The newly updated draft guideline identifies the changes that adults and children can make which will help them maintain a healthy weight or prevent further weight gain if they are already overweight. It emphasises that any improvements, however small, to physical activity or dietary habits are likely to help, but that no single factor such as a specific food, drink or physical activity, will help someone keep a healthy weight.
NICE is updating its guideline on the identification, assessment and management of overweight and obesity, the original recommendations were published in 2006. This draft update to one section of the original guideline is aimed at those with a responsibility for public health – such as those who commission or implement activities or interventions aimed at preventing obesity.
Professor Mike Kelly, director of the Centre for Public Health at NICE, said: “Obesity rates have nearly doubled over the last 10 years and continue to be a huge concern for local authorities and the health service in England. NICE has already published a range of guidelines to help prevent and manage obesity, but this draft update focuses on the changes individuals can make that might help them reduce their risk of overweight and obesity. Following a healthier diet and being more physically active is important for everyone, not just if you are already overweight or obese.
“The general rule for maintaining a healthy weight is that energy intake through food and drink should not exceed energy output from daily activity. We all know we should probably take the stairs rather than the lift, cut down on TV time, eat more healthily and drink less alcohol. But it can be difficult to know the most useful changes that we can make in terms of our weight.
“This updated guideline makes a number of recommendations which aim to ensure that the advice people are given about maintaining a healthy weight is more specific and based on real evidence.”
Draft recommendations include:
Encourage physical activity habits that increase energy expenditure: Everyone should be encouraged to:
- Walk or cycle to school, work or other local destinations
- Be more active during leisure time and as part of usual routines
- Reduce TV viewing and other leisure screen time. Any strategy that reduces TV viewing and other leisure screen time is likely to be helpful (such as TV free days or setting a limit to watch TV for no more than 2 hours a day).
Encourage dietary habits that reduce the risk of excess energy intake: Everyone should be encouraged to:
- Reduce the overall energy density of the diet by reducing how often energy dense foods (such as fried foods, biscuits, confection and full fat cheese) are eaten and choosing lower energy density foods (such as fruit and vegetables) instead.
- Follow the principles of a Mediterranean diet, which is a diet predominantly based on vegetables, fruits, beans and pulses, wholegrains, fish and using olive oil instead of other fats.
- Avoid sugar-sweetened drinks (including carbonated drinks, sports drinks, squashes and any other hot or cold drinks that contain added sugar).
- Limit the amount of ‘fast’ or ‘take away’ foods eaten.
Encourage adults to limit the amount of alcohol they drink: Everyone should be made aware that all alcoholic drinks are a source of additional energy. For example, a man drinking the upper weekly limit of 21 units will be consuming around 1400 to 1800 extra calories each week.
The guidance also includes recommendations addressing misconceptions about behaviours that may influence weight and gives some examples of simple and easy ways people can keep an eye on their weight. For example, using one of the numerous apps available to track food intake or physical activity or weighing yourself on a regular basis.
The updated draft guideline will be available for consultation on the NICE website from Tuesday 23 September 2014. The guideline is for those who commission, design, implement or evaluate interventions that aim to help different population groups maintain a healthy weight or prevent excess weight gain.
For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.
Notes to Editors
About the guidance
- The draft guidance will be available at /guidance/indevelopment/GID-PHG78 from 23 September 2014. Embargoed copies of the draft guidance are available from the NICE press office on request.
- The Committee noted that the concept of ‘maintaining a healthy weight’ used for adults needs to be modified for children because of growth in height and because a healthy BMI increases from age 6 to age 18. The concept for children is instead about ‘maintaining a healthy BMI for one’s age’.
- NICE is also in the process of updating the aspect of the 2006 guideline which focus on the clinical assessment and management which sets out what treatments should be offered to people with obesity and in what order. Further information can be found on the NICE website – /Guidance/InDevelopment/GID-CGWAVE0682.
- Overweight and obesity increase the risk of coronary heart disease, hypertension, liver disease, osteoarthritis, stroke, type 2 diabetes, and some cancers such as breast, colon, endometrial and kidney cancer.
- It is estimated that life expectancy is reduced by an average of 2 to 4 years for people with a BMI of 30 to 35 kg/m2, and 8 to 10 years for people with a BMI of 40 to 50 kg/m2 (Prospective Studies Collaboration 2009).
- Black African, African–Caribbean and Asian (South Asian and Chinese) groups are at risk at a lower BMI than white Europeans. Lower BMI thresholds (23 kg/m2 to indicate increased risk and 27.5 kg/m2 to indicate high risk) to trigger action to reduce the risk of conditions such as type 2 diabetes has been recommended for these groups. See BMI and waist circumference - black, Asian and minority ethnic groups (NICE public health guideline 46).
- In 2012, the mean body mass index (BMI) of adults in England was approximately 27 kg/m2. Adults with a healthy weight (BMI 18.5 to 24.9 kg/m2) were in the minority (32% of men and 41% of women). Most people were either overweight (BMI 25 to 30) or obese (BMI over 30). Around 28% of children aged 2 to 15 were classified as either overweight or obese (Statistics on obesity, physical activity and diet: England 2014 The Health and Social Care Information Centre 2014).
- Mean BMI among adults has increased by about 1.3kg/m2 since 1993 and the proportion of adults classified as a healthy weight has decreased by about 9 percentage points between 1993 and 2012. (Statistics on obesity, physical activity and diet: England 2014 The Health and Social Care Information Centre 2014).
- The cost to society and the economy of people being overweight or obese was estimated at almost £16 billion in 2007 (more than 1% of gross domestic product). It could rise to just under £50 billion in 2050, if obesity rates continue to increase unchecked (Tackling obesities: future choices – project report Foresight 2007). The cost to society and the economy of people being overweight or obese was estimated at almost £16 billion in 2007 (more than 1% of gross domestic product). It could rise to just under £50 billion in 2050, if obesity rates continue to increase unchecked (Tackling obesities: future choices – project report Foresight 2007).
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