Is noncentral obesity metabolically benign? Implications for prevention from a population survey

To determine if individuals who are overall obese but have low waist-to-hip ratios have unfavorable lipid profiles, blood pressures, and glucose statuses.

Cross-sectional study.

The Manitoba Heart Health Survey surveyed a representative sample of residents of the Canadian province of Manitoba.

--A total of 2,792 adults aged 18 to 74 years were interviewed, 2,339 of whom underwent clinical examinations.

Blood pressure, fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein measurements were compared across categories of body mass index (BMI) and waist-to-hip ratio (WHR).

Manitobans with noncentral obesity tend to occupy positions between those of the nonobese and the centrally obese in terms of the effect on blood pressure, plasma lipids, and glucose. In multiple linear regression models involving age, BMI, and WHR as independent variables and one of the metabolic variables as dependent variables, both BMI and WHR are significant independent predictors of most metabolic variables. Where both are significant, BMI tends to be the stronger predictor, with a larger standardized regression coefficient.

Noncentral obesity is not metabolically benign; BMI as an overall measure of obesity is as important as, and sometimes more important than, WHR in predicting metabolic effects. The recognition of the epidemiological significance of the WHR as a centrality measure of obesity should not divert attention from the metabolic risk status of noncentrally obese individuals who require continued health education to reduce weight.