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When was the last time you measured your waistline? If you assume that BMI is the only number to focus on when it comes to your health, think twice. New research has revealed a shocking revelation—your waist circumference might be a far better predictor of men's cancer risk than BMI.
The study finds that for each 4-inch increase in waist size, a man's risk of cancer increases by a staggering 25%. Meanwhile, BMI, commonly regarded as the gold standard for assessing obesity, raises cancer risk by only 19% for the same weight gain. So, if you've been dismissing that pesky belly fat, it's time to take notice.
But why is your waistline so important? The reason is visceral fat—the hidden, deep fat that accumulates around your organs. Unlike other body fat, visceral fat is a stealthy troublemaker, causing inflammation, insulin resistance, and abnormal blood fat levels—all of which combine to create a cancer-perfect storm.
Obesity has been associated with an increased risk of numerous health conditions, including cancer, for decades. The research, though, indicates that a specific measure of the body—waist circumference—may be an even more reliable forecaster of cancer risk in men than the more frequently employed Body Mass Index (BMI). This finding emphasizes the need to pay particular attention to the distribution of fat and not merely to the weight of the body.
BMI has been the go-to measure for years for gauging health risks related to obesity. New research, though, that appears in The Journal of the National Cancer Institute indicates that waist measurement is a better predictor of cancer risk in men. According to the research, four more inches (10 cm) around the waist will add 25% to a man's cancer risk. Conversely, a 3.7 kg/m² rise in BMI (from a BMI of 24 to 27.7) increased cancer risk by only 19%.
Why is waist circumference a better predictor, then? Unlike BMI, which measures weight relative to height, waist circumference actually measures abdominal fat—specifically, visceral fat. This type of fat encircles internal organs and is also linked to higher levels of inflammation, insulin resistance, and abnormal blood lipids, all of which are factors in cancer growth. BMI, however, does not measure fat distribution, so two individuals with the same BMI can have very different levels of health risk depending on where fat is deposited on their bodies.
Interestingly, the research identified a significant difference between men and women when it came to waist circumference and cancer risk. Although waist circumference and BMI were linked with obesity-related cancers in women, the relationship was weaker than for men. An increase of 12 cm (4.7 inches) in waist size or a 4.3 rise in BMI (from 24 to 28.3) raised the cancer risk in women by just 13%—a much lower percentage than for men.
Experts credit this difference to the way that fat is stored in the body. Men are more likely to carry fat around the abdomen, especially as visceral fat, which is more metabolically active and associated with cancer-producing biological alterations. Women, by contrast, store fat in peripheral sites such as the hips and thighs, where it is less likely to drive systemic inflammation and metabolic disturbances.
A possible reason is that men tend to depot fat more in the visceral regions, whereas women tend to carry more subcutaneous and peripheral fat," wrote the researchers. "This may render waist circumference a more robust risk factor for cancer in men and account for why waist circumference provides additional risk information beyond BMI in men but not women."
The research used the International Agency for Research on Cancer (IARC) data to define obesity-related cancers. These cancers are esophageal (adenocarcinoma), gastric (cardia), colorectal, rectal, liver, gallbladder, pancreatic, renal, and thyroid cancers, and multiple myeloma and meningioma. In men, abdominal obesity is especially significant in raising the risk of these cancers through high levels of insulin and markers of inflammation.
For women, the research proposes that both waist circumference and hip circumference may give a more accurate estimate of visceral fat and cancer risk. "Adding hip circumference to risk models could strengthen the link between waist circumference and cancer, especially in women," researchers observed.
With these results, doctors advise men to be more mindful of their waistline than only their BMI. Waist size is an easy method to gauge health risk, and its maintenance through lifestyle changes might be the key to cancer prevention.
Track Your Waist Size: Regularly measure your waist circumference and try to keep it in a healthy range (below 40 inches for men, according to medical advice).
Eat a Balanced Diet: A diet containing high fiber, lean protein, and healthy fats can assist in limiting visceral fat gain.
Exercise Consistently: Regular exercise with a combination of aerobic and strength training will help maintain a healthy waistline.
Control Stress and Sleep: Persistent stress and inadequate sleep tend to cause weight gain, especially in the midsection of the body.
Regular Health Screenings: Early identification of cancer risk factors through regular screening can greatly enhance long-term health status.
