This briefing summarises NICE's recommendations for local authorities and partner organisations on the use of body mass index (BMI) as a signal for preventive action against long-term medical conditions. The focus is on people from black, Asian and other minority ethnic groups (for a definition see 'Assessing body mass index and waist circumference thresholds for intervening to prevent ill health and premature death among adults from black, Asian and other minority ethnic groups in the UK '). It is particularly relevant to health and wellbeing boards.
This briefing will complement advice in NICE's local government briefing on NHS health checks, due to be published in February 2014.
The following BMI thresholds are recommended as a trigger to intervene to prevent ill health among adults from black, Asian and other ethnic groups:
This compares with the usual thresholds of 25 kg/m2 and 30 kg/m2 recommended for intervening with white European adults. (Also see box 1 in 'Assessing body mass index and waist circumference thresholds for intervening to prevent ill health and premature death among adults from black, Asian and other minority ethnic groups in the UK' for international guidance on BMI/waist circumference thresholds.)
The prevalence of chronic conditions such as type 2 diabetes, coronary heart disease and stroke is up to 6 times higher (and they occur from a younger age) among black, Asian and other minority ethnic groups. In addition, these groups progress from being at-risk to being diagnosed with these conditions at twice the rate of white populations. So tackling this issue will help tackle health inequalities and satisfy public sector obligations under the Equality Act 2010.
Action now will result in significant social care and health savings, by delaying and improving the management of complications associated with limiting long-term illnesses. It could result in particularly high savings for local authorities with a high proportion of black, Asian and other minority ethnic groups. (See make significant cost savings.)
Lifestyle interventions targeting sedentary lifestyles and diet have reduced the incidence of diabetes by about 50% among high-risk individuals (Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis). This includes people from South Asian, Chinese, black African and African Caribbean descent with a BMI of 23 kg/m2 or more, where interventions to identify and manage pre-diabetes have been found to be cost effective.
Diabetes is the most common cause of visual impairment and blindness among people of working age and the most common cause of kidney failure and non-traumatic lower limb amputations. See reduce future demand on health and social care services. Interventions to prevent type 2 diabetes will also reduce the risk of other major health problems including Alzheimer's disease, coronary heart disease, hypertension and stroke.
The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care.
For further information on how to use this briefing and how it was developed, see about this briefing.