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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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