[acb-diabetics] mortality rate higher in people with large waists

[Patricia LaFrance-Wolf]

This article originally posted 

20 August, 2010

 and appeared in  

Complications and Co-morbidities, 

Issue 535

Larger Waist Associated with Greater Risk of Death 

Individuals with a large waist circumference appear to have a greater risk
of dying from any cause over a nine-year period, according to a report.  

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Having a large waist circumference has previously been associated with
inflammation, insulin resistance, Type 2 diabetes, abnormal cholesterol
levels and

heart disease, according to background information in the article. This may
be because waist circumference is strongly correlated with fat tissue in the

viscera -- surrounding the organs in the abdomen -- which is thought to be
more dangerous than fat tissue under the skin. 

Eric J. Jacobs, Ph.D., and colleagues at the American Cancer Society,
Atlanta, examined the association between waist circumference and risk of
death among

48,500 men and 56,343 women age 50 and older (median or midpoint age, 69
years in men and 67 years in women). All had participated in the Cancer
Prevention

Study II Nutrition Cohort, for which they completed a mailed questionnaire
about demographic, medical and behavioral factors in 1992 or 1993 and
provided

information about weight and waist circumference in 1997. Deaths and their
causes were tracked through the National Death Index until Dec. 31, 2006; a

total of 9,315 men and 5,332 women died during this timeframe.

After adjusting for body mass index (BMI) and other risk factors, very large
waists (120 centimeters or 47 inches or larger in men, and 110 centimeters

or 42 inches or larger in women) were associated with approximately twice
the risk of death during the study period. A larger waist was associated
with

higher risk of death across all categories of BMI, including normal weight,
overweight and obese; however, among women, the association was strongest
for

those at a normal weight.

"The reason for the stronger association between waist circumference and
mortality among women with low BMI in our study is unclear," the authors
write.

"Future detailed analyses of the relationship between waist circumference
and visceral adipose tissue or measures of insulin resistance within
categories

of BMI could identify biological reasons for potential differences in the
strength of the association between waist circumference and mortality."

The results may affect the development of future guidelines for obesity, the
authors suggest. "Currently available clinical guidelines from the National

Institutes of Health are based on evidence from the 1990s," they write.
"These guidelines recommend that waist circumference be used to identify
increased

disease risk only among individuals in the overweight and obese categories
of BMI. In addition, the NIH guidelines recommend weight loss goals for all

patients in the obese category of BMI (30 or greater), but they do not
specifically recommend weight loss goals for abdominally obese patients
(waist circumference

of 88 centimeters or larger in women or 102 centimeters or larger in men)
who are in the normal or overweight BMI category unless they also have two
or

more cardiovascular risk factors or a desire to lose weight."

Arch Intern Med. August 9,2010;170[15]:1293-1301.   

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