Apple or Pear? How Body Shape Affects Diabetes Risk

Where do you carry your extra weight? The answer may have implications for your type 2 diabetes risk.

New Health Risks Linked to Big Bellies

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Apple or pear? The question may imply a healthy snack — or an important distinction between body shapes that affects type 2 diabetes risk.

In general, people whose fat collects on their abdomen — making them resemble apples over time — are at greater risk for type 2 diabetes. But the good news is, you can escape your shape.
Being overweight is a significant risk factor for diabetes, no matter your shape. “Patients who have a higher body mass index have a higher risk [of diabetes],” says Danny Sam, MD, an internal medicine physician with Kaiser Permanente in Santa Clara, Calif., who specializes in the treatment of adult diabetes. Body mass index (BMI) is calculated by comparing weight and height.
But while any overweight person is at increased risk for diabetes, those who carry a lot of that extra weight over the belly are at particular risk. The apple shape not only predisposes you to diabetes but to poor heart health as well.

Identifying Your Type 2 Diabetes Body Type

Experts believe that where you store excess fat may be genetically determined — in other words, if your mother worried about her muffin top, chances are you do the same. And the body shapes determined by those fat deposits seem to predict your type 2 diabetes risk. It may be helpful to know the terms for the body shape categories:

• Apple. People whose fat collects around their waistline may end up looking more like apples than any other fruit. This body type is also called “android” and the fat collection is sometimes referred to as “central adiposity.”
• Pear. In women especially, fat can be drawn to the buttocks and thighs. The good news is that this type of fat distribution is less likely than abdominal fat to lead to insulin resistance or type 2 diabetes. This is also called the “gynecoid” body shape or “gluteo-femoral” fat.
• Overall. Some people collect fat everywhere at a fairly even rate. But because being overweight or obese, regardless of your body shape, increases type 2 diabetes risk over being normal weight, the fact that you don’t fall into either apple or pear shape doesn’t completely let you off the hook when it comes to preventing type 2 diabetes and other chronic health conditions.

Measure Your Waist

Some people can tell by sight if they are apple- or pear-shaped. But if your risk of diabetes isn’t clear from a glance in the mirror, there is one important measurement that can help you determine your risk of diabetes and heart disease: your waist. If you are a woman and your waistline is greater than 35 inches, you are at increased risk for type 2 diabetes. For a man, the magic number is 40 inches. If your tape measure reveals you are at or above these numbers, it’s time for a little waist whittling.

Escape Your Shape

The good news is that your body shape is not your disease destiny. There is one way to reduce your type 2 diabetes risk: weight loss to maintain a healthy body weight.
Here are the steps you can take:

• Be physically active. Sam emphasizes that physical activity has been shown to help prevent diabetes and will help you control your weight. Mix up your activities to include both aerobic activities, such as walking or swimming, and some weight training or core-strengthening so you get overall slimming benefits.
• Watch your weight. If you already know you are an apple or a pear, chances are you are also overweight. Getting back to a normal weight and staying there is your best bet for staving off diabetes. If you are having a hard time figuring out what your goal weight should be, talk to your doctor.
• Eat a healthy diet. A nutritious, varied diet full of lean protein, whole grain, fruits, and veggies is your best bet for long-term health. If you are pre-diabetic or have diabetes already, you must also control your blood sugar. Aim for low-fat menu planning as well, if you want to whittle down your waist.

If the body shape you see in the mirror isn't where you want it to be, don’t despair. With some work you can beat your diabetes risk — while feeling and looking healthier.