Endocrinol Metab.  2020 Dec;35(4):681-695. 10.3803/EnM.2020.772.

Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations

• Williams R
• Periasamy M

• KMID: 2510997
• DOI: http://doi.org/10.3803/EnM.2020.772

Abstract

Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity—the “skinny-fat” Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors—most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress—contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.

Keyword

Intra-abdominal fat; Adiposity; Asian

Figure

• 

  Fig. 1 Percentage of the overweight or obese population for select South and Southeast Asian countries: (A) Indians, (B) Chinese, (C) Koreans, (D) Japanese, (E) Vietnamese, and (F) Malaysians. Overweight is defined as having a body mass index (BMI) greater than or equal to 25 kg/m2. Obesity is defined as having a BMI greater than or equal to 30 kg/m2. BMI is an individual’s weight (in kilograms) divided by height (in meters) squared. Graphs were derived from data from Our World in Data “https://ourworldindata.org/obesity”; obesity by “https://ourworldindata.org/team”; Hannah Ritchie and Max Roser, used under “https://creativecommons.org/licenses/by/4.0/”; CC BY 4.0 [73].

• 

  Fig. 2 The complex interplay between genetic and environmental factors contributing to increased visceral adiposity in Asian populations. Many factors contribute to the Asian propensity to store fat viscerally. Of these, we propose the Malaysian gene-environment multiplier hypothesis in which a population’s genetic foundation—developed over thousands of years and varying according to regional feast-and-famine cycles—is increasingly modified when an individual is exposed to modern-day conditions such as altered diets, urbanization, and reduced physical activity.

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