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Shape up or ship out?

Much attention has been given to the particular health consequences of so-called central (upper body) obesity, as measured by the waist-to-hip ration (WHR), for example. Among the increased risk factors of central obesity are diabetes, coronary heart disease, and stroke. Another important measurement is the body mass index (BMI), which measures overall obesity. Until now, health promoters have been less concerned with the consequences of an elevated BMI that is not associated with and elevated WHR.

A Canadian study reported in the December 27, 1995, Journal of the American Medical Association sought to determine the extent to which persons who are overweight overall, but whose waist-to-hip ratios are within acceptable limits, might be subject to the same or other health risks.

The researchers used the Manitoba Heart Health Survey (MHHS) to interview and later examine clinically 2,792 adults aged 18 to 74 years. (The MHHS was part of a national study that examined the prevalence and distribution patterns of cardiovascular risk factors and assessed the level of knowledge of cardiovascular health among Canadians.) The survey included an interviewer-administered risk factor questionnaire a self-administered nutrition questionnaire, and clinical and laboratory studies.

In overweight men with normal waist-to-hip ratios, the patterns of blood pressure, cholesterol levels, and fasting food sugar were significantly worse than those in nonobese men--and except for blood sugar levels, their risk patterns were as unfavorable as those of men with high WHRs. In overweight women with normal WHRs, on the other hand, only diastolic blooded pressure was significantly worse than in women with elevated WHRs.

The researchers concluded that BMI as an overall measure of obesity is as important as, and sometimes more important than, WHR in predicting risks from obesity. They therefore stress the importance of nutritional and behavioral counseling for obese persons, even if the risk for some noncentrally obese persons maybe less than for those with elevated WHRs.
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Title Annotation:adapted from the Journal of the American Medical Association, December 27, 1995; upper body obesity risk factors
Author:Brown, Edwin W.
Publication:Medical Update
Date:Feb 1, 1996
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