Does a large waistline mean you are at risk of diabetes and heart disease? – The Indian Express

A large waistline, also known as central obesity, is not just a cosmetic concern, it is a powerful marker of many severe health conditions such as diabetes and heart disease. Here are a few need-to-knows of how a large waistline is a strong indicator of future health risks.
Does a large waistline mean you are at risk of diabetes and heart problems?
The waist circumference is an indicator of the fat mass or the adipose tissue in the abdominal region, what we call visceral fat. The current upper limit of the waist circumference in men is 90 centimetres and in women, 80 centimetres.
According to Dr Subhash Kumar Wangnoo, Senior Consultant, Endocrinologist and Diabetologist, at Indraprastha Apollo Hospital, if the waist circumference is higher than these limits, then you are at a risk of developing diabetes, high cholesterol, high blood pressure and heart diseases. The higher circumference denotes that you have underlying insulin resistance.
“The extra fat in the abdomen is bad metabolically because the fat is a reservoir of many chemicals called cytokines. One of these are adipocytokines, which cause insulin resistance. For example, there is another chemical called adiponectin which improves insulin sensitivity and prevents diabetes but when excessive fat builds around the waistline, the adiponectin levels go low. Then the patient develops insulin resistance, which is an initial trigger of diabetes,” he adds.
Large waistline means insulin resistance
Dr Wangnoo says that insulin resistance is basically present right from birth, which manifests later on when the patient gains weight, has a sedentary lifestyle and has a family history of diabetes. When the patient is obese, then the genes which regulate insulin sensitivity become abnormal and lead to a state of insulin resistance. “We keep telling patients that the process of diabetes starts at least a decade before they get detected. A decade before insulin resistance starts, the body tends to compensate for it with extra production of insulin from the pancreas so that the sugar remains normal. The body has a sensing mechanism and it produces more insulin but after eight to ten years, the pancreas, which produces extra insulin, cannot do so. Then the insulin deficiency starts and patients start developing diabetes,” he adds.
Prone to hypertension, coronary heart diseases
According to Dr Wangnoo, insulin resistance not only causes diabetes but also changes cholesterol metabolism, resulting in elevation of bad cholesterol.
“And last and not the least, hypertension has a link with coronary heart diseases. So, there is a link between heart disease, cholesterol, blood pressure and insulin resistance. The main culprit is the insulin resistance which drives all the complications,” he adds.
Does PCOS also lead to increased fat around the waistline?
“PCOS is because of insulin resistance and the women suffering from it can make insulin but can’t use it effectively, increasing their risk for Type 2 diabetes,” says he.
How to reduce your waist circumference?
There are several effective ways to reduce your waist circumference in a healthy manner. Lifestyle changes, eating a healthy diet and getting regular exercise. “Quit smoking and maintain self-control. If you have Type 2 diabetes, the medication Metformin may provide benefits in helping you reduce waist circumference,” says Dr Wangnoo.
How can we prevent obesity in children?
According to Dr Ashutosh Marwah, Director, Paediatric Cardiology, Fortis Escorts Heart Institute, obesity affects children in three ways. One is psychological and this insecurity of standing out leads to more stress-eating, resulting in hypertension, hyperlipidemia and early diabetes disorders in adulthood. “Precocious puberty is also a major problem. Prevention is important. Continue breastfeeding for four to six months. As a child grows to be a toddler, then the family has to be more cautious while feeding. They should avoid giving/feeding over-refined foods, noodles, fast food, aerated drinks and all indulgence that can make a child obese/gain weight. Promote outdoor activities for children and build athleticism through running or any kind of sports. Limit screen time of children. Practise healthy snacking in the family to avoid obesity/weight gain in children. They should opt for roasted food instead of fried ones,” he adds.
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Ankita UpadhyayAnkita Upadhyay is a health reporter with The Indian Express' Delhi bu… read more

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