Hormonal
Among adults aged 50–95, abdominal adiposity (measured by waist circumference) is a significantly stronger predictor of insulin resistance than cardiovascular fitness (VO2max) or whole-body adiposity (BMI/fat percentage).
If you are over 50, your waist size matters more for your blood sugar health than your cardio fitness level. While staying active is beneficial, focusing on reducing abdominal fat (measured by waist circumference) is the most effective way to lower insulin resistance risk. Do not assume high fitness cancels out the risks of a large waistline.
Waist circumference was the strongest independent correlate of ISI (r = -0.52, P < 0.0001)... after controlling for waist circumference, only VO2max remained significant (r = 0.13, P = 0.009).
Why this rating
Large sample size (n=407), rigorous measurement (OGTT, VO2max), but cross-sectional observational design limits causal inference.
Source
Abdominal Adiposity Is a Stronger Predictor of Insulin Resistance Than Fitness Among 50–95 Year Olds
Susan B. Racette et al. · Diabetes Care · 2006
DOI 10.2337/diacare.29.03.06.dc05-1605
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