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Tuesday, Sept. 9, 2008
Waistline scrutiny a midlife bugbear
The term metabolic syndrome has become a hot topic with middle-aged workers now that the government has made it mandatory for companies and local governments to check for it during annual employee health examinations.
With little time for exercise and higher consumption of Western food, more Japanese are experiencing metabolic syndrome, which increases the risk of diabetes and stroke.
Following are some questions and answers about metabolic syndrome:
What is metabolic syndrome?
According to the International Diabetes Federation, metabolic syndrome is a cluster of the most dangerous risk factors for a heart attack: diabetes and prediabetes, abdominal obesity, changes in cholesterol and high blood pressure.
But the criteria to define a person as suffering from metabolic syndrome differ from country to country.
The Health, Labor, and Welfare Ministry says metabolic syndrome is a condition combining abdominal obesity and two of the following symptoms — high blood sugar level, high blood pressure and blood fat disorders.
To test excessive abdominal fat, the health ministry decided to introduce in April waistline criteria for people 40 years old and above. Men whose waists are 85 cm and larger and women whose girth is 90 cm or more are defined as having abdominal obesity, the health ministry says.
Why did the health ministry decide to start metabolic syndrome checks?
It is part of efforts to curb future budget spending on medical costs. Social welfare spending, including funding for medical services, public pensions and welfare services, stands at more than ¥20 trillion a year and is expected to rise further as the population rapidly ages.
People diagnosed with metabolic syndrome receive advice on how to improve their lifestyles.
However, there is no penalty for people who do not have the checkup.
Why do scholars question the fairness of the Japanese criteria?
First, the ministry does not explain why the limit for a woman's waist is larger than that for a man's.
The diabetes federation says its recommended ethnicity-specific waistline threshold for Japanese is 90 cm for men and 80 cm for women.
Second, the waist is defined differently in Japan than in other countries.
The health ministry defines the waist in the checkups as a line around the navel, while others define the line as slightly above the navel, according to Yoichi Ogushi, a professor of medical informatics at Tokai University.
"Because the female pelvis is bigger than that of a man, the line at the navel reflects the size of the pelvis rather than abdominal fat," Ogushi said.
Meanwhile, some see no meaning in waistline criteria.
The health ministry's criteria do not take into account height, meaning that a 150-cm-tall person with a 84-cm waist is not diagnosed as having metabolic syndrome, while a 190-cm-tall person with a 85-cm girth is diagnosed with the syndrome.
Are there any new developments?
The International Diabetes Federation and the U.S. National Cholesterol Education Program are reportedly reviewing their metabolic syndrome criteria and removing waist measurements from their definition of the syndrome.
They are expected to announce temporary definitions by the end of the year. Japan, however, is likely to stick to the existing definition.