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Epidemiology and population health

Increase of body mass index and waist circumference predicts development of metabolic syndrome criteria in apparently healthy individuals with 2 and 5 years follow-up



The metabolic syndrome (MetS) is associated with overweight and abdominal obesity. Our aim was to use longitudinal measurements to provide clinically relevant information on the relative influence of changes in body mass index (BMI), waist circumference (WC), and weekly physical exercise duration on the development of each of the MetS components.


We analyzed data collected at the Tel-Aviv Medical Center Inflammation Survey (TAMCIS). Apparently healthy individuals with two consecutive visits that were not treated for any metabolic criteria were included in this study. We analyzed the influence of changes in BMI, WC, and time engaged in physical exercise on the change in each of the components of the metabolic syndrome using linear regressions.


Included were 7532 individuals (5431 men, 2101 women) with 2 years follow-up. Participants who gained two BMI points, had the mean number of criteria increase from 1.07 to 1.52, while participants who lost two BMI points, decreased from 1.64 to 1.16. A long-term analysis over 5 years showed similar results. Furthermore, an increase in WC was independently associated with increased severity of each of the other components, when controlling for increase in BMI. Increase in weekly exercise duration had a small but statistically significant favorable effect on blood triglycerides and HDL levels, but not on blood pressure or HbA1C.


Changes in BMI and WC are highly associative with the likelihood and severity of the MetS independently of the baseline levels, suggesting that obese individuals can substantially improve their MetS prognosis by losing both body weight and abdominal fat.

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  1. 1.

    World Health Organization. Obesity: preventing and managing the global epidemic. WHO Technical Report Series 894. 2000.

  2. 2.

    Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31:219–30.

    Article  Google Scholar 

  3. 3.

    Scott MGrundy. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation. 2002;105:2696–8.

    Article  Google Scholar 

  4. 4.

    Kip KE, Marroquin OC, Kelley DE, et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women’s Ischemia Syndrome Evaluation (WISE) study. 2004; 109:706–13.

  5. 5.

    Scott MGrundy. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2004;89:2595–600.

    Article  Google Scholar 

  6. 6.

    Ritchie SA, Connell JM. The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis. 2007;17:319–26.

    CAS  Article  Google Scholar 

  7. 7.

    Després JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444:881–7. 14

    Article  Google Scholar 

  8. 8.

    O’Neill S, O’Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes Rev. 2015;16:1–12.

    Article  Google Scholar 

  9. 9.

    Greenberg Shenhar-Tsarfaty, Rogowski, et al. Exercise-induced albuminuria is related to metabolic syndrome. Am J Physiol Ren Physiol. 2016;310:F1192–6.

    CAS  Article  Google Scholar 

  10. 10.

    Milwidsky A, Steinvil A, Shapira I, Letourneau-Shesaf S, et al. Multiplicity of dysmetabolic components in males is associated with elevated cardiac troponin T concentrations. J Metab Synd. 2014;3:15.

    Article  Google Scholar 

  11. 11.

    Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–8.

    Article  Google Scholar 

  12. 12.

    McNemar Quinn. Note on the sampling error of the difference between correlated proportions or percentages. Psychometrika. 1947;12:153–7.

    CAS  Article  Google Scholar 

  13. 13.

    R Core Team. R: A language and environment for statistical computing. 2017.

  14. 14.

    Park Y-W, Zhu S, Palaniappan L, et al. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med. 2003;163:427–36.

    Article  Google Scholar 

  15. 15.

    Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev. 2010;11:202–21.

    CAS  Article  Google Scholar 

  16. 16.

    Keinan-Boker L, Noyman N, Chinich A, et al. Overweight and obesity prevalence in Israel: finding of the first national health and nutrition survey (MABAT). IMAJ. 2005;7:219–23.

    Google Scholar 

  17. 17.

    Bray GA, Frühbeck G, Ryan DH, et al. Management of obesity. Lancet. 2016;387:1947–56.

    Article  Google Scholar 

  18. 18.

    Lean MEJ, Malkova D. Altered gut and adipose tissue hormones in overweight and obese individuals: cause or consequence? Int J Obes. 2016;40:622–32.

    CAS  Article  Google Scholar 

  19. 19.

    Kraschnewski JL, Boan J, Esposito J, et al. Long-term weight loss maintenance in the United States. Int J Obes. 2010;34:1644–54.

    CAS  Article  Google Scholar 

  20. 20.

    Weiss EC, Galuska DA, Kettel Khan L, et al. Weight regain in U.S. adults who experienced substantial weight loss, 1999–2002. Am J Prev Med. 2007;33:34–40.

    Article  Google Scholar 

  21. 21.

    Ford ES, Williamson DF, Liu S. Weight change and diabetes incidence: findings from a National Cohort of US Adults. Am J Epidemiol. 1997;146:214–22.

    CAS  Article  Google Scholar 

  22. 22.

    Wannamethee SG, Shaper AG. Weight change and duration of overweight and obesity in the incidence of type 2 diabetes. Diabetes Care. 1999;22:1266–72.

    CAS  Article  Google Scholar 

  23. 23.

    Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health. 2005;59:1x34–9.

    Article  Google Scholar 

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Correspondence to Eyal Fisher.

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Fisher, E., Brzezinski, R.Y., Ehrenwald, M. et al. Increase of body mass index and waist circumference predicts development of metabolic syndrome criteria in apparently healthy individuals with 2 and 5 years follow-up. Int J Obes 43, 800–807 (2019).

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