Studies show that BMI cutoffs for the risk of obesity and diabetes do not work in non-white populations

A new study presented at this year’s European Obesity Conference (ECO) and simultaneously presented at the Lancet Diabetes & Endocrinology is a body mass index (BMI) cutoff currently in use by the World Health Organization (WHO) and the National Institute for Health and Care Technology. And Care Excellence (NICE) is not suitable for adults with a background in Black Asia and Minority Ethics (BAME) in the United Kingdom and may endanger their health.

“This study shows that one size fits all approaches and does not really work with BMI and type 2. Diabetes Dr. Rishi Kaleyachetti, a junior doctor and epidemiologist at the University of Warwick in the United Kingdom, said, “There is a risk when looking at the diverse population of the United Kingdom. As a doctor, is the current BMI value used by people in BAME? I’m very worried about it. If not properly modified, many BAMEs will unnecessarily slip through the net and unknowingly be at risk of type 2 diabetes. “

Researchers from four major institutions (University of Warwick, Oxford University, London School of Hygiene and Tropical Medicine, and UCL Institute of Health Informatics) have collaborated with the Ethnic Health Forum to create this population-based researcher. .. Cohort study Use UK linked primary and secondary care electronic records.

The study consisted of individuals over the age of 18 who were enrolled in general practice in the United Kingdom between 1990 and 2018. A total of 1,472,819 people had complete BMI and ethnicity data and were followed up for at least one year (1,333,816 Caucasians, 75,956 South Asians). , 49,349 blacks, 10,934 Chinese, 2,764 Arabs) were included in the analysis. Researchers used a statistical model to determine whether adults in the BAME group had an equivalent risk of type 2 diabetes with a lower BMI than Caucasian Europeans.

Equivalent age and gender-adjusted incidence of type 2 diabetes with a BMI of 30.0 kg / m² In the Caucasian population, the BAMEBMI cutoff was much lower. 23.9 for South Asians. Chinese, 27.0; Black 28.2; and Arab 26.8.

Increasing attention is being paid to health inequality affecting millions of people with a BAME background, and the link between obesity and COVID-19, a condition that also adversely affects BAME people in the United Kingdom. Given that, the findings of this study have come at an important time.

Collaborator of the study, Dr. Thomas M. Barber (Associate Professor and Honorary Consultant Endocrinologist at the University of Warwick and University Hospital Coventry and Warwickshire) [UHCW]), The UK, and UHCW’s clinical leaders in obesity services said: “These data are very important and need to inform future clinical guidance and policies regarding the management of obesity in BAME people. Screening and screening of obesity-related conditions (such as type 2 diabetes) in BAME people. management.”

Currently, both WHO and NICE recommend a BMI cutoff point of 27.5 kg / m.² Define obesity in both South Asian and Chinese populations and induce lifestyle interventions.This new study was clearly demonstrated in comparison to the risk of developing type 2 diabetes at a BMI of 30.0 kg / m.² In the Caucasian population, an equivalent risk between individuals from South Asia occurred with a BMI of 23.9 kg / m.²Cutoff much lower than recommended by WHO and NICE.

Dr. Paramjit Gil, a collaborator in the study (general practitioner, general practitioner, director of health sciences at the University of Warwick, Warwick Medical College), said: Evidence of all ethnic groups due to the risk of diabetes at different levels of BMI. A comprehensive approach is no longer accepted. “

Following these new discoveries, the research team is encouraged by GPs and other healthcare professionals to use these ethnically-specific BMI cutoffs to trigger action to prevent type 2 diabetes in the United Kingdom. I think.

An important result of this study is that people in the UK BAME will be able to better and more personally understand BMI cutoffs. In addition, the findings help raise awareness within these groups that they are at increased risk of type 2 diabetes with a much lower BMI than previously recognized.

Importantly, Dr. Caleyachetty and his research team are now working closely with key organizations to share findings with UK government health ministry policy makers, NHS experts, and UK BAME people. I will.

Regarding the causes of different BMI cutoffs in different ethnic groups, they say: “The low BMI cutoff point in the non-white population is due to differences in body composition, biochemical properties, lifestyle factors (such as physical activity and diet)), genetics, or lifestyle-gene interaction. The effects remain unclear. Future studies examining the relative contribution of these mechanisms to the development of type 2 diabetes may help explain our findings. “

Dr. Caleyachetty explains: “This extensive and extensive study sheds light on the worried generalization of the BMI cut-off of obesity at the expense of people from different ethnic minority backgrounds. Completely revised ethnic-specific type 2 diabetes BMI cut-offs are needed to induce preventive behavior, which allows medical professionals to make appropriate recommendations to BAME patients regarding lifestyle changes, referrals to weight management services, and investigations into type 2 diabetes. Can be provided. “

He adds: “We hope that this study will promptly begin a review of the UK’s current BMI policy for people with BAME to prevent both type 2 diabetes and promote early and effective treatment of type 2 diabetes. The NHS is known to everyone. It is based on the principle of fairness and that all patients should be treated equally regardless of background. But at this time, these principles Is clearly not realistic for many BAME people. ”

Provided by the European Association for the Study of Obesity