People are being encouraged to keep their waist measurement to
less than half their height to reduce the risk of potential
health problems, according to recommendations in an updated NICE
draft guideline.
For the first time, this update encourages adults with a body
mass index (BMI) below 35 kg/m² (obesity class 2) to measure
their own waist-to-height ratio.
Using the waist-to-height ratio, in conjunction with BMI, can
help to provide a practical estimate of central adiposity, which
is the accumulation of fat around the abdomen, to help to assess
and predict health risks, such as type 2 diabetes, hypertension
or cardiovascular disease.
NICE added the waist-to-height ratio to its draft guideline after
looking at evidence from several studies which showed that,
alongside BMI, it could be used to assess and predict
weight-related conditions in all ethnicities and sexes.
The 2019 Health Survey for England estimated the prevalence of
obesity in adults in England to be 28%, with overweight affecting
a further 36%. Government estimates indicate that the current
costs of obesity in the UK are £6.1 billion to the NHS and £27
billion to wider society.
The guideline also recommends, in line with international
guidance, using lower BMI thresholds for overweight and obesity
for people from South Asian, Chinese, other Asian, Middle
Eastern, Black African, or African-Caribbean family compared to
the general population.
This approach is already widely used because research shows
people from some Black, Asian and minority ethnic groups are more
prone to central adiposity and have an increased cardiometabolic
health risk at lower BMI thresholds.
The guideline highlights the importance of healthcare
professionals asking permission before any discussions with
people that are linked to being overweight, obese or central
adiposity, and to ensure they do so in a sensitive and positive
manner.
Dr Paul Chrisp, director for centre for guidelines at
NICE, said: “Our updated draft guideline offers
people a simple and effective way of measuring their weight so
they can understand the factors that could impact on their health
and take action to address them.
“Our committee found that a clear benefit of using the
waist-to-height ratio is that people can easily measure it
themselves, interpret the results, and seek medical advice if
they are at increased health risk.
“The evidence shows that people from some Black, Asian and
minority ethnic groups have a greater propensity to develop
central adiposity and have an increased cardiometabolic health
risk so we have lowered the BMI thresholds for those communities,
in line with international guidance, to ensure people from those
family backgrounds can get support from weight management
services if required.
“We are now looking for views from the healthcare professionals
and the public on the proposed recommendations in the guideline
before final publication.”
Guideline committee member Professor Rachel Batterham,
consultant in obesity, diabetes and endocrinology,
said: “Increased fat in the abdomen increases a
person’s risk of developing several life-limiting diseases
including type 2 diabetes and heart disease. Waist-to-height
ratio is a simple, easy to use measure that identifies people who
are at increased health risk and would benefit from weight
management support to improve their health.”
Another guideline committee member, Dr Nivedita Aswani,
consultant paediatrician specialising in diabetes and weight
management at Sheffield Children’s Hospital,
said: “We know that increased fat in the abdomen
increases the risk of conditions such as type 2 diabetes,
non-alcoholic fatty liver, hypertension and cardiovascular
disease, even in young children.
“A waist measurement can be taken independently by a young person
in the security of their own home, or by a carer for their child.
A waist measurement of more than half of a person's height, is an
indication of greater risk. Young people should be encouraged to
seek advice about weight management, and sensitively supported to
lower their risk of developing these conditions, and to improve
overall health and wellbeing.”
The guideline has a number of further recommendations for
research, including gathering additional information to assess
health risks in adults and children and young people.
A consultation on the proposed recommendations is now taking
place until Wednesday, 11 May 2022. People can have their say
via nice.org.uk.
