Durk Pearson & Sandy Shaw’s®
Life Extension NewsTM
Volume 14 No. 4 • September 2011

Why Are Rates of Diabetes Higher in Americans
As Compared to Brits of Similar Weight

An interesting report1 described how the U.S. has higher rates of diabetes than the English in the old-age population. The authors used data from the English Longitudinal Study of Aging (ELSA) and the American National Health and Nutrition Examination Survey (NHANES) for 1999–2006 (time comparable with ELSA) to study this risk differential.

The higher rates of diabetes in the U.S. were largely accounted for by raised waist circumference and not BMI (body mass index) differences especially among women. (In fact, remarkably, American women were less overweight—32.1% as compared with 38.7% of English women—and more of normal weight—35.0% compared with 30.8%—as represented by BMI distributions.) Approximately three quarters of the country differences for women and 38% among men can be explained by the different waist sizes. “Even among those with normal weight, the fraction with raised waist risk was not trivial for US women—40.6% of Americans who were neither overweight nor obese were categorised as high waist risk compared with 8.9% among equivalent English women.”1

Interestingly, one of the findings was that there was a significant role for height, as well as waist size, in diabetes risk. “Adult stature reflects childhood growth patterns and an association of short stature with type 2 diabetes indicates that impaired childhood growth leads to adult insulin resistance and diabetes.”1

A Link Between Shorter Stature and Inflammation

One of the papers we cited in our report (see above) on exposure to stimulants of inflammatory signaling via Toll-like receptors2 (Crimmins and Finch, 2006), in fact, provides detailed analysis of the authors’ hypothesis that lifelong exposure to inflammatory stimuli contributes importantly to the risk of age-related diseases, including insulin resistance and diabetes. In their analysis, reduced growth in childhood (and, hence, shorter stature) can result from increased exposure to inflammatory stimuli such as infectious disease, leading to differences in cohorts which tend to be exposed to similar infectious milieu. “If infections occur during development, substantial energy is reallocated at the expense of growth, as required by the body for immune defense reactions and for repair. In adults, the fever associated with severe infections increases resting metabolic rates by 25–100%.”2


  1. Banks et al. What explains the American disadvantage in health compared with the English? the case of diabetes. J Epidemiol Community Health (2010) doi:10.1136/jech.2010.108415.
  2. Crimmins and Finch. Infection, Inflammation, Height, and Longevity. Proc Natl Acad Sci USA 103(2):498-503 (2006).

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