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With public health experts raising concerns about ultra-processed foods (UPFs), food brands are increasingly using health-focused claims such as ‘natural’, ‘multigrain’ and ‘immune-boosting’ to appeal to health-conscious consumers. But do these labels actually mean the products are healthy, particularly for children?
Research has linked diets high in ultra-processed foods, processed meat and sugar-sweetened beverages to several health concerns. This is particularly concerning amid rising childhood obesity, which can increase the risk of conditions such as diabetes and hypertension. Children's food choices and eating habits can also influence their health later in life.
So, how can parents distinguish genuine nutritional value from clever food marketing? To understand how we may be mistaking food marketing for healthy eating, HealthandMe spoke to experts.
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Food marketing requires critical evaluation before a product is considered genuinely healthy, experts said. Terms such as ‘natural’, ‘superfood’, ‘immune-boosting’ and ‘low-fat’ are often marketing claims and do not necessarily reflect a product's overall nutritional value.
Beyond individual food products, experts emphasise the importance of overall dietary patterns in determining long-term health. From a cancer perspective, large cohort studies and the World Cancer Research Fund have linked diets high in processed meat, sugar-sweetened beverages and ultra-processed foods to an increased risk of cancer. Diets rich in whole grains, vegetables, fruits, legumes and fibre, on the other hand, are associated with a lower risk.
No single food prevents cancer; the overall dietary pattern matters.
"The main myth about packaged foods is that generic terms like 'organic', 'natural' and 'multigrain' automatically label the product as healthy. These look at the surface and tell us nothing of the overall food picture," Dr Narendra BS, Lead Consultant, Endocrinology, Aster Whitefield Hospital, told HealthandMe.
He explained that parents should look beyond these claims and examine what has been added to a product and whether it is replacing healthier foods in a child's diet. For example, replacing a whole fruit with a packaged fruit drink can decrease fibre intake and increase free sugars.
Read More: Every Extra 100g Ultra-Processed Food Linked To 14% Higher Heart Risk, 11% Higher BP Risk
Consuming large quantities of sugar-laden drinks and energy-dense foods can increase calorie intake and contribute to weight gain. In children, this can also increase the risk of insulin resistance and other metabolic abnormalities from an early age, Dr Narendra said.
Dr Smitha Saldanha, Senior Consultant, Medical Oncology, HCG Cancer Hospital, KR Unit, Bangalore, said excess body fat is a risk factor for cancer. Sugar-sweetened beverages and other foods associated with weight gain can contribute to this risk over a person's lifetime.
"We know that excess body fat is a risk factor for cancer, and sugar-sweetened beverages and other foods tied to weight gain are one of them in terms of lifetime risk. That is, most people who eat a bad diet at the beginning of their life with high amounts of ultra-processed foods and refined carbs tend to do the same later in life," she told HealthandMe.
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She added that the focus should be on maintaining a balanced diet and avoiding excessive consumption of ultra-processed foods and refined carbohydrates.
"Sugar in and of itself, any ultra-processed food, for that matter, should not be the focus of cancer. It's about eating in a balanced manner, balanced portions, and avoiding excess consumption of ultra-processed, refined carbohydrate-heavy foods every day or multiple times a week."
Rather than relying on claims printed on the front of a package, parents should examine the nutrition information and ingredients, the experts advised.
Dr Narendra urged parents to compare nutrition labels, particularly serving sizes, and prioritise whole or minimally processed foods.
"I would challenge all parents to start comparing the nutrition label, in particular the serving sizes, and never underestimate the power of whole or minimally processed foods. Not to scare them against all packaged foods, but to make sure that convenience doesn't overtake nutrition."
Dr Smitha also advised consumers to turn the package over and check its nutritional information.
"Flip it over, read the label, scan for sodium and added sugars, and ask: is this label talking about the product or just marketing it? And you be the judge: is this really a healthy choice?"
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GLP-1 receptor agonists have established themselves as one of the most sought-after treatment methods to manage type 2 diabetes. Conversations around these drugs often focus on their ability to improve blood sugar control, promote weight loss and support metabolic health. However, what happens after a patient takes the first dose deserves equal attention.
These medications, which include semaglutide, liraglutide and dulaglutide, mimic a naturally occurring hormone called GLP-1. They stimulate insulin release when blood glucose is high, suppress glucagon, slow stomach emptying and promote a feeling of satiety to reduce cravings.
