Central obesity and increased risk of dementia more than three decades later
AzeezFarooki, Memorial Sloan Kettering Cancer Center, 1275 York Ave Box 296, New York, NY 10065farookia@mskcc.org
Submitted June 26, 2008
I read with interest the longitudinal study [1] of US patients which adds dementia to the other well known negative outcomes associated with visceral obesity. [5] I would like to add a useful caveat: waist circumference is most accurately interpreted in the context of ethnicity.
Current ATP-III criteria for metabolic syndrome define abdominal obesity as a waist circumference in men >102 cm (40 in) and in women >88 cm (35 in). [6] The International Diabetes Foundation created definitions for four different ethnic groups and may include three more groups when data become available. [7] Using ATP-III criteria, a patient of Asian origin, for example, might be misclassified as having “normal” waist circumference.
For many patients with visceral obesity, losing weight through diet control and exercise is difficult but this study provides yet another motivation to pursue these therapeutic lifestyle changes.
References
5. Lapidus L, Bengtsson C, Larsson B, et al. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984;10:289:1257-1261.
6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-2497.
7. George, K, Alberti, MM, Zimmet, P, et al. The metabolic syndrome - a new worldwide definition. Lancet 2005;336:1059.
I read with interest the longitudinal study [1] of US patients which adds dementia to the other well known negative outcomes associated with visceral obesity. [5] I would like to add a useful caveat: waist circumference is most accurately interpreted in the context of ethnicity.
Current ATP-III criteria for metabolic syndrome define abdominal obesity as a waist circumference in men >102 cm (40 in) and in women >88 cm (35 in). [6] The International Diabetes Foundation created definitions for four different ethnic groups and may include three more groups when data become available. [7] Using ATP-III criteria, a patient of Asian origin, for example, might be misclassified as having “normal” waist circumference.
For many patients with visceral obesity, losing weight through diet control and exercise is difficult but this study provides yet another motivation to pursue these therapeutic lifestyle changes.
References
5. Lapidus L, Bengtsson C, Larsson B, et al. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984;10:289:1257-1261.
6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-2497.
7. George, K, Alberti, MM, Zimmet, P, et al. The metabolic syndrome - a new worldwide definition. Lancet 2005;336:1059.
Disclosure: The author reports no disclosures.