BMI of 1 million minority ethnic adults in England wrongly classified

A million minority ethnic adults are wrongly classified as weighing below the thresholds for being overweight or obese due to official figures not using up-to-date guidance, a leading charity has warned.

Analysis by Nesta has found that, while official statistics class 64% of adults in England as being overweight or living with obesity, the correct figure should be 67%.

The 3% difference between Nesta’s analysis and Health Service for England data represents around a million people, and is explained by Black and Asian adults being underrepresented in the data.

Nesta found that recorded rates of Black adults being overweight or living with obesity should be 13 percentage points higher. For Asian adults, the figure should be 18 percentage points higher.

The error in the official figures is the result of government statistics not using new body mass index (BMI) calculations. Earlier this year, The National Institute for Health and Care Excellence (Nice) updated its BMI measurement guidelines to recommend lower thresholds for adults from Black, Asian and other minority ethnic backgrounds.

Nice’s revised thresholds reflect the fact that people from certain minority backgrounds have a greater risk of some chronic health conditions – such as cardiovascular disease or type 2 diabetes – at a lower threshold than their white counterparts.

The updated guidance also addresses how body composition, which includes variations in fat and muscle mass, varies across ethnic groups. People from Black, Asian, and other minority backgrounds are more prone to central adiposity, which occurs when excess fat accumulates around the abdomen and is a risk factor for cardiovascular diseases and related mortality.

Nesta, a charity that promotes innovation, said that the government should make sure the updated Nice thresholds are adopted in future publications of the Health Survey for England.

Parita Doshi, deputy director of healthy life at Nesta, said: “Reducing Britain’s obesity levels is achievable, but only with a clear-eyed understanding of the size of the problem and levels of inequality.

“NHS England and DHSC [the Department of Health and Social Care] should look to ensure these guidelines are adopted in future health data publications, to provide a clear picture of the challenge of reducing obesity in the country.”

Jabeer Butt OBE, the chief executive of the Race Equality Foundation, said: “The analysis carried out by Nesta shows the urgent need for better guidance and training for healthcare staff on assessing health risks for people of Black, Asian and minoritised ethnic backgrounds.

“However, this analysis should also make the government prioritise action on drivers of poorer health, such as insecure employment [and] poor-quality housing in economically deprived areas, amongst other issues. Those who will conclude that it is individuals’ choices about diet and exercise that needs to change will have misunderstood Nesta’s analysis.”

The DHSC was approached for comment.