Study Says Children’s Waist Measurements are not a Better Predictor of Diabetes

As the obesity crisis worsens in the west, the consequences are spreading even to children, with the rate of Type II diabetes in children under 20 having risen to around 5 in 100,000.  The rate is higher with some ethnic backgrounds, including black, Hispanic and Native American children, and has been ascribed to western eating habits and lifestyle changes.

With obesity and childhood diabetes on the increase, there is an increased need for diagnostic tests that can accurately identify children at greater risk from the disease.  Physicians use a number of methods for assessing the risk of developing diabetes in children and adults, including noting the Body Mass Index (BMI) of the patient, as being overweight (with a BMI of 25 or more) or being obese (with a BMI of 30+) increases the risk of diabetes.

In recent years, taking the waist measurements of patients has gained ground as an important diagnostic test.  In adults a waist measurement of more than 37 inches, or 32 inches in women, can indicate an increased risk of developing Type II diabetes.  This central placing of fat on the abdominal area is sometimes described as an “apple” shape, as compared to the “pear” shape of people who tend to deposit fat on their bottom and thighs, and is associated with a higher risk of diabetes and heart disease.

Now researchers say the waist circumference may not be as vital as recently thought in assessing the diabetes risk in children and young people, and doctors should continue to use the BMI as the best indicator.

Type II diabetes was once almost unknown in children and seen as a disease of later life produced by factors such as weight gain, poor diet, and sedentary lifestyle.  However, 21st century lifestyles have changed this, as children eat fattier, sugary junk foods.  Thanks to television, computer games and parents’ fears of traffic hazards and pedophiles, many children get less exercise now than in the past when they played active games in the street.  The result has been a sharp rise in the obesity levels of children – and a higher number of children being diagnosed with Type II diabetes.

Researchers at the University of Michigan concluded that waist measurement is not a better indicator of diabetes risk in children than BMI after studying data from the National Health and Nutrition Examination Survey carried out from 1999-2002.  The data included BMI, waist measurements, and insulin and glucose levels in the blood in 1,571 young people from a variety of ethnic backgrounds.  Around 12% of the subjects showed insulin resistance, and the facts showed waist measurements and BMI were of equal value in identifying children with this symptom, a danger signal for diabetes.

They therefore concluded that taking waist measurements of children was not a better test than the established BMI indicator and should not be used in its place.  More studies are needed before waist measurement is included in routine pediatric care screening, the researchers reported.

The study was led by Dr Joyce Lee, a pediatric endocrinologist at the university’s C S Mott Children’s Hospital, acknowledged as one of the best pediatric hospitals inAmerica.

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