Rimm A A, Hartz A J, Fischer M E
Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
J Clin Epidemiol. 1988;41(5):459-65. doi: 10.1016/0895-4356(88)90047-9.
The medical literature gives ample evidence of the relationship between obesity and specific diseases such as adult-onset diabetes and hypertension. Until recently the sole focus of the relationship has been between morbidity and the degree of overweight which is usually measured as weight relative to height. Recently we have shown that the location of body fat is not only associated with morbidity but that this relationship is independent of the total amount of adipose tissue. Clinical studies have shown that adipocyte size, location and metabolism are related to fat distribution. An excess of large fat cells in the upper body explains the increase risk of diabetes in women. The location of body fat has been used to delineate three body types: gynoid (pear shape), intermediate, and android (apple shape). We used waist girth divided by hip girth for scaling body shape and found that it is associated with morbidity after adjustment for relative weight. The use of relative weight and body shape simultaneously gives a better estimate of risk of morbidity than either alone. This study of 44,820 women presents easy to read graphs, derived from the multiple logistic model, which will permit practicing physicians to estimate visually the combined risks associated with relative weight and body fat location.
