Filipino Americans Over 50 at High Risk of Diabetes, Even If Not Obese

A new study finds that the prevalence of diabetes is significantly higher among non-obese Filipino Americans aged 50 and older than in their white counterparts, even after controlling for lifestyle factors.

The research, published in the Canadian Journal of Public Health, used data from 3 waves of the California Health Interview Survey in 2007, 2009, and 2011. The study sample of respondents 50 or older with a body mass index less than 30 consisted of 1629 Filipino Americans and 72,072 non-Hispanic whites.

Of the Filipino group, 7.6% had diabetes, compared with just 4.3% of the white subjects. The researchers then conducted statistical analyses to account for potentially confounding variables in the form of diabetes risk factors like age, sex, fruit and vegetable consumption, exercise, smoking, and poverty. After this analysis, they found that the risk of diabetes was nearly 3 times higher for the Filipino Americans, said study co-author Adity Roy, MS, in a press release.

The researchers also found that the factors associated with increased diabetes risk in the Filipino population varied by sex. Among Filipina women, older age was the only factor that significantly predicted diabetes, but Filipina men were at higher risk if they were older, lived in poverty, smoked cigarettes, or were overweight.

Though this study indicated that Filipino Americans have greater odds of developing diabetes, it could not establish a causal relationship, the authors noted.

“In this study, we could not explain why Filipino-Americans are at such higher risk of diabetes,” said lead author Esme Fuller-Thomson, PhD, in the press statement. “In future research we hope to investigate ethnic variations in central obesity, dietary patterns (particularly white rice consumption), insufficient sleep, low birth weight, and hypertension, among other risk factors for diabetes that may disproportionately disadvantage the Filipino population in North America."

The findings take on greater urgency as the population of Americans with Filipino heritage continues to grow. The 3.9 million Filipino Americans now form the second-largest subgroup of Asian Americans and Pacific Islanders in the county, after Chinese Americans.

The researchers also wrote that Filipino Americans have a lower obesity rate at 30% compared with the overall US population, as around 35.7% of all American adults are obese. This could delay diabetes screening if Filipino Americans and their doctors perceive the risk of diabetes to be lower due to their weight.

“This highlights the urgent need to screen non-obese Filipino Americans for diabetes and to target them for prevention efforts, because preventive approaches with lifestyle intervention have been shown to be effective in preventing and/or postponing the onset of diabetes in other high-risk non-obese populations,” said co-author Keith Tsz-Kit Chan, PhD, in the statement.