Archive for April 2013

Large Waist Size Linked to Higher Dibetes Rates

April 17, 2013

Large Waist Size Linked to
Higher Diabetes Rates

A higher rate of diabetes is recognized among adult
Americans when compared to peers in England is
explained primarily by a larger waist size rather than
conventional risk factors such as obesity, according to
a new study by researchers from the RAND Corporation,
University College London and the Institute for Fiscal
Studies in London.

Researchers say the findings offer more evidence that
accumulating fat around the mid-section poses a health
risk and suggests that studies of diabetes risk should
emphasize waist size along with traditional risk factors.

“Americans carry more fat around their middle sections
than the English, and that was the single factor that
explained most of the higher rate of diabetes seen in the
United States, especially among American women,” said
the RAND researchers, a nonprofit research organization.
“Waist size is the missing new risk factor we should be
studying.”

The findings were published online by the Journal of
Epidemiology and Community Health.

Researchers say that Americans middle-aged and
older are significantly more likely to suffer from diabetes
compared to their peers in England despite a similar
standard of living. About 16 percent of American men
report having diabetes as compared to 11 percent of
English men. About 14 percent of American women
have diabetes, compared to 7 percent among
English women.

An earlier study co-authored by Banks and Smith
demonstrated that middle-aged Americans are less
healthy than their English counterparts, although medical
spending in the United States is more than twice as high
as it is in the United Kingdom.

Analyzing studies about the health and lifestyles of large
numbers people from the United States and England,
researchers found no association between higher diabetes
rates in the United States based upon conventional risk
factors such as age, smoking, socio-economic status or
body mass index, the commonly used ratio of height and
weight that is used to measure obesity and over-weight.

The conventional risk factors for diabetes were similar
among both the American and English populations.
Americans had slightly higher scores on body mass
index and were a little older. The English were less
educated and more likely to have smoked.

However, American men had waists that averaged
3 centimeters (1.25 inches) larger than their English peers
and the waists of American women were 5 centimeters
(2 inches) bigger than English women. American women
were significantly more likely to face higher risk because
of their waist size when compared to English women
(69 percent to 56 percent), while American men had only
a slightly higher waist risk than their English peers.

The higher waist size of Americans posed more risk
compared to their English peers across most body mass
index categories. For example, among women with normal
weight, 41 percent of American women were categorized
as having high waist risk compared to 9 percent of
English women.

The study concludes that waist circumference explains
a substantial proportion of the higher diabetes rate in
America for men and virtually all the higher rate seen
among women.

Researchers say there may be many reasons why
Americans have larger waists than their English peers.
It may be caused by different rates of physical activities
through exercise or daily activities, diet differences or
perhaps other social and environmental factors such
as stress that occur in the United States.

Researchers say that future research needs to address
the different mechanisms that may be responsible for this
association. For example, there is evidence that fat in the
midsection has a different metabolism than fat carried
elsewhere on the torso.

Researchers say that past evidence has shown that waist
circumference is a better marker for visceral fat than other
measurements. Previous studies have shown that fat cells
located in a person’s midsection have specific dysfunction
that may be involved in the mechanisms that lead to diabetes.

The research was supported by a grant from the National
Institute on Aging and was conducted through the RAND
Labor and Population program. The program examines
issues involving U.S. labor markets, the demographics of
families and children, social welfare policy, the social and
economic functioning of the elderly, and economic and
social change in developing countries.

Journal Reference:
“What explains the American disadvantage in health
compared with the English? the case of diabetes.”
Journal of Epidemiology & Community Health, 2010