Global Diabetes Crisis Driven by Visceral Fat

Excess visceral fat contributes to the increased number of people living with diabetes.

Recent news about the on-going fight to stop the diabetes epidemic is discouraging, to say the least. Medical experts from the International Diabetes Federation announced on World Diabetes Day that a record 382 million people are living with diabetes this year—and that doesn’t even account for the estimated 175 million diabetic cases that are undiagnosed.

While cases of diabetes are skyrocketing around the world, China tops the charts with the caseload expected to rise to 142.7 million in 2035 from 98.4 million presently. Experts blame many factors for this increase including the expansion of high-calorie fast food restaurants and increased sedentary lifestyles.

Although research shows an association between obesity (BMI >30) and increased diabetes risk, having a normal BMI (<25) doesn’t necessarily mean you aren’t at risk for developing diabetes. In fact, many with type 2 diabetes in China are considered to be normal weight. A recent study with more than 98,000 Chinese adults with a mean BMI of 23.7 found that 11.6 percent of the subject had diabetes (1). Body composition—the ratio of body fat to lean body mass—is possibly a better indicator for disease risk, including diabetes, than BMI.

Normal-weight obesity, or being “skinny fat”, is a growing problem in China. While those who are “skinny fat” do not appear to be unhealthy or overweight, they have a high percentage of body fat, especially visceral fat or the fat that surrounds vital organs. Numerous studies show that increased visceral fat leads to increased risk of chronic disease.

One study examined body fat and BMI of a sample of multi-ethnic (Asian, Caucasian, Hispanic, and other) college-aged men and women and found that Asian women, while having the lowest BMI, had the second highest percent body fat (2). The researchers concluded that, “The high percent body fat with low BMI pattern exhibited by Asian-American women suggests that they could escape detection for obesity-related disease if BMI is the sole measure that estimates body composition.”

With the growing number of people with diabetes around the world, it seems as if the battle is being lost. Current measures to educate and provide resources about the benefits of a healthy diet and lifestyle are not effectively slowing the progression of diabetes. With 5.1 million deaths per year attributed to diabetes (or one death every six seconds), there is still a lot of work to do.