) 53.9 (0.8) 21.3 (0.2) >= (0.8) 48.5 (1.0) 19.8 (0.4) Other indigenous women (0.3) 50.5 (0.4) ) (0.3) 54.7 (0.4) ) (0.3) 54.0 (0.6) 23.8 (0.3) (0.4) 50.4 (0.7) 22.5 (0.3) (0.5) 44.4 (0.8) 20.5 (0.3) >= (0.7) 42.0 (1.2) 19.7 (0.5) Med J Malaysia Vol 55 No 1 March

19 Table XXIX Crude Percentage Distribution of BMI According to WHO* Classification Thinness Normal Overweight Grade 3 (SE) Grade 2 (SE) Grade 1 (SE) Normal (SE) Grade 1 (SE) Grade 2 (SE) Grade 3 (SE) BMI < >=40 All 2.0 (0.1) 2.5 (0.1) 8.2 (0.2) 60.8 (0.4) 20.7 (0.3) 5.5 (0.2) 0.3 (0.0) men 1.5 (0.1) 2.1 (0.1) 7.9 (0.3) 64.5 (0.5) 20.1 (0.4) 3.8 (0.2) 0.2 (0.0) women 2.6 (0.2) 3.0 (0.2) 8.5 (0.3) 56.8 (0.5) 21.4 (0.4) 7.2 (0.3) 0.4 (0.1) Malay 2.3 (0.2) 2.7 (0.2) 8.4 (0.3) 57.5 (0.5) 22.0 (0.4) 6.6 (0.3) 0.4 (0.1) men 1.5 (0.2) 2.4 (0.2) 8.3 (0.4) 63.3 (0.7) 20.0 (0.6) 4.3 (0.3) 0.2 (0.1) women 3.1 (0.2) 3.0 (0.2) 8.6 (0.4) 51.9 (0.7) 23.9 (0.6) 8.9 (0.4) 0.6 (0.1) Chinese 1.4 (0.2) 2.2 (0.2) 7.5 (0.4) 62.3 (0.7) 21.6 (0.6) 4.8 (0.3) 0.2 (0.1) men 1.0 (0.2) 1.7 (0.2) 6.3 (0.5) 61.8 (0.9) 24.5 (0.8) 4.6 (0.4) 0.1 (0.1) women 1.8 (0.2) 2.7 (0.3) 8.8 (0.6) 62.7 (1.0) 18.7 (0.7) 4.9 (0.4) 0.4 (0.1) Indian 2.2 (0.4) 2.7 (0.4) 6.5 (0.6) 56.8 (1.3) 24.9 (1.1) 6.6 (0.7) 0.2 (0.1) men 1.9 (0.5) 2.0 (0.5) 6.5 (0.9) 61.6 (1.9) 24.2 (1.6) 3.7 (0.7) 0.1 (0.1) women 2.5 (0.5) 3.5 (0.6) 6.5 (0.9) 52.2 (1.8) 25.6 (1.5) 9.4 (0.9) 0.4 (0.2) Other 2.4 (0.3) 3.0 (0.3) 8.6 (0.5) 63.5 (0.9) 17.9 (0.7) 4.4 (0.4) 0.1 (0.0) indigenous men 1.1 (0.3) 2.0 (0.3) 8.2 (0.7) 69.3 (1.2) 16.7 (1.0) 2.7 (0.4) 0.0 (0.0) women 3.7 (0.4) 4.0 (0.5) 9.1 (0.7) 57.7 (1.2) 19.1 (0.9) 6.2 (0.6) 0.1 (0.1) *WHO Expert Committee on Physical Status 5 Table XXX Age-adjusted* Percentage Distribution of BMI According to WHO Classification" Thinness Normal Overweight Grade 3 (SE) Grade 2 (SE) Grade 1 (SE) Normal (SE) Grade 1 (SE) Grade 2 (SE) Grade 3 (SE) BMI < >=40 All 2.0 (0.1) 2.5 (0.1) 8.2 (0.2) 60.8 (0.4) 20.7 (0.3) 5.5 (0.2) 0.3 (0.0) men 1.5 (0.1) 2.1 (0.1) 7.9 (0.3) 64.5 (0.5) 20.1 (0.4) 3.8 (0.2) 0.2 (0.0) women 2.6 (0.2) 3.0 (0.2) 8.5 (0.3) 56.8 (0.5) 21.4 (0.4) 7.2 (0.2) 0.4 (0.1) Malay 2.3 (0.2) 2.7 (0.2) 8.5 (0.3) 57.5 (0.5) 22.0 (0.4) 6.6 (0.2) 0.4 (0.1) men 1.5 (0.2) 2.5 (0.2) 8.3 (0.4) 63.3 (0.7) 19.9 (0.5) 4.2 (0.3) 0.2 (0.1) women 3.1 (0.2) 3.0 (0.2) 8.6 (0.4) 51.9 (0.7) 23.9 (0.6) 9.0 (0.4) 0.6 (0.1) Chinese 1.4 (0.1) 2.3 (0.2) 8.0 (0.4) 62.6 (0.7) 20.9 (0.5) 4.7(0.3) 0.2 (0.1) men 1.0 (0.2) 1.7 (0.2) 6.5 (0.5) 62.1 (0.9) 23.9 (0.8) 4.7 (0.4) 0.1 (0.1) women 1.7 (0.2) 2.9 (0.3) 9.5 (0.6) 63.2 (0.9) 17.7 (0.7) 4.6 (0.4) 0.4 (0.1) Indian 2.3 (0.4) 2.9 (0.4) 6.7 (0.6) 57.0 (1.3) 24.4 (1.0) 6.5 (0.6) 0.2 (0.1) men 2.0 (0.5) 2.0 (0.5) 6.7 (0.9) 61.7 (1.9) 23.7 (1.5) 3.7 (0.6) 0.1 (0.1) women 2.5 (0.6) 3.7 (0.7) 6.7 (0.9) 52.4 (1.7) 25.1 (1.4) 9.2 (0.9) 0.3 (0.2) Other 2.5 (0.2) 3.0 (0.3) 8.6 (0.5) 62.9 (0.8) 18.3 (0.6) 4.5 (0.3) 0.1 (0.0) indigenous men 1.2 (0.2) 2.1 (0.3) 8.3 (0.7) 68.5 (1.1) 17.1 (0.9) 2.8 (0.4) 0.0 (0.0) women 3.8 (0.4) 3.9 (0.5) 8.9 (0.6) 57.3 (1.1) 19.6 (0.8) 6.3 (0.5) 0.1 (0.1) *Age-adiusted to the Malaysian population *WHO Expert Committee on Physical Status Med J Malaysia Vol 55 No 1 March 2000

20 DISTRIBUTION OF BODY WEIGHT, HEIGHT AND BODY MASS INDEX Table XXXI Age Specific Percentage Distribution of 8MI According to WHO' Expert Committee Classification Thinness Normal Overweisht Grade3 (SE) Grade2 (SE) Gradel (SE) Normal (SE) Gradel (SE) Grade2 (5E) Grade3 (SE) Malay men >= Malay women >= Chinese men >= Chinese women >= Indian men >=70 Indian women >=70 Other indigenous men >=70 Other indigenous ( (0.3) 1.3 (0.4) 8.4 (1.2) 78.3 (1.8) 9.2 (1.3) 2.3 (0.6) 0.0 (0.0) (0.6) 5.2 (1.0) 12.0 (1.2) 63.6 (1.8) 12.6 (1.2) 4.5 (0.8) 0.2 (0.2) women } g >= * WHO Expert Committee on Physical Status 5 Med J Malaysia Vol 55 No 1 March