Can you be large and not obese? The distinction between body weight, body fat, and abdominal fat in occupational standards.

Weight control is an important early intervention in diabetes, but the nature of the association between weight and disordered metabolism has been confused because fat mass and its distribution are only partly associated with increasing body size. Weight, fat, and regional fat placement, specifically in the abdominal site, may each have distinctly different associations with diabetes risk. Abdominal circumference may be the common marker of poor fitness habits and of increased risk for metabolic diseases such as diabetes. This is an important question for public health policy as well as for occupational standards such as those of the military, which are intended to promote fitness for military missions and include strength and aerobic capacity, as well as military appearance considerations. U.S. soldiers are heavier than ever before, reflecting both increased muscle and fat components. They also have better health care than ever before and are required to exercise regularly, and even the oldest soldiers are required to remain below body fat limits that are more stringent than the current median values of the U.S. population over age 40. The body fat standards assessed by circumference-based equations are 20-26% and 30-36%, for various age groups of men and women, respectively, and the upper limits align with threshold values of waist circumference recommended in national health goals. The basis and effects of the Army standards are presented in this paper. U.S. Army body fat standards may offer practical and reasonable health guidelines suitable for all active Americans that might help stem the increasing prevalence of obesity that is predicted to increase the prevalence of Type 2 diabetes.