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Big Waist, Heavy Weight Both Raise Diabetes Risk

Having either a large waistline or being overweight raises a person’s risk of developing type 2 diabetes, but the combination of the two is most dangerous, a study shows. It’s well known that overweight and obese adults stand a greater chance of developing type 2 diabetes than those who are leaner. Also, many studies have found that excess abdominal fat may carry a particular risk, though not all have reached that conclusion.

As a result, there’s some controversy over which measurements should be used to estimate an adult’s diabetes risk, according to the authors of the new study. Body mass index (BMI), a measure of weight in relation to height, is the standard way of classifying people as normal weight, overweight or obese. But taking a tape measure to the waistline is a more precise way of gauging abdominal obesity.

In the current study, BMI and waist circumference were each found to be strong predictors of diabetes risk. The risk was greatest among men and women with both a high BMI and large waist.

Dr. Christa Meisinger, the study’s lead author stated that, "Doctors should measure waist circumference in addition to BMI to assess the risk of type 2 diabetes in both sexes." Waist size did, however, seem to be particularly important for women, she pointed out. Women who were overweight but not "apple-shaped" did not have an elevated risk of diabetes, whereas a large waistline conferred a higher risk regardless of BMI — a pattern that was not true of men.

The study included 6,012 men and women ages 35 to 74 who were followed over 8 years. At the outset, all were free of diabetes and underwent medical exams that included measurements of BMI and waist and hip circumference. By the end of the study period, men with the highest BMI were four times more likely than their normal-weight peers to have developed diabetes. The risk was even greater among the heaviest women, who had a 10-fold greater risk than the thinnest women.

Similarly, waist size also predicted diabetes risk, with the relationship being stronger in women than in men. Women with the largest waists were again 10 times more likely to develop diabetes — with risk factors like age, exercise habits and parents’ history of diabetes taken into account.

The findings, according to Meisinger’s team, highlight the importance of measuring body size in more than one way. Waistline measurements, Meisinger noted, could be particularly helpful in judging a woman’s risk of developing diabetes.
American Journal of Clinical Nutrition, September 2006.

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