WAIST circumference is a stronger risk marker than BMI for obesity-related cancer in men, a study of almost 340,000 people has found.
However, that was not the case for women, where the association was weaker.
During a median follow-up of 14 years, around 18,000 obesity-related cancers were recorded.
Cancers linked with obesity include cancers of the oesophagus (adenocarcinoma), gastric (cardia), colon, rectum, liver/intrahepatic bile ducts, gallbladder, pancreas, breast (postmenopausal), endometrium, ovary, renal cell carcinoma, meningioma, thyroid, and multiple myeloma.
As well as finding that waist circumference (WC) is a more reliable indicator of risk than BMI, the researchers found that after accounting for BMI, high WC remains a risk factor for obesity-related cancer in men.
This suggests that the elevated risk associated with abdominal adiposity is specific, and not explained by high body size alone, as measured by BMI.
The authors, who presented the researcher at the recent European Congress on Obesity, explained that while BMI is a measure of body size, it does not provide information on fat distribution, "whereas waist circumference is a proxy more closely related to abdominal adiposity".
"This distinction is crucial because visceral fat, which accumulates around the abdominal organs, is more metabolically active and has been implicated in adverse health outcomes, including insulin resistance, inflammation, and abnormal blood fat levels.
"Consequently, individuals with similar BMIs may have distinct cancer risks due to differences in fat distribution."
As to why it was different for men versus women, they suggested: "A plausible explanation is that men are more likely to store fat viscerally, while women generally accumulate more subcutaneous and peripheral fat.
"Consequently, WC is a more accurate measure of visceral fat in men than in women.
"This may make waist circumference a stronger risk factor of cancer in men, and explain why waist circumference adds risk information beyond that conveyed by BMI in men, but not women."
The researchers noted that including hip circumference into risk models may provide further insights into this sex difference and enhance the association between WC and cancer - particularly for women, where the combination of waist circumference and hip circumference give a better estimation of visceral fat than waist circumference alone. KB
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