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 Based on the findings, researchers suggest the definition of obesity
should be different for different populations, in order to trigger
diabetes interventions in a timely manner.
Body mass index (BMI) is a measure of weight in relation to height
used to assess health risks. The Centers for Disease Control and
Prevention (CDC) defines overweight as a BMI of 25 to 29.9 and
obesity as a BMI of 30 and above.
However, those cutoffs are primarily applicable to white people,
which has been noted by the World Health Organization (WHO), Dr.
Naveed Sattar told Reuters Health.
“But few people really recognize this,” he said. Institutions like
the WHO and CDC have yet to adopt ethnicity-specific BMI cutoffs for
overweight and obesity.
Sattar worked on the study at the Institute of Cardiovascular and
Medical Sciences at the University of Glasgow in the UK.
He and his team analyzed data on almost 500,000 middle-aged UK
adults, 96 percent of whom were white. The remaining four percent
included South Asian, black and Chinese adults.
Five percent of the total group, or about 25,000 people, had
diabetes, according to findings published in Diabetes Care.
Compared to whites, nonwhite adults were at least twice as likely to
have diabetes. Diabetes rates for white people with a BMI of 30, the
lower threshold for obesity, were equal to diabetes rates for South
Asians with a BMI of 22, black people with a BMI of 24, Chinese
women with a BMI of 24 and Chinese men with a BMI of 26.
Results were similar when the researchers looked at waist
circumference: nonwhite people were at risk for diabetes at smaller
waist sizes than white people.
In 2013, the National Institute for Health and Care Excellence
(NICE) in the UK recommended new BMI thresholds for intervening to
prevent ill health among ethnic minorities including people of
African, Caribbean and Asian descent. The group indicated an
increased risk of chronic conditions at a BMI of 23 or higher and a
high risk of chronic conditions starting at a BMI of 27 for those
people.
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“The guidance and briefing documents make recommendations for health
services and local government to take action,” Dr. Tonya Gillis,
media relations manager for NICE, told Reuters Health by email. She
noted that NICE public health guidance only applies to England and
not to international standards.
Researchers have suggested that a combination of genetic and
environmental factors play a role in different body fat patterns by
ethnicity, but questions remain.
The new study and others suggest that the obesity cutoff for Asians
in particular might need to be reevaluated, Sattar said.
The report included many people but only addressed one point in
time, he noted. These findings need to be verified by another study
that follows a group of people over time, he said.
Establishing ethnicity-specific cutoffs for obesity is important
partly to make doctors aware that diabetes risk can be heightened at
much lower BMIs for some ethnicities, which should prompt them to
give lifestyle advice and screen for diabetes at lower weights,
Sattar said.
“If any population of people are at an increased risk of developing
a range of serious conditions, then it’s vital to highlight any
relevant risk factors that can help professionals and the
individuals affected to take action at the earliest opportunity,”
Gillis said.
SOURCE: http://bit.ly/1jcPYIt
Diabetes Care, online June 29, 2014.
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