Project 834 | WWI for cardiometabolic equity

Ethnicity-Specific Weight-Adjusted Waist Index (WWI) for Cardiometabolic Risk Assessment: Development and Testing in Community Settings

Obesity is a major cause of preventable diseases like heart disease and type 2 diabetes. General practitioners (GPs), nurses and other primary care team members often use Body Mass Index (BMI), calculated using a person’s weight and height, to assess risk of disease. However, BMI categorises people into “underweight”, “normal weight”, “overweight” and “obese” ranges using certain thresholds and is not a perfect guide. It does not accurately show how much harmful internal body fat a person has, and does not work equally well for everyone. In particular, people from South Asian and Black backgrounds can have high levels of harmful fat even when their BMI is in the ‘healthy’ or ‘overweight’ range, rather than the ‘obese’ range. This means their higher risk of developing disease is often missed, which is unfair and widens health inequalities.

A better measure is waist circumference, which directly measures tummy fat linked to health risks. However, it is rarely measured in busy GP surgeries. There is now a more useful measure called the Weight-Adjusted Waist Index (WWI). It combines waist circumference and weight to give a clearer picture of risk. However, we don’t yet know the most appropriate WWI risk thresholds for people from different ethnic groups in the UK, or how practical it is to measure WWI in community settings.

This research project will use anonymous health records from thousands of GP patients to calculate WWI and identify the risk levels that best predict heart disease and type 2 diabetes in White, South Asian, and Black communities. Because waist circumference is needed to calculate the WWI, we will also assess whether it is practical and acceptable to measure waist circumference outside GP surgeries, such as in local community centres and pharmacies. We will talk to people from different ethnic groups and health professionals to understand their views, and test whether community measurements are as accurate as those taken by a practice nurse.

The goal is to develop a fairer, more accurate, and more accessible way to identify people at risk of heart disease and diabetes earlier, helping to prevent illness and save lives.