Public Health Nutrition

Assessment and methodology

Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population

Kee Chee Cheonga1 c1, Ahmad F Yusoffa1, Sumarni M Ghazalia1, Kuang H Lima2, Sharmini Selvarajaha3, Jamaiyah Haniffa3, Geok L Khora4, Suzana Shahara5, Jamalludin Abd Rahmana6, Ahmad A Zainuddina2 and Amal N Mustafaa1

a1 Epidemiology and Biostatistics Unit, Institute for Medical Research, 50588 Kuala Lumpur, Malaysia

a2 Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia

a3 Clinical Epidemiology Unit, Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia

a4 Department of Nutrition and Dietetics, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia

a5 Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

a6 Department of Community Health and Family Medicine, Faculty of Medicine, International Islamic University, Kuantan, Malaysia


Objective To determine the optimal cut-offs of BMI for Malaysian adults.

Design Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.

Setting All fourteen states in Malaysia.

Subjects Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.

Results The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23·3 to 24·1 kg/m2 for men and from 24·0 to 25·4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.

Conclusions Our findings indicate that BMI cut-offs of 23·0 kg/m2 in men and 24·0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

(Received December 30 2011)

(Revised March 13 2012)

(Accepted April 23 2012)

(Online publication June 01 2012)


  • BMI;
  • Optimal cut-off;
  • Diabetes;
  • Hypertension;
  • Hypercholesterolaemia


c1 Corresponding author: Email