The Telegraph
Since 1st March, 1999
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Size up your waist
- Doctors find safe midriff line for Indians

New Delhi, Sept. 23: It might be time for health-conscious Indians to re-measure their waists. For some, waist size alone would justify medical consultations to avoid heart disease or stroke.

A new study from India has shown that the cut-offs for safe waist sizes for Indians should be 78 cm for men and 72 cm for women. These values are lower than the currently-accepted international and Asian-Pacific cut-offs.

All people with waist sizes higher than the new cut-offs would have to launch weight-control action, medical researchers have said.

The study, the first to analyse in detail the link between abdominal obesity in Indians and risk factors for cardiovascular diseases, has confirmed long-held suspicions that cardiovascular risk shows up at lower waist sizes in Indians than in Caucasians.

“This means you might be thin and yet be at risk of heart disease or stroke,” said Dr Anoop Misra, professor of internal medicine at Delhi’s All India Institute of Medical Sciences and principal investigator of the study.

The international waist cut-offs had been fixed about a decade ago at 102 cm for men and 88 cm for women.

But these values were based on observations in European Caucasians, and researchers have been looking for population-specific cut-offs.

A World Health Organisation committee on obesity had issued revised guidelines last year for cut-offs for Asian and Pacific populations: 90 cm for men and 80 cm for women. The new study now shows that the cut-offs for Indians should be even lower.

“Indians pack more fat in the abdomen and below abdominal skin than Caucasians,” said Misra.

Scientists believe that fat below abdominal skin, which can be felt by pinching the stomach with the fingers, is an important risk factor for diabetes and heart disease.

In their study, doctors from AIIMS and Jaipur measured waists and obesity in 883 men and 1,167 women and investigated their connections with risk factors for diseases such as diabetes, high blood pressure and high cholesterol.

The study has revealed that above the new cut-offs, in men and women, the higher their waist size, the greater their likelihood of having one or more risk factors for heart disease or stroke.

The waist circumference was measured around the navel.

Men with waist sizes between 78 cm and 90 cm and women with waist sizes between 72 cm and 80 cm should avoid weight gain or lose weight through exercise, the doctors said in a research paper set to appear in the International Journal of Obesity.

Men with waists larger than 90 cm and women with waists 80 cm or higher should seek consultations for “medically supervised weight management”, the AIIMS researchers and collaborating doctors from a hospital in Jaipur said.

Earlier studies have shown that Asian Indians have higher abdominal fat compared with either Caucasians or black populations. High abdominal fat may result in insulin resistance and other risk factors for diabetes or heart disease.

Three years ago, Chinese researchers proposed cut-off points of 85 cm for men and 80 cm for women.

Independent studies have indicated that cut-offs also need to be lowered for non-Asian populations in Brazil, Cameroon, Iran, Mexico, and Nigeria.

Over the past decade, a number of studies have suggested that an interplay of genes, changing food habits, and inadequate physical activity has spawned epidemics of diabetes and heart disease in India.

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