Use Tape Measure to Track Diabetes

Identifying who is at risk of diabetes and a number of other health concerns may be as simple as measuring waist size, according to a new report.

U.S. researchers found that people who had relatively large waists and an excess of fats in their blood were more likely to also have diabetes or appear to be at risk of diabetes or other conditions, such as high cholesterol.

Consequently, a simple tape measure may be all the tools a doctor needs to identify people who need extra medical attention to ward off future health problems, study author Dr. Henry S. Kahn of the Centers for Disease Control and Prevention in Atlanta told Reuters Health.

"If you come into my office, and I can't tell if you're skinny or fat, I will put a tape measure around your belly," Kahn said.

If a person's waist is relatively large, Kahn said he subsequently orders an inexpensive blood test to measure the amount of fat circulating in the blood.

If a person has both a large waist and large amount of fat in the blood, Kahn said he will offer advice about diet and exercise, and perhaps treatments to ease the symptoms of pre-existing conditions.

Body fat tends to accumulate around the abdomen with age, and this is not the first study to link a "spare tire" to a number of health problems.

During the current study, reported in the American Journal of Clinical Nutrition, Kahn and his co-author Rodolfo Valdez measured the waist sizes and blood fat levels of 9183 adults of all ages, noted who fell above certain "threshold" levels, and what other conditions they had.

In an interview, Kahn explained that he determined the threshold levels for waist size and blood fats by looking at the predominant values in people aged 18-24, a time of relative health and vigor.

The threshold value for waist size was 95 centimeters (about 38 inches) in men and 88 centimeters (about 35 inches) in women.

The proportion of people with both waist sizes and blood fats above threshold levels increased with age, going from only 6 percent of people between the ages of 18 to 24, and rising to 43 percent of people between 55 and 74 years old.

People with large waists and high blood fats were more than three times as likely to have diabetes, and tended to show relatively high levels of glucose and insulin in their blood, a sign they are at risk of developing diabetes.

In an accompanying editorial, Jack Wang of Columbia University in New York writes that very few doctors include waist measurements in their practice, largely because there has been little effort to publicize the importance of doing so or to establish international standards for threshold values and measuring techniques.

However, the current findings "should encourage physicians to include (waist size) measurement in the health evaluation procedures that they use in their routine clinical practices," Wang notes.

American Journal of Clinical Nutrition, November 2003.

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