Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Journal Club
  • Published:

Obesity

Global patterns of visceral adiposity and cardiometabolic disease

Nature Reviews Endocrinology (2025)Cite this article

Subjects

Access through your institution
Buy or subscribe

By the mid-20th century, researchers began to recognize that body adipose tissue distribution, rather than total adipose mass alone, was a key determinant of cardiometabolic risk. Building on Jean Vague’s seminal observations, subsequent studies confirmed that central obesity, particularly abdominal adipose tissue, was closely linked to insulin resistance, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In the 1980s, work by Ahmed Kissebah in the USA and Per Björntorp in Sweden demonstrated that waist-to-hip ratio, a surrogate for abdominal adiposity, was more predictive of CVD and T2DM than body mass index (BMI) was. More advanced imaging further distinguished between subcutaneous adipose tissue and visceral adipose tissue, with the latter now recognized as a particularly pathogenic adipose depot owing to its strong association with systemic metabolic dysfunction. Subsequent work highlighted the utility of other anthropometric measurements such as waist circumference in identifying CVD risk and T2DM.

Despite mounting evidence of the importance of body adipose distribution, global epidemiological data on abdominal adiposity were sparse. The International Day for the Evaluation of Abdominal Obesity (IDEA) study, launched in 2005, was a landmark cross-sectional investigation that aimed to fill this gap, culminating in a key paper published by Beverley Balkau and colleagues in 2007. Conducted across 63 countries, the IDEA study measured waist circumference and BMI in >168,000 adults seen in primary care settings, and assessed the associations between these anthropometric markers, CVD and T2DM.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

Original article

  • Balkau, B. et al. International Day for the Evaluation of Abdominal Obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. Circulation 116, 1942–1951 (2007)

    Article  PubMed  PubMed Central  Google Scholar 

Related articles

  • Cornier, M. A. et al. Assessing adiposity: a scientific statement from the American Heart Association. Circulation 124, 1996–2019 (2011)

    Article  PubMed  Google Scholar 

  • Feller, S., Boeing, H. & Pischon, T. Body mass index, waist circumference, and the risk of type 2 diabetes mellitus: implications for routine clinical practice. Dtsch. Arztebl. Int. 107, 470–476 (2010)

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    John C. Lin

  2. Warren Alpert Medical School, Brown University, Providence, RI, USA

    Clara E. Tandar

Authors
  1. John C. Lin
    View author publications

    Search author on:PubMed Google Scholar

  2. Clara E. Tandar
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to John C. Lin.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, J.C., Tandar, C.E. Global patterns of visceral adiposity and cardiometabolic disease. Nat Rev Endocrinol (2025). https://doi.org/10.1038/s41574-025-01191-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1038/s41574-025-01191-z

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing