Chinese adults who are either underweight or obese increase their risk of early death, say Tulane University epidemiologists in an article published this week in the Journal of the American Medical Association.

“The relationship between weight and health outcomes has primarily been studied in Western populations,” says lead author and principal investigator Jiang He. “Our results show that a universal standard of healthy weights that puts body mass index between 23 and 27 can and should be applied to all racial and ethnic groups.”

Obesity is a growing concern in developing nations as related chronic diseases, such as diabetes and heart disease, are also on the rise.

The researchers analyzed data from 154,736 adults over the age of 40 years living in mainland China. The data had been collected over a ten year period, once in 1991 and again in 1999-2000. Researchers calculated body mass index (BMI) for each participant on a range between 0 and 30 as weight in kilograms divided by the square of height in meters. Men with a BMI between 24 and 24.9 and women with a BMI between 25 and 26.9 were the least likely to die during the study, while those with the highest and lowest BMIs were the most likely to die.

Researchers note that male gender, cigarette smoking and alcohol use were common among leaner participants while heavier study subjects were more likely to be physically inactive and have high blood pressure.