THE NONGENETIC DETERMINANTS OF CENTRAL ADIPOSITY

Central adiposity carries an increased risk of non-insulin dependent d iabetes mellitus (NIDDM), cardiac disease, hypertension and death, and is closely related to insulin resistance. Genetic factors explain a l arge proportion of the population variance in central adiposity, altho ugh the genotypic characteristics remain obscure. Hormonal factors suc h as endogenous sex steroid levels, the menopause, hormone replacement therapy and cortisol may influence body fat partitioning. The link be tween dietary factors and central adiposity is controversial, with con tradictory results in the literature. Smoking is associated with lower total body fat, but investigations of its influence on central adipos ity have also yielded contradictory results. Higher levels of physical activity are associated with lesser amounts of central fat, both cros s-sectionally and in intervention studies. Some of the contradictory r esults regarding putative influences on central adiposity may be due t o limitations of some of the anthropometric parameters of central adip osity, such as the waist-hip ratio. Further research is required to cl arify the relationships between many of these factors and with both co mpartments of central adiposity: subcutaneous abdominal and intraabdom inal adipose tissue.