While there are plenty of benefits, GLP-1 medications are not suitable for everyone. Existing digestive conditions, other diabetes medications, kidney function and even retina health can influence how safely a patient responds to treatment.
On World Diabetes Day, doctors explain why starting GLP-1 therapy requires more than checking blood sugar levels, and what patients should know about its complications. They also discuss lesser-known side effects a patient may face after the first dose.
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Before initiating GLP-1 treatment, doctors need to understand a patient's overall health, diabetes as well as medication history. This includes checking HbA1c levels, blood glucose patterns, kidney function and any history of pancreatitis, gallbladder disease or gastrointestinal problems.
Dr Bibhu Anand, Internal Medicine Specialist at Sir Ganga Ram Hospital, told HealthandMe that treatment decisions must be made according to the patient’s history.
He said, "We see the patient's HbA1c, blood glucose profile, kidney function, medicine history, and medicine prior to the first dose in detail. We specifically identify patients already receiving insulin or sulfonylureas, as these doses may require modification to reduce the risk of hypoglycemia.”
Patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 are generally advised against using these medications.
Dr Anand said that those with a history of pancreatitis, severe gastrointestinal disease or gallbladder problems may also need assessment. The objective is generally to establish whether the benefits outweigh the risks.
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Nausea, bloating, vomiting, constipation and diarrhoea are among the commonly reported gastrointestinal effects of GLP-1 medications. These symptoms are expected in the initial weeks of treatment or after an increase in dose. However, constant digestive discomfort in someone with diabetes should not be neglected.
Dr Richa Chaturvedi, Senior Consultant and Endocrinologist at Indraprastha Apollo Hospitals, Delhi, told HealthandMe that diabetic gastroparesis can cause symptoms that closely resemble gastrointestinal side effects due to GLP-1 drugs.
Gastroparesis develops when nerve damage related to diabetes affects food movement through the stomach. Patients may experience frequent nausea, early fullness, vomiting food consumed several hours earlier and unpredictable blood glucose levels. Unlike discomfort due to medicines, these symptoms may already exist before treatment begins.
"The key difference lies in the onset and pattern of symptoms. GLP-1 medications slow gastric emptying, meaning food remains in the stomach longer. This can cause nausea, bloating, belching and early fullness, particularly when treatment begins or the dose increases. These symptoms may settle as the body adapts."
Dr Chaturvedi emphasises that gastrointestinal symptoms should be assessed before starting treatment, especially in patients with chronic diabetes.
A gastric emptying study can be done if symptoms suggest gastroparesis. GLP-1 medications are generally not recommended for patients with severe gastroparesis, as they can further delay stomach emptying and affect nutritional intake.
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Although mild digestive discomfort may improve as the body adjusts to treatment, certain symptoms require immediate attention.
Severe pain in the upper abdomen or pain radiating towards the back, can indicate pancreatitis. Repeated vomiting, an inability to retain fluids, significant dizziness, reduced urination and upper-right abdominal pain accompanied by fever are other warning signs.
Dr Chaturvedi explains that pancreatitis has been reported during GLP-1 treatment, although it is uncommon and a causal relationship has not been established.
She said, “Gallbladder complications, including gallstones and inflammation, have a more established association with GLP-1 treatment. Rapid weight loss is an important contributing factor, as it can increase the likelihood of gallstone formation. Changes in gallbladder emptying may also play a role.”
Another concern is kidney injury due to dehydration. Persistent nausea and vomiting can reduce fluid intake, potentially affecting kidney function, particularly in patients who already have kidney disease.
Patients should therefore not dismiss severe abdominal pain or prolonged vomiting as routine side effect of the drug.
Also read: Stopping Ozempic or Wegovy May Double Your Risk Of Heart Attack, Death
Digestive complications are not the only concern after starting GLP-1 medications. For patients with diabetes, retina health also warrants attention.
Dr Parul Maheshwari Sharma, Principal Director and Head of Ophthalmology at FMRI Gurgaon, told HealthandMe that a rapid improvement in blood glucose levels can sometimes cause an initial, temporary worsening of diabetic retinopathy. This phenomenon is known as early worsening of diabetic retinopathy.
Dr Sharma explained, “When blood sugar levels fall substantially over a short period, changes in retinal blood flow and vascular regulation may affect blood vessels that are already damaged. The concern is particularly relevant for patients with poorly controlled diabetes, high baseline HbA1c levels or pre-existing retinopathy.”
