Overall obesity, measured by high
body mass index (BMI) -- the height-to-weight ratio, and
abdominal obesity, measured by a large waist circumference,
each strongly and independently predict the risk of type
2 diabetes in men, but abdominal obesity appears to be the
better predictor, new research shows.
"Both BMI and waist circumference
are useful for assessing health risk and should be measured
in clinical settings...whenever possible," the investigators
say. But abdominal fat measured by waist circumference "can
indicate a strong risk for diabetes whether or not a man
is considered overweight or obese according to his BMI,"
lead author Dr. Youfa Wang added in a statement.
In the study, investigators
compared the predictive power of BMI, waist circumference,
and waist-to-hip ratio for the development of type 2 diabetes
in 27,270 men participating in the Health Professionals
Follow-up Study.
During 13 years of follow-up,
a total of 884 men developed type 2 diabetes, Wang, from
Johns Hopkins Bloomberg School of Public Health in Baltimore,
and colleagues report in the American
Journal of Clinical Nutrition.
According to the team, as
waist circumference increased, so did the risk of developing
diabetes, with the risk in men with the highest waist circumference
increasing by 12-fold, they report.
A similar graduated risk
was seen for waist-to-hip ratio and BMI, with the largest
values associated with a 7-fold and 8-fold increased risk,
respectively.
"Our findings support the
contention that the measurement of waist circumference should
be used in clinical practice instead of waist-to-hip ratio,"
the investigators write.
The study findings also suggest
that the currently recommended cutoff for high waist circumference
of 102 cm (40 inches) for men may need to be lowered to
95 cm.
"Many of the men who developed
type 2 diabetes had measurements lower than the cutoff,
Wang said, "and the risk associated with the waist circumference
increased at a much lower level."
SOURCE: American Journal
of Clinical Nutrition, March 2005.
