Smoking Linked to Spare Tire
October 20, 2005—Cigarette smoking may lead to increased abdominal fat—a type of fat associated with several diseases—according to a study in Obesity Research (2005;13:1466–75). Excess abdominal fat is associated with the development diseases such as type 2 diabetes and cardiovascular disease.
Over 97 million Americans are overweight or obese. Besides increasing the risk of heart disease and diabetes, being overweight substantially increases the risk of developing high blood pressure, elevated blood fats (cholesterol and triglycerides), gallbladder disease, respiratory problems, and certain cancers.
Several measurements are used to help assess the risk of obesity-related diseases. Body mass index (BMI) is a measure of body fat based on an individual’s height and weight. It is calculated by dividing one’s weight in kilograms by the square of one’s height in meters. A BMI of 18.5 to 24.9 is considered normal; 25 to 29.9 is considered overweight; and 30 or more is considered obese. Waist circumference, another gauge of obesity, is measured at the smallest area between the ribs and the hips. This measurement estimates the amount of abdominal (central) fat, and may be more predictive of disease risk than is overall body fat. In fact, having a larger waist circumference (over 35 inches in women and over 40 inches in men) can increase disease risk even in people of normal weight. Hip circumference is used to estimate fat content in areas other than the abdomen (peripheral fat). It is measured at the point between the top of the hips and the crotch that has the largest circumference. The waist-to-hip ratio helps to compare the amount of central to peripheral fat. Higher waist-to-hip ratios are another indicator of increased disease risk.
The risk of developing lung cancer, stroke, heart attack, and chronic lung disease is much higher among smokers than it is in nonsmokers. Previous studies have suggested that cigarette smoking may also influence body fat distribution. The new study explored this association by evaluating information from over 22,000 adults, ages 45 to 79. Height, weight, waist circumference, and hip circumference were measured, and from this information, the BMI and waist-to-hip ratios were calculated. Information pertaining to the participants’ smoking history was also gathered. For current and former smokers, the number of cigarettes smoked per day and the duration of smoking in years were ascertained. The time elapsed since quitting was noted for former smokers.
Current smokers had lower BMI values than did nonsmokers; however, the pattern of the fat distribution was markedly different between the groups. Current smokers had higher waist-to-hip ratios and waist circumferences, and lower hip circumferences than did people who used to smoke and those who had never smoked. The amount and duration of cigarette smoking was associated with waist-to-hip ratios among current and former smokers; the more time that had elapsed since quitting smoking, the lower the waist-to-hip ratio.
These results suggest that although smokers tend to have less overall body fat, the pattern of higher abdominal and lower peripheral fat seen in smokers may actually put them at higher risk for obesity-related diseases, compared with the risk in nonsmokers with more body fat.
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Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.
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