Patients with long-standing or poorly controlled diabetes, existing retinopathy or high HbA1c levels should ideally undergo a dilated retinal examination before initiating treatment, especially when substantial glucose reduction is anticipated.
Another emerging area of concern is non-arteritic anterior ischaemic optic neuropathy (NAION), a rare condition caused by reduced blood supply to the optic nerve that can result in sudden, permanent vision loss.
Some observational studies have reported an association between GLP-1 medications, particularly semaglutide, and NAION. However, a direct cause-and-effect relationship has not been established, and the evidence is still evolving.
Dr Sharma explains that this condition is different from diabetic retinopathy. While retinopathy affects the blood vessels in the retina, NAION involves damage to the optic nerve due to reduced blood supply.
Patients should be aware of warning signs such as sudden, painless blurring or loss of vision, particularly in one eye. Patients experiencing sudden visual changes should not wait for symptoms to resolve on their own.
She said, “Other symptoms include dark patches or blind spots in the visual field, distorted colour perception and difficulty seeing centrally. Sudden flashes, floaters or a curtain-like shadow across the vision also warrant urgent ophthalmological assessment. These symptoms could indicate conditions such as NAION, retinal complications or other sight-threatening emergencies.”
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HbA1c, also known as hemoglobin A1c or glycated hemoglobin, is a widely used blood test to diagnose and monitor diabetes. However, ahead of World Diabetes Day, experts have warned that the test may not be accurate for everyone.
HbA1c measures how much glucose is attached to hemoglobin in red blood cells, providing an estimate of average blood sugar levels over the previous two to three months.
Certain medical conditions and blood disorders can affect its accuracy, making readings appear higher or lower than actual blood sugar levels.
Conditions such as anemia and hemoglobin disorders can affect HbA1c readings by altering the lifespan of red blood cells.
"HbA1c can be misleading when conditions alter red blood cell lifespan. Iron, B12 or folate deficiency may falsely elevate HbA1c. Conversely, hemolytic anemia, certain hemoglobinopathies, chronic blood loss, recent transfusion and some kidney conditions can lower it falsely," Dr Manisha Arora, Director of Internal Medicine at CK Birla Hospital, Delhi, told HealthandMe.
Dr Sandeep Kharb, Senior Consultant – Endocrinology at Asian Hospital, added that iron-deficiency anemia can also lead to falsely high HbA1c readings.
Experts also cautioned that HbA1c is not a direct measure of insulin resistance. A person may be insulin resistant even before their HbA1c reaches the prediabetes threshold.
What Medical Conditions And Medications Can Affect HbA1c?
Iron, vitamin B12 and folate deficiencies, chronic alcohol use, high-dose aspirin and severe hypertriglyceridemia may contribute to falsely elevated readings.
Falsely low results can occur with hemolytic anemia, hemoglobin disorders, blood loss, transfusions, pregnancy, kidney disease and erythropoietin therapy.
Certain medicines, including dapsone, ribavirin and some antiretroviral drugs, can also affect HbA1c interpretation. The direction of the error depends on the underlying condition and the testing method.
Dr Himika Chawla, Senior Consultant, Endocrinology and Diabetology at PSRI Hospital, told HealthandMe HbA1c reflects average blood sugar over two to three months, while fasting blood sugar measures glucose at a particular point in time.
A person may have normal fasting glucose but experience repeated blood sugar spikes after meals, pushing their HbA1c higher. The reverse mismatch can also occur.
Doctors therefore consider both results and the patient's overall clinical picture before making a diagnosis.
When HbA1c may not be reliable, doctors can use blood glucose-based tests, including fasting plasma glucose and the oral glucose tolerance test (OGTT).
"First test it should be oral glucose tolerance test," Dr Anoop Misra told NDTV.
For the test, a person eats their usual meals for three days and then fasts for eight to 10 hours before their fasting blood glucose is measured. They then drink 75 grams of glucose mixed in water, followed by another blood test two hours later.
Misra explained that fasting glucose below 100 mg/dL and a two-hour reading below 140 mg/dL are normal. Fasting levels of 100–125 mg/dL or two-hour readings of 140–199 mg/dL indicate prediabetes. Fasting glucose of 126 mg/dL or higher, or a two-hour reading of 200 mg/dL or higher, falls in the diabetes range.
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