Diabetes researchers call for new BMI thresholds for different ethnic groups

by Barbara Hewitt on July 10, 2014

The definition of obesity should be different for some ethnic populations because black and Asian adults may be at risk of developing type 2 diabetes at a lower weight than others, a new study suggests.

According to the team at the University of Glasgow, new BMI thresholds are needed for ethnic minorities because being overweight or obese increases the risk of diabetes.


Different BMI thresholds are needed for different ethnic groups, say scientists

Presently, a BMI of 30kg/m2 or above is defined as obese but South Asian, Chinese and black populations have an equivalent risk of diabetes at lower BMIs than Caucasians.

The National Institute of Clinical Excellence has previously issued guidance on the subject to health professionals, but recommended that further studies be undertaken to define the thresholds for ethnic minorities.

In an attempt to define new thresholds, the researchers analysed data on 490,288 people who participated in the UK Biobank. They found that the rate of diabetes observed among whites classified as obese with a BMI of at least 30, was matched by South Asians with a BMI of at least 22, Chinese with a BMI at least 24 and black people with a BMI at least 26.

The study also showed the differences between South Asian sub-groups were small. The new BMI cut-offs were 21.5 in Pakistani men compared with 22.0 in Indian men, and 21.6 in Pakistani women compared with 22.3 in Indian women. Therefore, it would seem reasonable to apply the same cut-offs across all South Asian communities, the researchers said.

Professor Jill Pell, director of the Institute of Health and Wellbeing, said that by analysing the UK Biobank, researchers were able to access a very large study with sufficient numbers of participants from all of the main ethnic groups.

‘Therefore, they were able to produce separate cut-offs for each ethnic group. This study confirms that we need to apply different thresholds for obesity interventions for different ethnic groups. If not, we are potentially subjecting non-white groups to discrimination by requiring a higher level of risk before we take action,’ she explained.

‘Furthermore, a blanket figure for all non-white groups is inappropriate. We need to apply different thresholds for South Asian, Black and Chinese individuals,’ she added.

Professor Naveed Sattar, of the Institute of Cardiovascular and Medical Sciences, said that further research is needed to understand why South Asians get diabetes at much lower BMIs but in the meantime this study underlines the need for tailored advice for different ethnic groups.

Uduakobong Efanga Ntuk, a PhD student who conducted a large part of the research, said that since obesity is the main culprit behind the worldwide increase in type 2 diabetes, intervening at lower obesity cut-off points in those of non-white descent could save many lives.

‘Diabetes prevention programs need to be ethnicity specific. People of South Asian, Chinese and black descent need to be made aware that they are at a higher risk of diabetes. By adopting a healthy lifestyle, including physical activity and a healthy diet, they can significantly reduce their risk,’ he pointed out.

The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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